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When tissues in the mouth are injured or get irritated, bacteria may get into the area and cause an infection and a painful, pus-filled swelling. If the pus can't drain, the area will get more swollen and painful. This is known as an abscess. An abscess is your body's attempt to contain an infection and prevent it from spreading to other areas.
Abscesses can form very quickly, often within 24 to 48 hours of when the infection starts.

There are two main types of abscesses:

A gum, or periodontal, abscess is usually caused by an infection in the small space, or pocket, between the teeth and gums. This may happen when food particles get trapped between the gum and tooth. In more advanced cases of periodontal disease, bacteria can build up in deep pockets under the surface of the gums.

A tooth-related abscess, called a periapical abscess (located at the tip of the tooth root), occurs within the tooth itself when the nerve is dead or dying. This type of abscess can spread to the bone surrounding the tip of the root.
Most abscesses are painful, which means that people usually get treatment right away. In some cases, however, the infection causes little or no pain — or people ignore the discomfort and wait for it to go away. This can result in a chronic abscess, in which the infection lasts for months or even years.
When abscesses aren't treated promptly, the infection can damage nearby tissues or teeth. The buildup of scar tissue caused by the infection may result in the development of a hollow tunnel of tissue called a fistula or "sinus tract." Pus from the abscess may drain through this "artificial" tunnel to an opening on the surface, and may be seen in the mouth as a pimple that comes and goes. People with sinus tracts may feel a small bump in their mouths, or may have a strange taste in their mouths due to the drainage of pus.
In some cases, a chronic abscess can form a cyst in the bone. The cyst has to be removed surgically. There also are rare instances in which the infection spreads to the surrounding tissues and causes serious health problems.

What You Can Do

Abscesses are always serious because the infection may spread to other parts of the body.
If you can see or feel a pimple-like swelling on the gum, you may want to try rinsing your mouth several times a day with a mild salt-water solution (1/2 teaspoon of salt in 8 ounces of water). This may help draw the pus toward the surface and allow pressure in the area to be relieved temporarily. In all cases of abscess, you need to see your dentist as soon as possible.

What Our Emergency Dentist Will Do

Most gum abscesses will heal quickly once the area is cleaned thoroughly, the trapped material is allowed to escape, and the source of the infection is treated.
If a sinus tract has formed, your dentist will need to trace it back to the source of the infection. He or she will insert a probe into the tunnel and take an X-ray to see where the infection started. Once the source of the infection is identified and cleaned out, the sinus tract usually will close on its own.

If the infection started inside a tooth, your dentist may start root canal treatment by making a small hole in the tooth to allow the abscess to drain. This type of abscess typically occurs only when the tooth nerve is damaged or is already dead. The tooth will need a filling or a crown following successful root canal treatment.
If the abscess is severe or the tooth is badly damaged, you may need to have the tooth removed.

Superficial abscesses in the gums usually can be treated by cleaning out the debris or bacteria that has become trapped and washing out the area thoroughly. Your dentist or oral surgeon calls this procedure aspiration, incision and drainage. More serious periodontal abscesses often can be cleared up by the same method. However, the periodontal disease that caused the infection will require more intensive treatment to prevent another infection.

Your dentist may give you a prescription for antibiotics to help the abscess heal and prevent the spread of the infection to other parts of your body.

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