Dental abscesses are pockets of pus caused by a bacterial infection, and they can cause a lot of pain. If you have an infected tooth, your dentist might recommend pulling the tooth to get rid of the source of the infection.
While an extracted tooth with abscess can be a solution, the extraction doesn’t always solve the problem entirely.
This article will help you understand what happens when a tooth is extracted due to an abscess. We’ll cover what to expect after the extraction, other treatments you might consider, and potential problems that can still arise. It’s important to remember that removing the tooth is only part of the solution; you also have to address the infection itself.
What is a Dental Abscess?
A dental abscess is a pocket of pus that forms in your teeth, gums, or the bones that hold your teeth in place. It’s usually the result of a bacterial infection.
Types of Dental Abscesses
There are two main types of dental abscesses:
- Periapical abscess: This type of abscess starts at the tip of the root of your tooth. It’s usually caused by a cavity that hasn’t been treated or by some kind of trauma to the tooth.
- Periodontal abscess: This type of abscess affects the gums and the tissues that support your teeth. It’s often caused by gum disease or by a foreign object getting stuck in the gum.
Causes and Risk Factors
Several things can increase your risk of developing a dental abscess:
- Poor oral hygiene: If you don’t brush and floss regularly, bacteria can thrive in your mouth.
- Untreated cavities: Cavities give bacteria a way to get inside your tooth and infect the pulp.
- Gum disease (periodontitis): Gum disease creates pockets and inflammation, which makes it easier for an abscess to form.
- Weakened immune system: Conditions like diabetes can make it harder for your body to fight off infection.
When is a tooth extraction necessary?
A dentist might recommend extracting a tooth for a number of reasons:
- Severe tooth decay or damage: If a cavity has eroded too much of the tooth, or if the tooth has broken beyond repair with fillings or crowns, extraction may be the only option.
- Advanced gum disease: Gum disease can destroy the bone that supports your teeth. If enough bone is lost, the tooth may become too loose to save.
- Failed root canal therapy: Sometimes, a tooth that has had root canal therapy can become re-infected. If that happens, extraction might be the best course of action.
- Orthodontic reasons: To prepare you for braces, a dentist might extract a tooth to create space for the remaining teeth to align correctly.
- Impacted teeth: Teeth that can’t erupt properly, like impacted wisdom teeth, often need to be removed.
- Abscess with extensive bone loss: An abscess can spread and damage the surrounding bone. In severe cases, extracting the infected tooth is necessary to prevent further complications.
Why a tooth extraction might not be enough
A lot of people assume that pulling a tooth with an abscess fixes the problem. They think getting rid of the tooth gets rid of the infection.
While removing the tooth does eliminate the source of the infection, it doesn’t necessarily mean the infection is gone completely. The tissues around the tooth might still be infected.
If you don’t treat the infection, it can linger or even spread. That’s why your dentist might prescribe antibiotics after an extraction, especially if there was a significant abscess.
The reality check: What happens after extraction?
So, you’ve had the tooth pulled. What happens next?
Post-extraction socket and healing
After your dentist extracts a tooth, a blood clot will form in the socket. That’s essential for the healing process. Over time, the socket will fill in with bone and tissue.
Potential complications
Even after the tooth is out, some complications can occur.
- Dry socket. This happens when the blood clot is dislodged, exposing the bone underneath.
- Infection. Bacteria can still infect the extraction site, even after the tooth is gone.
- Bleeding. You might have more bleeding than expected, which could require intervention.
- Nerve damage. It’s rare, but possible, and could lead to numbness or tingling in your mouth.
Signs of persistent infection
How can you tell if you still have an infection after your tooth is extracted?
Call your dentist if you have any of these symptoms:
- Continued pain and swelling, even after the extraction
- Pus or drainage coming from the extraction site
- Fever, which suggests a systemic infection
- A foul taste or odor in your mouth, which could mean bacteria are present
Treatment Options: Extraction vs. Root Canal Therapy
When you’re dealing with an abscessed tooth, there are typically two main treatment paths to consider: root canal therapy or extraction.
Root Canal Therapy
Root canal therapy involves removing the infected pulp from inside the tooth, then cleaning and shaping the root canal before filling it with a special sealing material.
The pros of root canal therapy are that it preserves your natural tooth, helps maintain your jawbone structure, and prevents the need for a bridge or implant later on. However, it can be more expensive than an extraction, may require several appointments, and isn’t always successful.
Tooth Extraction
Tooth extraction means removing the entire tooth from its socket.
The advantages of extraction are that it gets rid of the infection quickly and can be less expensive than root canal therapy—at least initially. The downsides are that it can lead to bone loss in the jaw and may require a bridge, implant, or partial denture to keep your remaining teeth from shifting. There are also the general risks that come with any surgery.
What Influences the Decision?
Several factors come into play when deciding between root canal therapy and extraction:
- Severity of the Infection: A more severe infection might mean extraction is the better option.
- Condition of the Tooth: If the tooth is severely damaged, it might be beyond saving.
- Patient’s Overall Health: Certain health conditions can influence the best course of action.
- Cost Considerations: Root canal therapy and extraction have different costs associated with them, so that can be a factor too.
The Importance of Post-Extraction Care
Once your tooth is out, following your dentist’s instructions for post-extraction care is critical for a smooth recovery and to prevent further complications. Here’s what you can expect.
Immediate Post-Extraction Instructions
- Bite on Gauze: Apply pressure by biting firmly on a gauze pad placed over the extraction site. This helps control bleeding.
- Pain Management: Take pain relievers as prescribed by your dentist or use over-the-counter options as directed.
- Ice Packs: Apply ice packs to your cheek near the extraction site to reduce swelling.
- Rest: Avoid strenuous activity for at least 24 hours following the extraction.
Oral Hygiene
- Gentle Rinsing: Gently rinse your mouth with warm salt water (1/2 teaspoon of salt in 8 ounces of water) several times a day to keep the area clean. Avoid vigorous swishing.
- Soft-Bristled Toothbrush: Gently brush your teeth, being careful to avoid the extraction site.
- Avoid Smoking: Smoking significantly impairs healing and increases the risk of complications like dry socket.
Medication
- Antibiotics: If prescribed, take antibiotics as directed to combat infection.
- Pain Relievers: Take pain relievers as needed to manage discomfort.
Diet
- Soft Foods: Stick to soft foods like yogurt, soup, and applesauce for the first few days. Avoid hard, crunchy, or chewy foods that could irritate the extraction site.
- Hydration: Drink plenty of fluids to stay hydrated, but avoid using a straw as the sucking motion can dislodge the blood clot.
Follow-Up Appointments
- Monitoring Healing: Attend all scheduled follow-up appointments with your dentist so they can check the extraction site for proper healing.
- Addressing Complications: If you experience any complications, such as excessive bleeding, severe pain, or signs of infection, contact your dentist immediately.
Risks and Complications of Pulling an Abscessed Tooth
Like any medical procedure, having an abscessed tooth pulled carries some risks. These can range from localized issues at the extraction site to more serious, systemic complications.
Localized Complications
- Dry Socket: This painful condition happens when the blood clot at the extraction site is lost, exposing the bone and nerves.
- Infection: A new or persistent infection can develop at the extraction site, even after the initial abscess is addressed.
- Nerve Damage: There’s a risk of temporary or, in rare cases, permanent numbness in the area due to nerve damage during the extraction.
- Bleeding: Prolonged bleeding after the extraction might require additional intervention to stop.
Systemic Complications
These are less common but more serious, as they involve the spread of infection beyond the immediate area.
- Spread of Infection: Bacteria from the abscess can enter the bloodstream, leading to infection elsewhere in the body.
- Ludwig’s Angina: This is a severe infection of the floor of the mouth, which can obstruct breathing.
- Maxillary Sinus Involvement: An abscess in an upper tooth can affect the maxillary sinus cavity, causing pain and congestion.
- Endocarditis: A rare but serious infection of the heart valves can occur if bacteria from the mouth enter the bloodstream.
- Sepsis: A life-threatening response to infection can occur, though this is rare.
Considerations for Different Age Groups
While most adults heal well after a tooth extraction, the risk of complications can increase with underlying health conditions. Seniors may experience slower healing and a higher risk of complications due to age-related factors.
Frequently Asked Questions
Are abscesses common after tooth extraction?
Not really. While infection is always a risk after any surgery, abscesses aren’t typical after tooth extraction. Good oral hygiene following the procedure, along with following your dentist’s aftercare instructions, significantly reduces the risk.
Can a tooth be extracted if you have an infection?
Yes, a tooth can be extracted even if you have an infection, and often needs to be. In fact, an extraction is often the best way to eliminate the infection and prevent it from spreading. Your dentist will likely prescribe antibiotics before or after the extraction to help manage the infection.
What happens when you pull a tooth with an abscess?
When a tooth with an abscess is extracted, the infected tissue around the tooth is removed along with it. The dentist will thoroughly clean and disinfect the extraction site. You’ll likely be prescribed antibiotics to prevent the infection from spreading and to promote healing. Following post-extraction instructions is crucial to prevent complications like dry socket or further infection.
To Conclude
Treating an extracted tooth with an abscess is more complex than it might seem. Pulling a tooth isn’t always a guaranteed fix for a dental abscess.
The best approach involves:
- A skilled dentist who can properly diagnose your condition
- A comprehensive treatment plan
- Consideration of alternatives to extraction, such as root canal therapy
- Meticulous care after the extraction
- Targeting the underlying infection
If you think you have a dental abscess, contact your dentist as soon as possible to figure out the best course of action for your unique situation. Regular dental checkups and good oral hygiene are essential for preventing abscesses and keeping your mouth healthy.