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Dental abscess - Making a diagnosis
History
- Assess the likelihood of existing caries and periodontal disease. Ask about:
- Dental hygiene: frequency of brushing and flossing.
- Diet: ask about intake of sugar containing foods and sugared carbonated/fizzy drinks (non-sugared drinks are less of a risk).
- Previous dental procedures: fillings, root canal treatment, and extractions.
- Any coexisting factors that might increase the risk of dental disease progressing: the presence of diabetes, compromised immune system (either acquired or drug induced), smoking, and drug-induced gum conditions (e.g. phenytoin-induced gum hypertrophy) [Krebs et al, 2006].
- People may present with any combination of the following symptoms:
- Pain: this is usually of sudden onset, and worsens over a few hours to a few days.
- It may be intense and throbbing, worse when lying down and may cause waking from sleep during the night.
- The tooth may be tender to touch, or to pressure from biting.
- Pain may radiate to the ear, lower jaw, and neck on the same side as the dental abscess.
- Bad taste in the mouth.
- Fever and malaise if associated with systemic involvement.
- Trismus (inability to open the mouth) or dysphagia may be present in severe cases.
[American Academy of Periodontology, 2000; Herrera et al, 2000; Wilson and Kornman, 2003; Schneider and Segal, 2007]
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