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Dental abscess - Management
What treatments are available from a dental practitioner?

  • The treatment of dental abscesses includes a combination of mechanical treatment, systemic antibiotics, and possibly surgery.
  • Mechanical treatment and surgery [Dahlen, 2002]:
    • The most important and immediate step in treating a dental abscess is to mechanically incise the abscess and create drainage to reduce the load of infectious bacteria.
    • Periapical abscesses are normally managed by root canal treatment. The dentist will drill into the dead tooth and allow pus to escape through the tooth, and then remove necrotic pulpal tissue. A root filling is then placed into the tooth to prevent further infection. If the infection persists despite root canal treatment the dentist may have to extract the tooth, or consider referring to an oral surgeon who may surgically remove diseased tissue.
    • Periodontal abscesses are normally managed by drainage of the abscess and thorough cleaning of the periodontal pocket. Following this procedure the dentist will usually smooth out the root surfaces (subgingival scaling and root planing) of the tooth to promote healing and prevent the infection reoccurring. A repeat radiograph will normally be carried out at 3–6 months. Sometimes a referral to an oral surgeon may be needed (for repeated infections) to allow reshaping of the gum tissue. Reshaping of the gum will help the individual keep the area clean, reducing the risk of further infection.
  • Systemic antibiotics [Dahlen, 2002; American Academy of Periodontology, 2004; Jaramillo et al, 2005]:
    • Systemic antibiotic treatment is of secondary importance to surgical incision and drainage of abscesses. Its role is aimed at preventing bacterial spread and serious complications.

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