An infection of the gums can lead to tooth abscess, which can penetrate into the top layer of the bone. Acute dental abscess can cause a lot of pain and swelling, which must of course be treated immediately by the dentist. However, the situation can also worsen to the condition of Ludwig’s Angina, whereby the pressure of pus in the lower jaw is so great that a life-threatening situation arises. How is tooth abscess treated and why can it be dangerous?

Tooth abscess

• Increasing internal pressure and pain
• Indication of tooth abscess
• Therapy
• Ludwig’s Angina condition
• Treatment of Ludwig’s Angina

Increasing internal pressure and pain

After local tissue has died, pus forms, causing an abscess to grow. This can often go unnoticed under the tooth, after which an acute dental abscess can develop. This occurs in combination with swelling to severe swelling and pain. Because a nerve may be locally dead and additional inflammation may occur due to holes, an abscess can quickly develop. Poor oral hygiene also plays a role in this. Increasing internal pressure causes bone to break down, allowing the abscess to penetrate the top layer of the bone. If the abscess has already grown into the bone, it will cause a very painful swelling. The condition can continue to grow under the skin. If left untreated, it can lead to the life-threatening condition Ludwig’s Angina.

Indication of tooth abscess

If it concerns an acute form of dental abscess, the patient will experience severe pain. Usually the tooth is sensitive and loose on the jaw. The tooth is pushed up through the abscess, pulling on the nerve. The tooth abscess is often concentrated under the tooth at the root tip, where the root is attached to the bone. If the infection penetrates into the bone, the patient may experience severe pain and the condition may grow rapidly. However, if it concerns a chronic condition, this can be done without pain and must be recognized by taking a photo.

Therapy

The primary task is to alleviate the pain. This can often be successful by drilling into the inflammation through the tooth. This allows pus to be drained. The pressure decreases and with it the pain. If a dental abscess also manifests itself next to the tooth, drilling through the tooth is not necessary. To disinfect the abscess around the root canal, a sodium hypochloride solution should be used. This creates a clean dental wound under the tooth through regular rinsing, so that after disinfection a root canal treatment is performed and a filling placed. Because the condition responds less positively to anesthesia, pulling a tooth while having the condition is no fun. Therefore, disinfection should always be carried out before pulling, or rinsing daily for two to three weeks. A course of antibiotics can temporarily help clear the condition and reduce pain. However, a root canal treatment must be performed afterwards or the tooth must be extracted. If the severity of the condition is great and flushing does not provide relief, you may consider incising the abscess so that the pressure under the tooth and in the bone quickly decreases.

Ludwig’s Angina condition

In Ludwig’s Angina, dental abscess has developed into a condition in which several cavities in the lower jaw are filled with pus. In that case, there are multiple sources of infection, causing the patient’s situation to quickly deteriorate. The pressure is therefore so high in the transition from neck to jaw that it compresses the trachea. General malaise, fever, poor breathing ensure that health deteriorates rapidly. If nothing is done, the patient can be in a life-threatening situation as a direct result of the tooth abscess, which can lead to death by suffocation.

Treatment of Ludwig’s Angina

To treat this condition, it is first necessary for the patient to be admitted to hospital quickly. An auxiliary pipe must be placed to relieve the trachea or an incision must be made in the skin above the trachea so that the patient can breathe via intubation. Treatment consists of antibiotics and frequent monitoring of the condition. It may also be necessary to allow the pus to drain from the body through incisions, so that the pressure on the trachea decreases.

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