Acute Apical Periodontitis

A periapical abscess may present as a palpable swelling. Fever, facial oedema, trismus, difficulty swallowing or voice change can indicate a more serious infection.

Dental infection can start when bacteria invade the pulp and spread into surrounding tissues. It can also arise from periodontal pockets or pericoronitis.

Pulp vitality can deteriorate from irreversible pulpitis to necrosis. An acute periapical abscess can then develop with pain or a palpable swelling.

A swollen or firm floor of the mouth, drooling, limited tongue movement and a muffled voice are red flags for advanced or rapidly progressing infection.

Visual inspection and palpation are initial checks for infection. Periapical, bitewing or panoramic radiographs can show caries, a periapical abscess and bone loss.

Treatment removes the source with drainage, endodontic therapy or extraction. A large abscess or deep-space infection may need hospital admission, intravenous antibiotics and an operation.

Care becomes more extensive when infection spreads into deep facial or neck spaces. Hospital treatment and operative intervention are sometimes required for those infections.

Infection can spread contiguously into the deep neck spaces, mediastinum, facial sinuses or brain. It can cause airway compromise or sepsis.

Daily brushing, flossing and reducing sugar-containing foods help reduce dental cavities. Proper oral hygiene and early treatment reduce the prevalence of dental infections.