STORY BY“A year ago, I had a tooth that was hurting and went to the dentist,” says 26-year-old Beaumont resident Amanda Chesson. “I didn’t think much of it. They gave me medication and I didn’t go back because the swelling went down.”
Chesson’s lower wisdom tooth began to bother her again, and her local dentist referred her to an oral surgeon to have the tooth removed. Only days before her scheduled surgery, her situation worsened and she went to her local emergency room. That’s when she was referred to Houston oral surgeon Kamal Busaidy, DDS, assistant professor of oral and maxillofacial surgery at The University of Texas Dental Branch at Houston. Busaidy immediately had Chesson transferred by ambulance to Ben Taub General Hospital, where he evaluated her in the emergency room.
“When Chesson came into the ER, she had significant swelling in her neck, an inability to open her mouth and severe pain upon swallowing,” Busaidy recalls. “She had been on antibiotics for several days, but still was clearly getting worse. She required urgent surgery because of the danger that the swelling posed to her airway.”
Chesson’s abscessed tooth had turned life threatening.
“The abscess caused pus to spread into her neck and down the side of the wall of her throat. She required surgery to open her neck from the outside to drain all the pus and remove the bad tooth that had caused all the infection,” says Busaidy.
After the surgery, Chesson was put on a breathing tube to prevent her throat—and airway—from collapsing under the pressure of the swelling.
“I had never had trouble with my teeth before,” says Chesson. “Sure, like anyone I brush my teeth whenever possible, but I never thought anything like this could happen.”
Most of us don’t associate our teeth with our general health. Nothing could be further from the truth. A tooth abscess begins as a localized condition that can spread to other areas of the body. It originates as a tooth infection or untreated cavity and is one of the most painful reminders of the connection between oral health and our overall health.
Tooth abscesses are more common than we may think, says Steve Laman, DDS, director of the UT*Dentists clinic and assistant professor of Restorative Dentistry at the UT Dental Branch at Houston.
“It’s most commonly seen in adults but may occur in children,” Laman says. “It happens when the bacteria in the mouth cause an infection at the end of a tooth root. It can develop inside the tooth or between the tooth, the gum and bone (or jawbone) causing infection, swelling, and the pain of a toothache.”
An untreated cavity or broken tooth can lead to the infection of the nerve and blood vessels inside the tooth. This can cause the pulp or nerve cells to die and produce toxins which harm the healthy tissue and form pus.
“Patients are commonly referred on the basis of the severity of their symptoms,” Laman explains.
He adds that it is important that they be treated in a timely and appropriate manner. Sometimes that will result in treatment with antibiotics, to gain control of the situation, followed by root canal treatment or extraction.
“If there is any question about the advance of the infection or the general dentist’s ability to manage the situation clinically, the patient should be referred to an appropriate specialist. Often, this will be an oral surgeon but could be an endodontist (one who performs root canals) or periodontist (gum specialist),” says Laman.
Most abscesses do not progress to such severity. Patients who seek regular preventive dental checkups and follow professional advice do not often suffer such complications.
If a patient begins to experience tooth pain associated with sore throat, pain on swallowing, areas of inflammation, especially hard, localized swelling or sore masses under their cheeks or gums, they should contact a dentist.
More subtle symptoms may include a bitter taste in the mouth or foul breath, or swollen or tender lymph nodes in the neck. Persons with diabetes need to be particularly vigilant about oral hygiene as they are more susceptible to infection.
“I think the most important features are regular and timely preventive dental checkups and immediate evaluation and treatment if a problem arises,” says Laman.
Follow preventative hygiene suggestions: brush at least twice a day, floss daily and see your dentist regularly. If you break a tooth, or know you have untreated decay, get treatment immediately, before infection has a chance to develop.
After her experience, Chesson hopes to warn others and says that she now brushes her teeth at least three times per day.
Kamal Busaidy, DDS, also operates at Memorial Hermann – Texas Medical Center , the Michael E. DeBakey V.A. Medical Center, Texas Childrens’ Hospital, The Methodist Hospital and Lyndon Baines Johnson General Hospital.
Last Updated: 2-20-2008Editorial Board | Legal Disclaimer | Privacy & Security | Contact Us
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Dr. Kamal Busaidy is an assistant professor of oral and maxillofacial surgery at the UT Dental Branch.
Dr. Steve Laman is director of the UT Dentists clinic and assistant professor of Restorative Dentistry at the UT Dental Branch.
Men: Pay Attention
to Your Bicycle Seat
Men who bike more than three hours a week should be aware that standard bicycle seats, ridden for extended periods, can cause temporary numbness and, in some, more serious problems, such as erectile dysfunction.
Such problems are caused by compression of an artery and a nerve connected to the penis. New seat designs to minimize compression are now available.
Other preventive measures you can incorporate:
