Abscesses

The created pus will first find a way through the bone (enossal abscess). It then meets the sensitive periosteum (subperiosteal abscess). This creates acute and severe pain until the periosteum is penetrated and the pus drains into the tissue (submucosal abscess). An incision is often the only method to allow the pus to drain. Drainage keeps the outlet open. Pain and swelling recede. If the tooth is pain free and a bacteria-proof root canal filling is possible, the bone changes will also abate.

The created pus will first find a way through the bone (enossal abscess). It then meets the sensitive periosteum (subperiosteal abscess). This creates acute and severe pain until the periosteum is penetrated and the pus drains into the tissue (submucosal abscess). An incision is often the only method to allow the pus to drain. Drainage keeps the outlet open. Pain and swelling recede. If the tooth is pain free and a bacteria-proof root canal filling is possible, the bone changes will also abate.
Therapy consists of the surgical opening (incision) and keeping the point of incision open to allow the pus to drain. An abscess can sometimes drain itself through a fistula passage to the outside. Patients frequently have a fistula at a devital tooth for years without noticing it. These fistula passages can be removed by an excision. So-called odontogenic or dentogenic abscesses (starting from the teeth) in the head and neck area can occur at the surface or in the depth of tissue.


Superficial abscesses are classified according to their location:

• Submucosal (under the mucosa)
• Subcutaneous (under the skin)
• Subperiosteal (under the periosteum)
• Palatinal (in the palate)
• Sublingual (under the tongue)

Deeper abscess are found

• In the base of the mouth
• Submandibular (under the lower jaw)
• Submental abscess (under the chin)
• Perimandibular (around the lower jaw)