For deep abscesses, local pain and tenderness and systemic symptoms, especially fever, as well as anorexia, weight loss, and fatigue are typical. The predominant manifestation of some abscesses is abnormal organ function (eg, hemiplegia due to a brain abscess).
If the infection spreads, you may also develop a high temperature (fever) and feel generally unwell. In severe cases, you may find it hard to fully open your mouth and have difficulty swallowing or breathing.
Abscess Symptoms
Most often, an abscess becomes a painful, compressible mass that is red, warm to touch, and tender. As some abscesses progress, they may "point" and come to a head so you can see the material inside and then spontaneously open (rupture). Most will continue to get worse without care.
Brain abscess passes through 4 stages: early cerebritis, late cerebritis, early capsule, and late capsule.
Smaller abscesses (<5 mm) may resolve spontaneously with the application of warm compresses and antibiotic therapy. Larger abscesses will require I&D as a result of an increase in collection of pus, inflammation, and formation of the abscess cavity, which lessens the success of conservative measures.
If your symptoms persist or worsen despite over-the-counter treatments, or you have a fever and high levels of pain with an abscess, seek medical help at once. These situations require immediate attention in order to prevent further infections or serious complications in other parts of your body such as organ failure.
Time Span of an Untreated Abscess
In case a person does not treat a dental abscess in its initial stage, then the infection may last anywhere between 5 months to 12 months or even more. Moreover, if no treatment is meted out to the condition, the precious dental pulp will die away and may get another abscess.
Common abscesses that are not deep in body cavities (in the chest or in the abdomen) usually respond promptly to surgical drainage and antibiotic treatment. Hospitalization is short. Children return in about a week for drain removal. The type of surgical drain that we place can be removed with little or no pain.
Your healthcare provider will make a tiny cut (incision) in the abscess. They'll allow the abscess to drain and remove any remaining pus, dead tissue and debris. They'll leave the abscess open to allow any remaining pus to drain. (For larger abscesses, they may pack the open abscess with gauze.)
Usually, drain the abscess by incision or sometimes by needle aspiration. Use antibiotics when abscesses are large, deep, or surrounded by significant cellulitis.
We suggest trimethoprim-sulfamethoxazole, doxycycline, or minocycline (Grade 2C).
If they are not treated, they can last for several months or years. There are two types of dental abscess – one can form under the tooth (periapical) and the other in the supporting gum and bone (periodontal). An abscessed tooth comes in two different forms: acute and chronic.
Germs from a tooth abscess can spread to the brain. Once these germs infect the soft facial or sinus tissues, hospitalization is likely required. The “blood-brain barrier” makes it difficult to send medication to the brain, which complicates treatment. A tooth abscess can become life-threatening when ignored.
Cysts are fluid-filled pockets that form when an abscess isn't treated. Cysts can easily become infected, which can increase the risk that the bacteria will spread and cause other problems.
Most abscesses need to be drained. But, in some cases, you can treat them with antibiotics.
If left untreated, an abscess could cause permanent damage to surrounding teeth, the jaw, and other parts of the body. It is important to learn the signs and causes of a tooth abscess in order to avoid potentially life-threatening conditions.
Treatment. In most cases, your doctor will need to inject a local anesthetic over the abscess and cut open the abscess to remove pus and infectious material. If large, this area will usually be packed with strips of gauze to keep the abscess from re-accumulating.
Patients have much less pain after the surgery than they had prior to the surgery. However, depending on the size of the abscess there may be residual discomfort for a few days. Pain should slowly decrease. After a few days if there is a change in course and pain begins to intensify call the office.
This retrospective data suggests that abscesses greater than 0.4 cm in depth from the skin surface may require a drainage procedure. Those less than 0.4 cm in depth may not require a drainage procedure and may be safely treated with antibiotics alone.
Often, a skin abscess will not heal on its own without further intervention by a health care provider. Initially, an abscess may feel firm and hardened (indurated), at which time incision and drainage may not be possible.
It can cause permanent, severe paralysis and nerve loss. It may be life threatening. If the abscess is not drained completely, it may return or cause scarring in the spinal cord.
Antibiotics are effective at preventing the spread of bacteria. However, they should never be used as the only means of removing an abscess. As a result, a visit to the dentist is needed upon the occurrence of a dental abscess.