Treatment of tooth abscess includes incision and drainage of the abscess, root canal treatment (if tooth can be restored), extraction of the affected tooth (extraction is followed by curettage of all apical soft tissue) if it cannot be restored and use of appropriate antibiotic therapy for adequate duration for elimination of causative organisms.
Incision and drainage of tooth abscess:
A small incision is made into the tooth abscess by the dental surgeon, which will help in draining of the puss accumulated inside the abscess. The mouth is then washed with normal saline or salt water. Draining of pus is essential, because antibiotics cannot reach inside the abscess and it can never be cured by antibiotics alone.
Root canal treatment (RCT):
RCT can eliminate the infection and save your diseased tooth (restore it). For root canal treatment, your dentist will drill the tooth drain the abscess and remove all the pulp of the tooth. Your dentist will than fill the gap, seal the tooth, and cover it with appropriate material. Tooth should be taken care properly after RCT.
Extract the affected tooth:
If affected tooth (tooth abscess) cannot be restored/saved it should be removed (extracted) and pus in the abscess drained. This will help in elimination of infection. Tooth extraction is followed by curettage of all apical soft tissue, to remove any potential source of infection.
Antibiotic for treatment of tooth abscess:
If infection is limited to only the tooth, antibiotics may not be required after incision and drainage, root canal treatment or extraction. However, if there is risk of infection to nearby teeth or nearby tissues or infection has already spread to nearby teeth or nearby tissues, appropriate antibiotic therapy is must for elimination of infection and to save other teeth. In case of weak immune system also, antibiotic therapy is must for tooth abscess.
Tooth abscess may fail to heal if there is any of the following:
Inappropriate root canal treatment
Foreign body/material in the abscess/lesion
Associated gum disease
Fracture of the dental root