Being a favorite target of infections of all kinds, even the teeth are often found in the crosshairs of bacteria . These microscopic enemies of the teeth, attracted by rotten food residues trapped between the dental elements, attack the enamel and, having reached the dentin, continue their journey undeterred towards the dental pulp . Roughly speaking, this is how bacteria give rise to most dental infections, from the simplest cavities to the most complex pulpitis.
Tooth infections are numerous and varied, and each of them is distinguished by the triggering cause and symptoms with which it manifests itself (for more information, see the introductory article on dental infections).
Shutterstock
Table of dental infections
To simplify the analysis and offer an immediate understanding of the subject, all the main dental infections are shown in the table. We invite the reader to dwell on the causes and symptoms to anticipate infections, possibly stemming them in the bud. In the following discussion, the therapies currently available to remove the infectious outbreak will also be exposed.
Cavity
Infection triggered by the attack of some oral cavity bacteria directly on the tooth enamel . The infection, evolving in a negative direction, can progressively destroy the hard tissues of the tooth, until it spoils the pulp.
| CAUSES OF INFECTION | SYMPTOMS OF INFECTION | TREATMENTS AVAILABLE |
| · Plaque deposit around the tooth
· Reduction of saliva secretion (natural self-cleaning substance) · Crooked teeth and difficulty cleaning teeth thoroughly · Poor oral hygiene · Diet rich in sugary foods |
· Alteration of the natural dental color (the teeth appear yellowed and opaque)
· Evident presence of a dark groove (rich in food residues in the putrefactive phase) · Halitosis · toothache · Sensitivity to hot, cold, sweet and sour · Possible degeneration into pulpitis , abscess and root destruction |
· Filling (the treatment of choice to combat this type of dental infection)
· Devitalization (in case of progression of the pulp infection) · Tooth extraction (extremely rare event in the presence of mild to moderate caries ) |
Pulpit
Inflammation of the dental pulp (inflammation of the tooth nerve)
| CAUSES OF INFECTION | SYMPTOMS OF INFECTION | TREATMENTS AVAILABLE |
| · Complicated caries
· Trauma to the teeth · Periodontitis or pyorrhea · Thermal insults derived from dental procedures (e.g. laser whitening with CO 2 lamps ) · bruxism · Dental malocclusion · Poor/incorrect oral hygiene |
· Asymptomatic infection (first stage)
· Acute, piercing, throbbing toothache · Toothache difficult to locate with precision · Accentuation of tooth pain when chewing · Increased dentinal sensitivity |
· Devitalization of the tooth (elective treatment to fight infection)
· Administration of analgesics to mask the pain · Tooth extraction (extreme cases) |
Tooth abscess
Accumulation of pus (bacteria, white blood cells , cell debris and plasma ) in the tissues surrounding a tooth. The dental abscess tends to form, in particular, at the level of the gum, jaw bone or dental pulp.
| CAUSES AND RISK FACTORS OF INFECTION | SYMPTOMS OF INFECTION | TREATMENTS AVAILABLE |
| · Complicated tooth decay (causing pus-rich dental infections )
· Serious dental injuries · Failed dental procedures · Bad oral hygiene · Diabetes · Gastroesophageal reflux disease · AIDS · Dry mouth · Smoking and alcoholism · Long-term therapy with corticosteroids |
· Fierce and relentless toothache
· Swollen gums · Halitosis · Dentine hypersensitivity · Fever · Swollen lymph nodes in the neck |
· Specific antibiotic treatment
· Administration of anti-inflammatory / pain-relieving drugs ( NSAIDs ) to control pain · Pus drainage |
Dental cyst
Pathological sac lined with lining epithelium and filled with serous, mucous or gaseous fluid. Typical complication of pulp necrosis, the dental cyst always requires a rather invasive dental intervention.
| CAUSES OF INFECTION | SYMPTOMS OF INFECTION | TREATMENTS AVAILABLE |
| · Pulpit
· Complicated caries · Dental granuloma · Tooth abscess · Dental impaction · Failed devitalization · Bad tooth extraction |
· Asymptomatic (early stage)
· Toothache · Swelling of a mandibular / maxillary bone section · Swollen gums · Lip swelling · Halitosis · Dental mobility |
· Surgical removal of dental infection
· Dental cyst drainage · Apicectomia · Tooth removal |
Dental granuloma
Chronic inflammation , usually asymptomatic and non-suppurative, of the root apex and its surrounding tissues
| CAUSES OF INFECTION | SYMPTOMS OF INFECTION | TREATMENTS AVAILABLE |
| · Pulpits not cared for
· Advanced stage caries · Pulp necrosis · Badly chipped teeth · Complication of pyorrhea · Penetration of a foreign body into the gum · Failure of a dental filling |
· Early stage: Granuloma tends to be asymptomatic
· Advanced stage (months/years after granuloma formation): infection can cause toothache, dental pain and swollen gums · Complications: cysts and fistulas |
· Devitalization (treatment of choice for the treatment of the infection)
· Apicectomy (late stage granuloma) · Tooth extraction (extreme case) |
Alveolitis
Inflammation of the alveolus, the bone cavity where the roots of the teeth lodge. It is a typical infection that occurs after the extraction of a wisdom tooth or any other tooth. The condition tends to resolve itself within a few days or a few weeks after the onset of symptoms.
| CAUSES OF INFECTION | SYMPTOMS OF INFECTION | TREATMENTS AVAILABLE |
| · Improper extraction of a wisdom tooth
· Improper extraction of molars, incisors or canines · Extraction of teeth badly damaged by infections · Extraction of impacted teeth (risk factor) · smoking (risk factor) |
· Very intense toothache, such as to resist a common analgesic treatment with NSAIDs. The pain begins 3-4 days after a tooth extraction
· High fever · Gingivitis · Profuse infection · Fetid odor in the gum area affected by the alveolitis · Bad breath |
The alveolitis tends to regress by itself, without necessarily intervening with a specific treatment. No therapy can effectively reverse the infection in a short time. In any case, there are some tricks, useful for buffering or masking – albeit partially – the pain:
· Washing with chlorhexidine -based mouthwashes · Placement of a sterile gauze soaked in analgesic substances in the alveolus · Washing with saline solution · Topical application of lidocaine -based creams ( local anesthetic ) |
Gingivitis
Inflammation of the gums. Generally, the phenomenon is not worrying and does not always hide a tooth infection. Other times, however, gingivitis is a light on serious dental diseases such as pyorrhea.
| CAUSES OF INFECTION | SYMPTOMS OF INFECTION | TREATMENTS AVAILABLE |
| · Plaque buildup on the surface of teeth and gums
· Dental cleaning with a stiff bristle toothbrush · Poor oral hygiene · Long-term therapy with corticosteroids and antidepressants · Vitamin deficiency · Genetic predisposition · Pyorrhea · Caries · pulpits · Dental granuloma · Tooth cyst |
· Irritation and inflammation of the gums
· Bleeding gums · Halitosis · Tooth loss (in the presence of gingivitis associated with pyorrhea) · Change in colour, shape and texture of the gums |
Treatment depends on the underlying cause. Generally, gingivitis resolves after thorough scaling. However, when gingivitis hides tooth infections, it is necessary to intervene more aggressively by removing the responsible pathogen (e.g. filling, devitalization, apicectomy, etc.). |
Pyorrhea or periodontitis
Serious gingival infection affecting the periodontium , the tooth support apparatus made up of the gingiva, connecting elastic fibers and mandibular/maxillary bone. It is a serious dental infection which, by slowly destroying soft tissues and supporting bones , favors the loss of permanent teeth.
| CAUSES OF INFECTION | SYMPTOMS OF INFECTION | TREATMENTS AVAILABLE |
| · Plaque and tartar buildup
· Gingivitis · Untreated caries · Formation of bacterial pockets in periodontal pockets · Poor dental hygiene |
· Asymptomatic (early stage)
· Halitosis · Alteration of taste in the mouth · Swollen gums · Appearance of interdental spaces · Gum bleeding · Progressive destruction of bones and gums · Gum recessions · Sensitive teeth · Tooth loss |