Dental emergencies are rarely treated by actual surgery on the mouth, gums, or jaw, but there are cases in which emergency dental surgery may be necessary.

Do I need emergency dental surgery to treat a tooth abscess?

A tooth abscess is considered a dental emergency if you have severe pain that does not go away even with the maximum dose of paracetamol or ibuprofen. You also need to consult an emergency dental surgery if the swelling around your tooth starts to make it difficult to swallow, interferes with your breathing, or extends up to your eye socket.

A tooth abscess that requires emergency dental surgery can develop for several reasons:

  • Tooth decay can lead to tiny cracks or fissures in the surface of the tooth. These gaps allow bacteria from your mouth to reach down inside the soft tissue of the pulp of the tooth.
  • You lose a crown or a filling, allowing entry of the bacteria
  • You are injured and one of your teeth cracks

Once bacteria reach the soft pulp inside the tooth, this provides the perfect environment for them to grow; it is moist and warm and there are plenty of nutrients. They soon run out of space, however, and then the pressure forces a larger hole into the base of the tooth where the nerve and blood vessels lead into the gum. The bacteria can then escape down into the gum and cause a more serious infection that soon results in an abscess.

You then need to seek emergency dental surgery as soon as possible so that the build up of pressure causing the swelling can be released.

What does emergency dental surgery for an abscess involve?

Emergency dental surgery to relieve an abscess under a tooth is usually called emergency root canal surgery but the more correct dental term for this minor dental surgery is endodontic therapy.

Once you have been accepted for treatment at an emergency dental surgery, the root canal procedure will take about 2 hours. It is usually done under local anaesthetic and although it takes longer, there should be no pain and the discomfort is only about the same as having a tooth filled.

This type of emergency dental surgery involves drilling rather than any incisions. The emergency dentist first removes the top of the tooth to gain access to the root canals. A molar tooth can have three or even four root canals. The soft material, the blood vessels and nerves, is then hooked out of the tooth and each individual root canal is drilled using long and very thin drill bits that are almost as thin as needles. The tiny canals are irrigated with fluids that clean out debris and infection. When the root canal is clear it is filled with gutta percha, an inflexible latex that is extracted from the percha tree.

What happens after a root canal procedure?

Once the emergency dental surgery is complete, you will still need to take care of your gum as the underlying tissue will still be inflamed and sore, but healing should take place within a week or so. A tooth that has been drilled out and filled in this way is dead; it has no blood supply and no nerve.

A crown is fitted over the tooth to protect it, as a dead tooth becomes brittle over time and can break up. With careful dental hygiene after a root canal treatment, you can preserve a tooth for about 10 years.

Emergency dental surgery for a lost tooth?

If you have knocked out a tooth and it cannot be put back in place, all that an emergency dental surgery can do is to make sure the gum socket is cleaned, the bleeding has stopped, and the adjacent teeth have not been damaged.

Follow up treatment then needs to be done by your own dentist and can involve either a denture or non-emergency dental surgery to implant a tooth using a titanium rod that is placed within your jaw bone. Once this has healed and ‘taken’, you will be able to have a permanent replacement tooth fitted, which will feel and behave very much like your own tooth.


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