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Abscess
A dental
Abscess: A localized collection of pus surrounded by inflamed tissue.
abscess is a collection of purulent fluid caused by a bacterial infection. This collection of pus is located in the
Pulp: The highly vascular sensitive tissue occupying the central cavity of a tooth.
pulp of the tooth but can spread to the periapical structures of the jaw and beyond if not adequately and appropriately treated.

The most common cause of a dental abscess is extension of the dental caries process into the pulp of the tooth. Abscesses can also be caused by trauma to the tooth that allows bacteria to enter the pulp. An abscess limited to the tooth structure (ie, pulpitis) will often present with tooth pain from the increased pressure on the nerve endings within the pulp. This pain is often worsened with heat or cold exposure.

If the infection in the pulp extends beyond the tooth, a periapical abscess will develop. The pressure caused by the expanding area of necrosis and inflammation causes visible swelling and may lead to slight extrusion of the tooth from the socket.

As the abscess expands, the pus will spread to contiguous surfaces along the path of least resistance to form a fistula to the maxillary, mandular, or palatal mucosa. If the infection remains unchecked, it can progress to facial, submandibular, or sublingual cellulits. Facial cellulitis presents clinically with swelling, warmth, and tenderness to palpation along the jaw.

Cellulitis of the submandibular and sublingual spaces is called Ludwig’s angina and is of significant concern as the swelling can compromise the airway. Although rare in children, pediatricians should consider Ludwig’s angina in a child with redness and swelling of the upper neck, under the chin, or a swollen or displaced tongue.
 
 
Extension of dental caries is the most common precipitating cause of dental abscesses.
 
Ludwig's angina is a medical emergency due to potential airway compromise.
 
The spread of a dental abscess can cause severe morbidity.




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