Swollen face? Inflammatory discharge inside the tooth? Over the painkiller? Already considering antibiotics? Know this first! A pus-filled tooth, an inflamed tooth, a swollen face is no toy! Do not delay treatment, do not wait for unpleasant complications! Prevent tooth extraction and tooth loss! Read on, I’ll tell you what happens and what to do. It’s worth making an appointment with your dentist now for a check-up!

What is a pus tooth?
A pus-filled tooth is an umbrella term. The pus, an inflammatory secretion full of bacteria and tissue debris, can be inside the tooth, around the root, can break through to the gum and form a pus pouch on the gum above the tooth, or worse, can break through to the deeper tissues, with serious complications and consequences – one of the least serious of which is a swollen face. Why does it happen? What to do? What can you do if your face is swollen? Root canal treatment is all about saving the tooth – it’s worth reading more about it if you’re not familiar with modern root canal treatment, because the techniques and anaesthesia of the present day are very different to what they were decades ago!

How does purulent inflammation develop in the tooth?
A purulent inflammation in or around a tooth does not develop without a history. Pus essentially consists of dead bacteria and tissue elements, cells. It appears when bacteria invade the tissue, causing the immune system to release defence units (inflammatory tissue cells) to the site, which start to destroy the bacteria. In this case, not only the germs but also the bacteria’s own tissue elements fall victim. This dead tissue mass is called pus. So pus means both bacteria and inflammation. The bacteria must somehow get into the tissue – most often through the root canal inside the tooth. How do they get into the root canal? Through deep decay, filling or secondary decay adjacent to the crown. Read more about the root filling process here. To summarise, the formation of a pus-filled tooth is: 1. Deep caries with consequent pulp necrosis → 2. Infection of the necrosed pulp with bacteria → 3. Bacterial toxins leak through the root canal to deeper tissues (periosteum, bone, connective tissues) → 4. Activation of the immune system, development of inflammation → 5. Development of pus, accumulation in the root tip → 6. Pus finds its way (granuloma, formation of cysts in the root tip, formation of fistulas and pus pockets on the gums, if pus also finds its way to deeper tissues, severe inflammatory consequences)

What are the symptoms of a pus-filled tooth?
The most common symptoms of pus are a result of the way the process itself develops:

•     Pain in the affected area
•     Swelling of the affected area – this may be limited to a tightness, swelling of the gums over the tooth, or swelling of the whole face
•     A warm sensation in the affected area and even a fever due to the activation of the immune system
•     In more advanced stages, reddish discoloration of the swollen gum area above the tooth
•     The tooth may feel elongated, sensitive to pressure, biting or painful
•     If the pus may make its way towards the bone surface, a fistula opening and pus pouch may form at the outlet. This opening can be seen as a small pus-filled pustule on the gum in the area above the tooth. Occasionally pus is shed from the opening. Because of the pus discharge, the tension over the tooth may always be reduced, so the pain is not so severe in this case, but there is a serious inflammatory process going on deep down, and the bone around the root of the tooth is constantly being destroyed during the inflammation
•     In many cases, there are old, large fillings or old dental crowns in the tooth below or next to the socket – these are usually the source of the inflammation
•     Halitosisa
•     If the pus cannot find its way to the surface (see fistula) and bursts towards deeper areas, the face swells up first and then deeper areas can become infected.

What to do if you see pus on your gums?
A pus pouch, or fistula opening, is a sign that pus that has accumulated at the root tip has made its way to the thinner bone surface, usually appearing above the tooth, or perhaps high up between two teeth in the upper part of the gum. This ‘procedure’ of the body helps in the short term, as the tension can be reduced by shedding the pus deep down, so the pain is not significant. In the long term, however, it is not beneficial as tissue inflammation and bone destruction continues in the deep space. If you see pus on the gums above or below the tooth, I would advise you to see your dentist even if pus is the only symptom you notice, as this inflammation will not go away on its own. The dentist will use x-rays to determine which tooth the pus canal originates from, and then treat this tooth with painless root canal therapy. Sometimes the pus opening is above a perfectly healthy tooth! In such a case, the pus duct usually originates from the adjacent crowded tooth, the pus has made its way obliquely, deceiving the onlooker! If there is pus on the gum, these are the steps to be expected – you can check the prices for root canal treatment here: 1. Identification of the affected tooth by oral examination and x-ray 2. Root canal treatment, disinfection of the root canal, followed by a drug seal 3. If the drug seal is successful, the pus fistula will be completely gone within a few days 4.

What about antibiotics in the case of a suppurative tooth?
Antibiotics are not aspirin! There are several very serious complications and long-term serious consequences of taking unnecessary antibiotics. Never start taking antibiotics at home for your own “pleasure” if you suspect you have a suppurative tooth! Antibiotics are only a temporary “help” for a festering tooth, but rather delay the problem. Antibiotics do not penetrate the inside of the tooth! However, the cause of pus is the mass of bacteria living inside the tooth, which must be destroyed first and foremost, and the root canal must be precisely closed to prevent further infection. If the dentist feels that, in addition to the treatment of the root canal, systemic antibiotic support is needed, he will always do this with great care if the patient needs it.

When does a tooth become abscessed under a crown or filling?
Fillings and old crowns should be checked from time to time – at least once a year if possible! A tooth under a deep filling or old crown can die quietly and unnoticed. For a long time, it may not even cause a complaint. At first, there is only bacteria in the root canal, then slowly the root canal inflammation develops. In many cases, a very large bony lesion (e.g. a cyst) develops at the root apex without the patient feeling any particular signs, only to be discovered during an X-ray check-up.

Why do the dentists of Budapest Dental Dentistry achieve excellent results in the field of root canal treatment?
The dentists at Budapest Dental Dentistry pay special attention to root canal treatment. In our practice, root canal treatment is a high priority, supported by precise background technology, so we have a higher success rate than other practices that do not offer these technologies: 1. Specialized mechanical root canal exploration 4. Digital root canal scanning 5. Digital intra- and extraoral radiographs 6. Follow-up root canal examination, automatic retrieval every six months 7. Root canal protection with cover crowns