Acute Apical Abscess
A lower molar tooth with deep caries (tooth decay), which provided a pathway for bacteria into the pulp of the tooth and led to an abscess at the root apex.
Acute apical abscess is a painful condition in which the apex (tip) of a tooth’s root becomes inflamed, often resulting in swelling and fever. Almost always, the condition occurs following a long-term infection.
To clarify the definition of the term, “apical abscess”, it is becoming more commonplace to hear the term “periradicular” instead of “apical” or “periapical”. This is because the word “apical” implies that the problem originated at the tooth’s root tip; “periapical” implies that it began somewhere around the root tip. In fact, the problem frequently originates along the root somewhere (periradicular).
Thus, the terms acute apical abscess, acute periapical abscess, and acute periradicular abscess all represent the same process—the problem just arises at different places along the root. Where an infection originates along a tooth’s root gives the dentist clues as to the cause. Most often, a leaking filling or crown allows access to the root canal through the top of the tooth, and the bacteria eventually exit at the root tip—resulting in an apical infection.
A tooth which has experienced bone loss around it may afford bacteria access along the root somewhere, resulting in a periradicular abscess. Teeth which have been injured or forcefully moved (luxated), frequently experience periapical injuries due to mechanical leverage forces applied on the tooth. There are many other possible mechanisms for allowing bacteria access to the tooth and its surrounding structures.
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