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Phoenix Abscess

What is a Phoenix Abscess?

An acute apical abscess resulted from deep dental caries or decay in this molar tooth.

A lower molar tooth with deep tooth decay (caries), which provided a pathway for bacteria into the pulp of the tooth and led to an abscess at the root tip (apex).

Phoenix abscess is a painful condition in which the tip (apical portion) of a tooth’s root becomes inflamed, which may result in swelling and fever. Almost always, the condition occurs secondary to a long standing (chronic) infection. The term phoenix is an older term, and its use is becoming less commonplace in favor of more descriptive terms like “chronic,” which generally features a lesion that can be seen on an X-ray, and “suppurative” (draining). Draining infections can produce a bad taste and bad breath (halitosis).

How does the dentist diagnose a Phoenix Abscess?

Note: ToothIQ.com contains general information. Only a dentist can properly diagnose your specific condition.

The following criteria support a diagnosis of phoenix abscess:

  • The term phoenix abscess implies that acute sudden pain has arisen out of a chronic (long-standing) infection.* Although the patient may not be aware of a long-standing infection, the tooth now hurts when biting, chewing, or tapping on it.
  • Swelling may or may not be present, depending on whether the intense pressure from the infection has been able to vent into or through the tooth’s bony housing.
  • Presence of fever and general malaise (feeling poorly)
  • An X-ray image of the tooth shows a dark area in the bone around the root tip (apex)
  • Pain may be relieved to an extent by application of cold substances to the affected tooth, and the patient may present at the dentist’s office sipping ice water. Cold temperatures reduce gas pressure created by bacteria, which have infected the hollow interior (pulp) of the tooth.

* An acute apical abscess has all of the same symptoms, but shows no dark area around the root on X-ray images.

How is a Phoenix Abscess treated?

A phoenix abscess generally requires urgent treatment to relieve the pain and swelling. In some circumstances, antibiotics may be prescribed. Adjusting the bite on the tooth may provide some relief, but will not resolve the problem (which is infection).

Saving the tooth requires definitive treatment. Root canal therapy (endodontics) is commonly prescribed to eliminate the infection, pain and swelling. Depending on where in the mouth the affected tooth is located, the tooth’s restorative history (i.e. decay, cracks, large fillings, crowns, etc.), the tooth may require additional procedures following root canal therapy.

Removal of the tooth (simple tooth extractions and surgical tooth extractions) may also an option. One or more X-ray images (radiographs) of the tooth will usually be needed to plan and safely perform treatment.

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Author: Thomas J. Greany, D.D.S. / Editor: Ken Lambrecht

This page was last updated on March 6, 2018.

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