Tooth abscess, a collection of pus inside of the oral tissues, can result from severe infections like those associated with untreated gum disease. When abscess occurs, patients commonly experience intense pain and are at risk of having the infection spread to other parts of the body. Here is more about the causes and treatments of tooth abscess.
Why Tooth Abscess Occurs

Abscess is the result of a trapped bacterial infection inside the tissues of the mouth. In some cases, untreated tooth decay can cause a bacterial infection that produces an abscess. An abscess can also develop after a tooth is affected by cracks or breakage, which allows entry of bacteria into the tooth pulp. Finally, infections may result from accumulation of food particles between the gums and teeth, particularly when gum disease creates larger pockets in which bacteria thrive.
How Tooth Abscess Is Treated

Tooth abscess is treated in a number of ways depending on severity and symptoms. Initially, at Vistasol Dental, Dr. Noushin Adhami a montebello dentist addresses the abscess itself before working on the infection behind it. If pulp infection is involved, root canal treatment or root canal surgery may be required. In many cases, more than one appointment is necessary to eliminate the infection and protect against future problems.

Patients can reduce their risks of suffering a tooth abscess by brushing and flossing their teeth every day and visiting our dentist for check-ups at least twice each year. To learn more about tooth abscess prevention and treatment, patients can schedule a consultation with our dentist at Vistasol Dental in Montebello.

A root canal #rootcanal
is the anatomic space within the root of a #tooth. Part of a naturally occurring space within a tooth, it consists of the pulp chamber (within the coronal part of the tooth), the main canal(s), and more intricate anatomical branches that may connect the root canals to each other or to the surface of the root.

Tooth structure
At the center of every tooth is a hollow area that houses soft tissues, such as the nerve, blood vessels, and connective tissue. This hollow area contains a relatively wide space in the coronal portion of the tooth called the pulp chamber. These canals run through the center of the roots, similar to the way pencil lead runs through a pencil. The pulp receives nutrition through the blood vessels, and sensory nerves carry signals back to the brain. A tooth can be relieved from pain if there is irreversible damage to the pulp, via root canal treatment.

Dental pulp
The space inside the root canals is filled with a highly vascularized, loose connective tissue, called dental pulp. The dental pulp is the tissue of which the dentin portion of the tooth is composed. The dental pulp helps complete formation of the secondary teeth (adult teeth) one to two years after eruption into the mouth. The dental pulp also nourishes and hydrates the tooth structure, making the tooth more resilient, less brittle and less prone to fracture from chewing hard foods. Additionally, the dental pulp provides a hot and cold sensory function.
Root canal is also a colloquial term for a dental operation, endodontic therapy, wherein the pulp is cleaned out, the space disinfected and then filled.

Root canal anatomy
Root canal anatomy consists of the pulp chamber and root canals. Both contain the dental pulp. The smaller branches, referred to as accessory canals, are most frequently found near the root end (apex), but may be encountered anywhere along the root length. The total number of root canals per tooth depends on the number of the tooth roots ranging from one to four, five or more in some cases. Sometimes there are more than one root canal per root. Some teeth have a more variable internal anatomy than others. An unusual root canal shape, complex branching (especially the existence of horizontal branches), and multiple root canals are considered as the main causes of root canal treatment failures. (e.g. If a secondary root canal goes unnoticed by the dentist and is not cleaned and sealed, it will remain infected, causing the root canal therapy to fail).

Root canal system
The specific features and complexity of the internal anatomy of the teeth have been thoroughly studied. Using a replica technique on thousands of teeth, Hess made clear as early as 1917 that the internal space of dental roots is often a complex system composed of a central area (root canals with round, oval or irregular cross-sectional shape) and lateral parts (fins, anastomoses and accessory canals). In fact, this lateral component may represent a relatively large volume, which challenges the cleaning phase of the instrumentation procedure in that tissue remnants of the vital or necrotic pulp as well as infectious elements are not easily removed in these areas. Thus, the image of root canals having a smooth, conical shape is generally too idealistic and underestimates the reach of root canal instrumentation.

Anatomic complexity by cone-down CT and ultrasound
Root Canal pulp removed, cleaned and made ready for filling and placing a crown.
Root canals presenting an oval cross-section are found in 50%-70% of root canals. In addition, canals with a “tear-shaped” cross section are common when a single root contains two canals (as occurs, for example, with the additional mesial root seen with the lower molars), subtleties that can be more difficult to appreciate on classical radiographs. Recent studies have shown that use of cone-down CT can detect accessory canals that would have been missed in 23% of cases, which can in turn lead to apical periodontitis. The upper molars, in particular, are predisposed to have an occult accessory canal in nearly half of patients.
When rotary nickel titanium (NiTi) files are used in canals with flat-oval or tear-shaped cross sections, a circular bore is created due to the rotational action of the metal. Also, small cavities within the canal such as the buccal or lingual recesses may not be instrumented within the tooth, potentially leaving residual disease during disinfection.
Tissue or biofilm remnants along such un-instrumented recesses may lead to failure due to both inadequate disinfection and the inability to properly obturate the root-canal space. Consequently, the biofilm should be removed with a disinfectant during root canal treatment.

Dr Noushin Adhami D.D.S

Root Canal Therapy is a painless dental treatment

Electronic cigarettes are often marketed as a safer alternative to conventional cigarettes. When it comes to oral health, however, new research suggests vaping may be just as harmful as smoking.

Researchers suggest vaping may be equally – if not more – harmful for oral health than smoking.
In a study published in the journal Oncotarget, researchers found that the chemicals present in electronic cigarette (e-cigarette) vapor were equally as damaging – in some cases, more damaging – to mouth cells as tobacco smoke.
Such damage can lead to an array of oral health problems, including gum disease, tooth loss, and mouth cancer.
E-cigarettes are battery-operated devices containing a heating device and a cartridge that holds a liquid solution. The heating device vaporizes the liquid – usually when the user “puffs” on the device – and the resulting vapor is inhaled.
While e-cigarette liquids do not contain tobacco – a highly harmful component of conventional cigarettes – they do contain nicotine and other chemicals, including flavoring agents.

According to the Centers for Disease Control and Prevention (CDC), the use of e-cigarettes has increased in recent years, particularly among young people. In 2015, 16 percent of high-school students reported using the devices, compared with just 1.5 percent in 2011.
E-cigarettes are considered by many to be safer than conventional smoking, but because the devices are relatively new to the market, little is known about the long-term effects of vaping on health.
In particular, study leader Irfan Rahman, Ph.D., professor of environmental medicine at the University of Rochester School of Medicine and Dentistry in New York, and colleagues note that there has been limited data on how e-cigarette vapor affects oral health.

Flavored vapor worsens damage to gum tissue cells
To address this gap in research, the team exposed the gum tissue of nonsmokers to either tobacco- or menthol-flavored e-cigarette vapor.
The tobacco-flavored vapor contained 16 milligrams of nicotine, while the menthol flavor contained 13-16 milligrams of nicotine or no nicotine.
The researchers found that all e-cigarette vapor caused damage to gum tissue cells comparable to that caused by exposure to tobacco smoke.
“We showed that when the vapors from an e-cigarette are burned, it causes cells to release inflammatory proteins, which in turn aggravate stress within cells, resulting in damage that could lead to various oral diseases.”
Irfan Rahman, Ph.D.
The researchers note that nicotine is a known contributor to gum disease, but e-cigarette flavoring appeared to exacerbate the cell damage caused by e-cigarette vapor, with menthol-flavored vapor posing the most harm.
While further research is needed to investigate the long-term effects of e-cigarette use, Rahman and team believe their findings indicate that the devices may have negative implications for oral health.
“Overall, our data suggest the pathogenic role of [e-cigarette] aerosol to cells and tissues of the oral cavity, leading to compromised periodontal health,” they conclude.
E-cigarette vapor damaged, killed 53 percent of mouth cells in 3 days
Another study recently published in the Journal of Cellular Physiology builds on the findings from Rahman and colleagues, after finding a high rate of mouth cell death with exposure to e-cigarette vapor over just a few days.
To reach their findings, Dr. Mahmoud Rouabhia, of the Faculty of Dental Medicine at Université Laval in Canada, and colleagues placed epithelial cells from the mouth in a chamber that contained a liquid similar to saliva.
To simulate vaping, the researchers pumped e-cigarette vapor into the chamber at a rate of two 5-second puffs every 60 seconds for 15 minutes a day. This was performed over 1, 2, or 3 days.
On analyzing the vapor-exposed epithelial cells under a microscope, the researchers identified a significant increase in the rate of cell damage and death.
The rate of damage or death in unexposed cells is around 2 percent, the researchers note. However, they found that with exposure to e-cigarette vapor, the number of dead or dying cells rose to 18 percent, 40 percent, and 53 percent over 1, 2, and 3 days, respectively.
While the cumulative effects of the cell damage caused by e-cigarette are unclear, the researchers believe their findings are a cause for concern