Abscess
From bonepath
A dental abscess refers to inflammation of a tooth’s pulp cavity which results in the formation of a pocket of pus the vicinity of the tooth root’s apex (Scott and Turner 1988, Roberts and Manchester 2005, Ferreira et al. 2011). Dental abscesses are caused by (usually anaerobic) bacterial infection of the pulp cavity. The pulp cavity can be exposed for microbial invasion by caries (cavities), trauma, attrition, and periodontal disease (i.e. periodontitis) (Siqueira 2002, Roberts and Manchester 2005). Herpes virus of some sort is fairly commonly identified in the discharge of apical (root) abscess (Ferreira et al. 2011), but it should be noted that herpes virus is only associated (i.e. not necessarily causal or medically related) with dental abscess.
Abscesses can be identified on dry skeletal material by the presence of a large resorbed cavity in a bony alveolus. Dias and Tayles (1997) caution that most of the bony lesions commonly identified as “abscesses” do not come from purulent infection, but are rather bony cavities surrounding a cyst or granuloma (though these are also caused by infection of the pulp cavity). In skeletal samples, a dental abscess is generally found in fewer than 10% of the tooth sockets (Manzi et al. 1999, Roberts and Manchester 2005), and in anywhere from 5 – over 50% of individuals (Leigh 1925, Lukacs 1992, Manzi et al. 1999). These may be underestimates of the true frequency of abscesses, as the inflammation may not always involve bony remodeling (Dias and Tayles 1997, Roberts and Manchester 2005).
Prior to abscess formation, dental infection can be treated with root canal treatment or tooth extraction (Seow 2003). An acute abscess, however, must be treated with antibiotics, surgical drainage of pus, and removal of the infected tissue, including the entire tooth (Siqueira 2002, Seow 2001). As a consequence of the widespread use of antibiotics today, a number of oral microbiota associated with abscess formation are becoming resistant to antibiotics (Siquiera 2002).
References
Dias G, Tayles N. 1997. ‘Abscess cavitya misnomer. International Journal of Osteoarchaeology 7: 548-54.
Ferreira DC, Paiva SSM, Carmo FL, Rôças IN, et al. 2011. Identification of herpesviruses types 1 to 8 and human papillomavirus in acute apical abscesses. Journal of Endodontics 37: 10-6.
Leigh RW. 1925. Dental pathology of Indian tribes of varied environmental and food conditions. American Journal of Physical Anthropology 8: 179-99.
Lukacs JR. 1992. Dental paleopathology and agricultural intensification in south Asia: new evidence from Bronze Age Harappa. American Journal of Physical Anthropology 87: 133-50.
Manzi G, Salvadei L, Vienna A, Passarello P. 1999. Discontinuity of life conditions at the transition from the Roman imperial age to the early middle ages: Example from central Italy evaluated by pathological dento-alveolar lesions. American Journal of Human Biology 11: 327-41.
Roberts C, Manchester K. 2005. The Archaeology of Disease. Ithaca: Cornell University Press.
Scott GR, Turner II CG. Dental anthropology. Annual Review of Anthropology 17: 99-126.
Seow WK. 2003. Diagnosis and management of unusual dental abscesses in children. Australian Dental Journal 48: 156-68.
Siqueira JF. 2002. Endodontic infections: concepts, paradigms, and perspectives. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology & Endodontics 94: 281-93.
