Name of the Condition

• Periapical abscess without sinus (Term: Dental abscess)

Summary

A periapical abscess is a pocket of pus that forms at the tip of a tooth's root due to a bacterial infection. This type of abscess occurs when the inner pulp of the tooth is infiltrated by bacteria, typically resulting from tooth decay, trauma, or a failed root canal treatment.

Causes

• Tooth decay penetrating deep into the tooth’s layers.
• Injury or trauma to the tooth causing pulp exposure.
• Poor dental hygiene leading to bacterial infection.

Risk Factors

• Poor oral hygiene and infrequent dental check-ups.
• High sugar diet contributing to tooth decay.
• Previous tooth injuries or untreated cavities.

Symptoms

• Severe, persistent, and throbbing toothache.
• Sensitivity to hot or cold temperatures.
• Swelling in the face or cheek.
• Tender, swollen lymph nodes under the jaw or in the neck.
• Fever and a general feeling of unease.

Diagnosis

• Dental examination and history evaluation.
• X-rays to detect abscess and related bone damage.
• Pulp vitality tests to assess the health of the tooth pulp.

Treatment Options

• Drainage of the abscess to remove pus and alleviate symptoms.
• Root canal treatment to remove infected pulp and save the tooth.
• Tooth extraction if the tooth cannot be salvaged.
• Antibiotics to clear the infection, especially if it has spread.

Prognosis and Follow-Up

• With timely treatment, the prognosis is generally good, and most patients recover without further complications.
• Regular follow-up is essential to ensure the infection is resolved and to monitor for recurrence.

Complications

• Spread of infection to surrounding tissues, leading to cellulitis.
• Formation of a sinus tract or fistula.
• Potential spread of infection to other parts of the body, causing serious systemic conditions.

Lifestyle & Prevention

• Maintain good oral hygiene with regular brushing and flossing.
• Limit intake of sugary foods and beverages.
• Regular dental check-ups to detect and treat cavities early.

When to Seek Professional Help

• Intense toothache lasting more than a day or two.
• Swelling in the jaw or cheek.
• Fever or swollen lymph nodes.
• Difficulty breathing or swallowing, indicating a severe infection.

Additional Resources

• American Dental Association: www.ada.org
• National Institute of Dental and Craniofacial Research: www.nidcr.nih.gov
• Mayo Clinic: www.mayoclinic.org

Tips for Medical Coders

• Confirm accurate documentation of "without sinus" to differentiate from similar conditions.
• Double-check for specific details indicating the absence of a sinus tract.
• Avoid confusion with periodontal abscesses, which affect the gum and bone.