Still have dental abcess 18 months later

[jd222]

Hi,

I still have my dental abcess that's been there 18 months now .
It's not swelled or causing any pain and it's draining .
Since a few months ago I've experienced debilitating depression/brain fog/anxiety/agoraphobia and just feeling generally strange .
Im not really leaving the house much at all.
I'm wondering if these symptoms are all related to the abcess?
My Dr's have prescribed me ssri which I'm yet to start taking .
I feel like i can't even get to a dental appointment now due to the cognitive issues I'm having .
I googled it and it said I need it treating asap.
I just don't know what to do.
Im only sleeping in 1 hour increments, I feel just generally awful.

 

[Gordon]

I'm wondering if these symptoms are all related to the abcess?

No.

 

[jd222]

@Gordon
Thanks Gordon, are you absolutely sure ?
Ive read it can trigger inflammation in the brain?

 

[Gordon]

Ive read it can trigger inflammation in the brain?

I've got a theoretical chance of a date with Scarlett Johansson, but it's not likely to happen

Dental infections are caused by a very fragile kind of bacteria, anyone with a functioning immune system has no real reason to worry about them causing systemic issues.

 

[jd222]

@Gordon Thanks, Gordon.
Do you have any advice on how I can actually get it taken care of?
I know i can ring 111 and get an appointment but I've become so anxious and barely sleeping at all. I thought the abcess may have triggered being in fight or flight/fighting off infection for so long ?

 

[Gordon]

Do you have any advice on how I can actually get it taken care of?

I'm not sure what you are asking? Maybe post in the support forum here for some encouragement to get started on making an appointment?

 

[jd222]

@Gordon Thank you, I will do

 

[Apex Prognosticator]

I've got a theoretical chance of a date with Scarlett Johansson, but it's not likely to happen

Dental infections are caused by a very fragile kind of bacteria, anyone with a functioning immune system has no real reason to worry about them causing systemic issues.

I get what you are trying to say about not scaring healthy patients, but calling these bugs “very fragile” misses how they actually behave inside a human mouth. A lot of the classic abscess organisms are obligate anaerobes, so yes, they die quickly if you drop them on a dry, oxygenated surface in the lab, but in vivo they are living in a sealed, low-oxygen niche inside necrotic pulp or deep periodontal pockets where immune cells and oxygenated blood cannot reach. That space is walled off from normal circulation, which is why a necrotic tooth does not sterilize itself and why we see chronic apical periodontitis that only resolves after root canal or extraction. On top of that, these organisms sit in mixed-species biofilms where facultative bacteria consume oxygen at the surface and create an anaerobic core that lets the “fragile” bugs thrive and resist both immune attack and antibiotics. So a healthy immune system can often contain the spillover around the root tip, but it cannot get into the canal to clear the source, which is why even immunocompetent adults walk around for years with persistent periapical lesions until the tooth is treated.


The more common problem in those “healthy” patients is not dramatic sepsis or a brain abscess, it is the constant low-grade inflammatory load the mouth is dumping into the rest of the body. Chronic apical and periodontal infections are associated with elevated systemic markers like CRP and pro-inflammatory cytokines (IL-6 and TNF-alpha), and longitudinal data link untreated periodontal disease with higher rates of cardiovascular disease, worse glycemic control in diabetes, increased risk for some adverse pregnancy outcomes, and so-called “sickness behavior” similar to what the OP is reporting, even after adjusting for the usual confounders. A contained abscess may not put someone in the ICU, but it can act like a slow IV of bacterial products and inflammatory mediators into the circulation, keeping the immune system in a chronically activated state that is not free physiologically even if the patient feels “fine.” From that standpoint, telling people with functioning immune systems they have “no real reason to worry” understates the price their body is already paying to hold the line. A more accurate reassurance in my view is: most serious catastrophes are rare if you are otherwise healthy and you get things treated promptly, but leaving a necrotic tooth or deep pocket to smolder for months or years is still a systemic burden, not a neutral choice.