Abscessed Tooth

A tooth abscess is a pocket of pus from a bacterial infection in your gums. An abscess usually looks like a red, swollen bump, boil or pimple. It affects the involved tooth, but the infection can also spread to surrounding bone and neighboring teeth. Abscesses can occur in various places around a tooth for different reasons.

Three types of tooth infections can cause abscesses:

• Gingival: This infection develops in your gums. It doesn’t usually affect your tooth or supporting structures.
• Periapical: A periapical abscess is an infection that forms at the tip of your tooth root. If you have a tooth that’s decayed or fractured, bacteria can enter your tooth and spread to the innermost part (pulp). When bacteria invade the pulp, infection can spread to the tip of your tooth’s root, then eventually, to the surrounding bone, causing an abscess to form.
• Periodontal: This infection starts in the bone and tissues that support your teeth. A periodontal abscess usually results from gum disease and is more common among adults.

Left untreated, a tooth abscess can spread to your jawbone, the soft tissues of your face and neck, and beyond. In extremely rare cases, the infection can travel to your heart (endocarditis) and brain (bacterial meningitis).

This is why it’s so important to see a dentist as soon as possible if you have symptoms of a tooth abscess.

Symptoms of an abscessed tooth

A tooth abscess can cause severe tooth pain. It may feel shooting, throbbing or like it’s radiating to your ear, jaw or neck. It may hurt all the time or only when you’re chewing.

Other symptoms include:

• Bad breath or a bitter taste in your mouth
• Gum redness and swelling
• Loosening of the affected tooth
• Swelling in your upper or lower jaw
• Swollen lymph nodes
• Open, draining sore on the side of your gums
• Fever

Tooth abscess causes

Anything that creates an opening for bacteria to get into a tooth or surrounding tissues can lead to an abscess, such as:

• Severe cavities: A cavity (tooth decay) destroys your tooth’s hard surface. This occurs when bacteria break down sugars in food and drink, creating acid that attacks enamel.
• Broken, chipped or cracked teeth: Bacteria can seep into any opening in a tooth and spread to the pulp.
• Gum (periodontal) disease: Gum disease is an infection and inflammation of the tissues around your teeth. As gum disease progresses, the bacteria can access deeper tissues.
• Injury to a tooth: Trauma to a tooth can injure the inner pulp even if there’s no visible crack. The injury makes it susceptible to infection.

Risk factors

You’re more likely to develop an abscessed tooth if you:

• Smoke: People who smoke are about twice as likely to get tooth abscesses as people who don’t.
• Have dry mouth: Bacteria thrive in a mouth with a low amount of saliva (spit).
• Have poor oral hygiene: Bacteria can build up if you don’t regularly brush, floss and get dental cleanings.
• Have a weakened immune system: Diseases and some medications can lower your immune response, making it harder to fight off germs.

How is an abscessed tooth diagnosed?

In addition to examining the tooth and surrounding tissue for signs of infection, your dentist may:

• Recommend a dental X-ray: This can help identify sources of dental disease that may have led to the abscessed tooth. X-rays can also show if the infection has spread.
• Recommend a CT scan: If the infection has spread to other areas within your neck, this will help to identify the extent of the infection.
• Tap and press on your teeth: A tooth with an abscess is often sensitive to touch or pressure.
• Do thermal tests: These tests will help your dentist assess the health of your tooth pulp.

How do you treat a tooth abscess?

The goals of treatment are to eliminate the infection and prevent complications. Treatment options include:

• Incision and drainage: Your dentist makes a small incision (cut) in the abscess to drain the pus. They may also place a small rubber drain. This keeps the area open so the infection can drain out.
• Root canal: This helps get rid of the infection and save your tooth. A dental provider will remove your tooth’s infected pulp and fill the space with material to prevent another infection. Afterward, your tooth should be back to normal, though you may need a dental crown to protect the root canal. If you care for the restored tooth properly, it can last the rest of your life.
• Tooth extraction: Sometimes, an abscessed tooth becomes damaged beyond repair. In these cases, your dentist may need to extract (pull) it.
• Antibiotics: You may need antibiotics to help with your treatment. The medicine may help fight off remaining bacteria, but it won’t get rid of the cause of the infection — the affected tooth.

How soon after tooth abscess treatment will I feel better?

A tooth abscess should clear up after treatment. Temporary sensitivity is common, and it may take a few days to feel completely back to normal.

As every case is unique, healing times can vary. Ask your dentist what to expect after your tooth abscess treatment.

When should I see a dentist?

If you develop mouth pain, a toothache or a red, swollen bump on your gums, schedule an appointment with a dentist right away. The sooner you get treatment, the less likely it is that the infection will spread beyond your tooth.

Head to your nearest emergency room if you have a tooth abscess accompanied by:

• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher
• Confusion
• Difficulty swallowing
• Elevated heart rate
• Facial swelling

Can a tooth abscess go away by itself?

A tooth abscess won’t go away on its own. Pain may stop if an infection causes the pulp inside your tooth to die. The pain stops because the nerves in the pulp aren’t working anymore, so you may not be able to feel it. But the bacteria will continue to spread and destroy surrounding tissue.

If you have tooth abscess symptoms, seek care even if you no longer have pain.

How long can a dental abscess go untreated?

Left untreated, a tooth abscess will eventually spread to the surrounding tissues and beyond, wreaking havoc on your oral and overall health. It can take days, weeks or months for the infection to spread — and it’s impossible to know exactly how long that will take. Because tooth abscesses don’t go away on their own, it’s critical that you see a dentist as soon as possible.

How can I relieve the pain of a tooth abscess?

Tooth pain is a sign that you should see your dentist. While you wait for your appointment, warm saltwater rinses and over-the-counter pain relievers (like acetaminophen, naproxen or ibuprofen) can ease discomfort.

But it’s important to remember that there isn’t a tooth abscess home remedy that can permanently solve the issue.

Can this be prevented?

You can reduce your risk of developing a tooth abscess by seeing your dentist routinely and getting regular dental check-ups and cleanings. It’s also important to see your dentist if a tooth becomes loose or chipped.

Remember that proper oral hygiene is essential for dental health. At home, brush your teeth twice a day and floss once a day.

What is the difference between an infected tooth and an abscessed tooth?

All tooth abscesses are also infections. But not all tooth infections lead to an abscess (pocket of pus).

If it helps, think of an abscessed tooth as a sign of a severe tooth infection. The pocket of pus contains dead tissue and dead or dying white blood cells — your body’s infection fighters. Pus is like the rubble that remains after your immune system does battle with a major infection.

But the pus contains the bacteria that are still around and ready to do even more damage. It can spread without treatment.

This is why you want to get treatment for dental infections so they don’t become abscessed.