What is an abscessed tooth?

A tooth abscess is a pocket of pus from a bacterial infection. Abscesses can occur in different places around a tooth for different reasons and affect the involved tooth, but also the surrounding bone and sometimes adjacent teeth. Three types of tooth infections can cause abscesses:

  • Gingival: This infection develops in the gums. It does not usually affect the tooth or supporting structures.
  • Periapical: A periapical abscess is an infection that forms at the tip of the root. This occurs because bacteria can spread to the inside of the tooth to the pulp through a fracture or cavity. The pulp is the innermost part of the tooth that contains nerves and blood vessels. When bacteria invades the pulp, they can spread to the tip of the tooth’s root causing the infection to spread to the bone eventually leading to an abscess.
  • Periodontal: This infection starts in bone and tissues that support the tooth. A periodontal abscess usually results from periodontitis or gum disease and is more common among adults.

Who gets tooth infections?

You’re more likely to develop tooth infections if you:

  • Smoke: Smokers are about twice as likely to get tooth infections as nonsmokers.
  • Have dry mouth: Bacteria thrive in a mouth with a low amount of saliva.
  • Have poor dental hygiene: Regularly brushing, flossing and getting dental cleanings reduces bacteria.
  • Have a weakened immune system: Diseases or medications can lower your immune response, making it harder to fight off germs.

What are the complications of a tooth infection?

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

What causes a tooth abscess?

Anything that creates an opening for bacteria to get into the tooth or surrounding tissues can lead to a tooth infection. Causes include:

  • Severe tooth decay: A cavity, or tooth decay, is the destruction of the hard surfaces of the tooth. 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 disease (periodontitis): Gum disease is an infection and inflammation of the tissues around the teeth. As gum disease progresses, the bacteria gain access to deeper tissues.
  • Injury to the tooth: Trauma to a tooth can injure the inner pulp even if there’s no visible crack. The injury makes it susceptible to infection.

What are the symptoms of a tooth infection?

If your tooth is infected, your pain may be:

  • Gnawing or throbbing.
  • Sharp or shooting.
  • Continuous or only when chewing.
  • Radiating to the jawbone, neck or ear.

Other oral symptoms of infection include:

  • Tooth sensitivity to hot or cold temperatures.
  • Bitter taste in the mouth.
  • Foul-smelling breath.
  • Gum redness and swelling.
  • Loosening of the tooth.
  • Swollen area in the upper or lower jaw.
  • Open, draining sore on the side of the gum.

In addition, you may experience more generalized symptoms like:

  • Fever.
  • Swollen neck glands.
  • General discomfort, uneasiness or ill feeling.

Last reviewed by a Cleveland Clinic medical professional on 08/24/2020.

References

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