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What Is a Tooth Abscess?

A tooth abscess, or dental abscess, is an infection of the mouth, face, jaw, or throat that begins as a gum infection, tooth infection, or cavity. These infections are common in people with poor dental health and result from lack of proper and timely dental care.

Different kinds of tooth abscesses include:

  • Periapical: This is the most common type. It happens when bacteria infect the pulp inside one of your teeth.
  • Periodontal: This is when bacteria infect your gums.
  • Gingival: This type is usually caused by something that gets stuck in your gums, like a food particle or a broken tooth.

Tooth Abscess Symptoms

Symptoms of a tooth abscess typically include:

  • Pain
  • Swelling
  • Redness of your mouth and face
  • A bad taste in your mouth
  • Sensitivity to hot or cold foods or liquids

Symptoms of advanced infection may include:

Other signs of an abscess might include, but are not limited to:

  • Cavities
  • Gum inflammation
  • Oral swelling
  • Tenderness with touch
  • Pus drainage
  • A hard time fully opening your mouth or swallowing
  • General discomfort
  • Swollen glands in your neck or upper or lower jaw (a very serious sign)

When to seek medical care for a tooth abscess

If you think you have an abscess, call your dentist. If you cannot reach a dentist, go to a hospital’s emergency department for evaluation, especially if you feel sick.

  • If an infection becomes so painful that it can’t be managed by nonprescription medicines, see your doctor or dentist for drainage.
  • If you get a fever, chills, nausea, vomiting, or diarrhea as a result of a tooth abscess, see your doctor.
  • If you have pain you can’t stand, or a hard time breathing or swallowing, seek medical care right away in the emergency room.

Tooth Abscess Causes

The cause of tooth abscesses is direct growth of bacteria from a cavity into the soft tissues and bones of the face and neck.

  • Bacteria from a cavity can extend into the gums, the cheek, the throat, beneath the tongue, or even into the jaw or facial bones. A tooth abscess can become very painful when tissues become inflamed.
  • Pus collects at the site of the infection and will become more painful until it either ruptures and drains on its own or is drained surgically.
  • Sometimes the infection can get to the point where swelling threatens to block the airway, making it hard to breathe. Dental abscesses can also make you generally ill, with nausea, vomiting, fevers, chills, and sweats.

An abscess can form when an infected tooth doesn’t get the right dental care. Poor oral hygiene (such as not brushing, flossing, or rinsing properly or often enough), smoking, alcohol, a poor diet, and certain medical conditions and medications can make it more likely that cavities will form in your teeth. The infection can spread to your gums and nearby areas and become a painful tooth abscess.

Continued

Tooth Abscess Diagnosis

A doctor or dentist often can use a physical exam to tell if you have a drainable abscess. X-rays of the teeth may be necessary to show small abscesses that are at the deepest part of the tooth.

Tooth Abscess Treatment

Home treatment

Many people who have cavities or toothaches can take NSAIDs, or nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen, or pain medicine such as acetaminophen as needed to relieve pain. Check with your doctor first if you have any medical problems or if you take any other medicines.

If an abscess ruptures by itself, warm water rinses will help cleanse the mouth and encourage drainage.

Medical treatment

The doctor may decide to cut open the abscess and allow the pus to drain. It can also be drained through the infected tooth at the start of a root canal procedure. Unless the abscess ruptures on its own, these are usually the only ways that the infection can be cured.

People with dental abscesses are typically prescribed pain relievers and, at the discretion of the doctor, antibiotics to fight the infection. An abscess that has extended to the floor of the mouth or to the neck may need to be drained in the operating room under anesthesia.

Follow-up care

With a dental abscess, as with every other illness, follow your doctor’s instructions for follow-up care. Proper treatment often means reassessment, multiple visits, or referral to a specialist. Cooperate with your doctors by following instructions carefully to ensure the best possible health for you and your family.

Prevention of a Tooth Abscess

Prevention plays a major role in maintaining good dental health. Daily brushing and flossing, and regular dental checkups can help prevent tooth decay and tooth abscesses.

  • Remember to brush, floss, and rinse as directed by your dentist.
  • If tooth decay is found early and treated promptly, cavities that could lead to abscesses can usually be corrected.
  • Avoid cigarette smoking, and don’t drink too much alcohol.

Outlook for Tooth Abscesses

The recovery is good from a small dental abscess, once it has ruptured or been drained. If the symptoms are improving, it’s unlikely the infection is getting worse. You’ll need follow-up care with your dentist to reassess your infection and to take care of the problem tooth. For example, you may need to have the tooth pulled or have a root canal performed on it.

If it’s not treated, a tooth abscess can spread to the floor of the mouth or to the neck and threaten your airway and ability to breathe. This may be life-threatening unless it’s properly drained.

An untreated infection also can spread to your jaw or other parts of your head or neck. In some cases, it can lead to sepsis, which is a serious infection that spreads through your body.

Medical Reference Reviewed by Hansa D. Bhargava, MD on July 16, 2020

Sources

SOURCES:

Columbia University College of Dental Medicine: “Abscess.”

Dental Abscess from eMedicineHealth

American Dental Association. 

MedlinePlus: “Tooth abscess.”

eMedicineHealth: “Dental Abscess.”

Michael Martin, MD, staff doctor, Department of Emergency Medicine, Temple University.

Jacob W. Ufberg, MD, assistant professor, Department of Emergency Medicine, Temple University School of Medicine.

College of Dental Hygienists of Ontario: “Dental Abscess.”

Cleveland Clinic: “Abscessed Tooth.”

Mayo Clinic “Total Abscess.”