The pain is what usually gets your attention first. It is not just a little twinge, but a deep, throbbing ache in your tooth that refuses to be ignored. You may also notice swelling in your face or a bad taste in your mouth. If this sounds familiar, you might be dealing with a dental abscess, which requires immediate attention from a dental professional.
What Exactly is a Dental Abscess?
A dental abscess is a pocket of pus that is caused by a bacterial infection. It can form in different parts of a tooth for different reasons. Your body creates this pocket of pus, which contains dead white blood cells, tissue debris, and bacteria, to try to contain the spreading infection.
The problem is that the infection is trapped with nowhere to go. This builds up pressure within the soft dental pulp of your tooth or the surrounding gum and bone tissue, which causes that awful pain you feel. There are three main types of dental abscesses, and a dentist can tell you which one you have based on where the infection started.
Periapical Abscess
This is the most common type of tooth abscess, often called an apical abscess. A periapical abscess happens at the very tip of the tooth's root. The abscess bacteria enter the tooth through an untreated cavity, crack, or chip, allowing them to invade the inner chamber.
The bacteria travel down through the dental pulp, which is the soft tissue containing nerves and blood vessels, all the way to the root tip. That is where the abscess forms. It often comes from dental caries that have been left to worsen over time.
Periodontal Abscess
This type of abscess starts in the gums, not the tooth itself. It is a common complication of advanced gum disease, also known as periodontitis. This condition causes the gums to pull away from the tooth, creating small pockets that are difficult to clean.
Bacteria and plaque get trapped in these pockets. If they cannot drain properly, a serious infection can start. This leads to an abscess forming in the gum tissue right next to the tooth's root.
Gingival Abscess
A gingival abscess is a bit different from other dental abscesses. It happens only in the gum tissue and does not involve the tooth or the deep periodontal pockets. It's often caused by a foreign object, like a popcorn hull or toothbrush bristle, getting stuck in the gums.
This trauma can cause a localized infection and an abscess on the surface of the gums. These are often less severe and easier to treat than the other types. However, they still need a dentist's attention for proper abscess treatment.
| Abscess Type | Location | Common Cause |
|---|---|---|
| Periapical | Tip of the tooth root | Untreated tooth decay or cracked tooth |
| Periodontal | Gums, next to the root | Advanced gum disease |
| Gingival | Surface of the gums | Trapped foreign object |
Are You Seeing These Abscess Symptoms?
The most obvious sign of an abscess is a severe and persistent toothache. It might feel like a throbbing or shooting pain. The dental pain can even radiate to your jaw, neck, or cause ear pain.
You might not know for sure if you have an abscessed tooth. But there are some common tooth abscess symptoms you can look for. Recognizing these signs can help you seek professional dental care quickly.
- A toothache that is severe, constant, and throbbing.
- Pain that gets much worse when you lie down.
- Sensitivity to hot or cold temperatures in your food or drinks.
- Pain when you bite down or chew.
- Swelling in your cheek or face.
- Tender, swollen lymph nodes under your jaw or in your neck.
- A sudden rush of foul-smelling and foul-tasting salty fluid if the abscess ruptures.
- Fever or just a general feeling of being unwell.
- Trouble opening your mouth or swallowing.
If the pain from your tooth suddenly stops, do not assume the problem is gone. An abscess that ruptures can relieve the pressure and the intense pain associated with it. However, the infection is still there and requires dental treatment from a qualified professional.
What Causes a Tooth Abscess to Form?
At its core, a tooth abscess is caused by bacteria getting where it should not be. An abscess is the final stage of an untreated tooth infection. Several different dental problems can open the door for this kind of infection.
Severe Tooth Decay
This is a leading cause of a periapical abscess. A cavity, also known as dental caries, is a hole in your tooth caused by decay. If it is not filled, the tooth decay goes deeper and deeper into the tooth.
Eventually, it reaches the soft inner dental pulp that contains nerves and blood vessels. Once abscess bacteria enter the pulp, it can get infected, die, and lead to an abscess at the root.
Gum Disease (Periodontitis)
Severe gum disease is a main cause of a periodontal abscess. As the National Institute of Dental and Craniofacial Research explains, gum disease causes the gums to pull away from the teeth. This creates pockets that trap bacteria and are hard to clean with normal brushing.
When these pockets get deep, the trapped bacteria multiply and cause an infection in the gum tissue. This can easily lead to a periodontal abscess forming. Good oral health habits can help prevent this progression.
A Cracked or Chipped Tooth
Any crack or chip in a tooth creates an opening for bacteria. It acts like a direct path for bacteria to get to the pulp. Even a tiny, invisible crack is enough for bacteria to invade the tooth.
Once bacteria get inside, they can cause an infection and an abscess, just like with deep tooth decay. This can happen from an injury during sports or just biting down on something hard. This is why protecting your teeth is so important.
Other Risk Factors
Certain factors can increase your risk of developing dental abscesses. Poor dental hygiene is a major contributor, as it allows plaque to build up and cause decay or gum disease. A diet high in sugar also feeds the bacteria that cause dental caries.
Medical conditions that result in a weakened immune system can make you more susceptible to infections, including in your mouth. Similarly, a chronically dry mouth means there is less saliva to wash away food particles and neutralize acids, increasing your risk for many dental problems.
The Serious Dangers of an Untreated Dental Abscess
An abscessed tooth is more than just a bad toothache. It is a serious infection that your body is fighting. Ignoring it and hoping it goes away on its own is a dangerous mistake.
The infection from a dental abscess will not clear up by itself. Without tooth abscess treatment, the infection can spread to other parts of your body. Some of these complications are very serious and can become a life-threatening infection.
One risk is losing the tooth. The infection can destroy the bone that supports the tooth, making it become loose. At that point, a dentist may not be able to save it. The infection spread can also reach your jawbone, a condition called osteomyelitis, which requires aggressive medical treatment.
The most serious risk is a spreading infection. Bacteria from abscessed teeth can enter your blood vessels and travel throughout your body. This can lead to sepsis, a life-threatening medical emergency. According to the CDC, sepsis is the body's extreme response to an infection and needs immediate hospital care.
Other rare complications include Ludwig's angina, where the infection spreads to the floor of your mouth and causes such severe swelling that it leads to difficulty breathing. An infection from an upper tooth can spread to the maxillary sinus or even the cavernous sinus, a network of veins near the brain, which could lead to meningitis or a brain abscess. An abscess untreated is a significant risk to your overall health.
When is it an Emergency?
Most dental abscesses can be handled by a dentist during normal hours. But, you should know the signs that mean your tooth infection has become a true medical emergency. You should go to the emergency room immediately if you have a toothache and also experience any of the following:
- A high fever and chills.
- Facial swelling that is large or makes it hard to breathe or swallow.
- Swelling that is closing your eye.
- An inability to fully open your mouth.
- A very rapid heart rate.
- Feeling confused or lightheaded.
These are signs that the infection is spreading rapidly through your body. The medical professionals in the emergency room can give you IV antibiotics and drain the abscess to get the infection swelling under control. You will still need to see a dentist later for dental treatment to fix the underlying tooth problem.
How a Dentist Fixes a Tooth Abscess
When you see a dentist, their first goal is to get rid of the infection. They also want to relieve your mouth pain and, if possible, save your tooth. The exact abscess treatment depends on what type of abscess you have and how bad it is.
The process almost always starts with a dental X-ray. This helps the dentist see exactly where the abscess is located. It also shows if the infection has spread to the bone surrounding the root.
Draining the Abscess
The very first step is often to drain the pocket of pus. This immediately relieves the pressure and much of the pain. Your dentist will make a small cut into the abscess to let the pus out, providing immediate pain relief.
After draining it, they will clean the area thoroughly with a saline solution. This procedure alone can make you feel a lot better. But it is just the first step in the full course of dental treatment.
Root Canal Treatment
If the abscess is periapical, you will likely need a root canal treatment. This procedure saves your natural tooth. During the canal treatment, the dentist drills into the tooth, removes the infected pulp, and thoroughly cleans the inside canals of the tooth root.
Then, they fill and seal the space to prevent another infection. According to the American Association of Endodontists, a root canal is a very effective procedure for treating an abscessed tooth. The tooth will often need a crown afterward for protection and to restore its function.
Tooth Extraction
Sometimes, the tooth is too damaged to be saved. If a root canal treatment isn't possible, the dentist may need to pull the tooth. This creates an open path for the abscess to drain and heal completely.
Having a tooth extracted is never the first choice. But sometimes it is the only way to fully get rid of the infection. You can discuss tooth replacement options like a dental implant or bridge later.
Antibiotics
Your dentist will likely prescribe antibiotics to help your body fight the infection. These are especially important if the infection has started to spread beyond the abscess site. It is critical to take the full course of antibiotics as prescribed.
You need to finish them even if you start feeling better. This ensures all the bacteria are killed and prevents the development of antibiotic-resistant bacteria.
What Can You Do For Pain Relief at Home?
The pain of a dental abscess can be intense. While you are waiting for your dental appointment, you need some way to manage it. These are not cures, but they may offer temporary help with tooth abscess symptoms.
Remember, home remedies will not fix a dental abscess. They are only for managing symptoms until you can get professional dental care. You must see a dentist for proper care and treatment.
- Rinse your mouth with warm salt water. This can help soothe the gums and may draw out some of the pus.
- Apply a cold compress to the outside of your cheek. This can help reduce infection swelling and numb the pain.
- Take over-the-counter pain medicine like ibuprofen or acetaminophen. Follow the directions on the package.
- Avoid very hot or cold temperatures in foods and drinks that trigger sensitivity.
- Try to chew your food on the opposite side of your mouth to reduce pressure on the affected tooth.
Do not place an aspirin directly on the tooth or gums. This is an old myth and can cause a painful chemical burn on your gum tissue. Stick to safe and approved methods for pain relief.
Can You Prevent a Dental Abscess?
The best way to deal with a dental abscess is to never get one in the first place. Thankfully, prevention is possible with good oral care and regular visits to your dentist. It is all about stopping bacteria from causing dental problems before they start.
Taking good care of your teeth every day is the most important step for your oral health. Small habits make a big difference over time. You can lower your risk by following these steps recommended by the American Dental Association:
- Practice good dental hygiene by brushing your teeth twice a day for two minutes with a fluoride toothpaste.
- Floss between your teeth every single day to remove plaque that brushing teeth can't reach.
- Visit your dentist regularly for checkups and professional cleanings. This allows them to catch cavities and gum disease early.
- Limit your intake of sugary foods and drinks that feed harmful bacteria.
- If you play contact sports, always wear a protective mouthguard to prevent injuries that can crack teeth.
Conclusion
Dealing with a dental abscess is a serious situation. The pain can be overwhelming, and the infection can pose a real threat to your overall health if it is not treated. It is not something that will go away if you just ignore it.
Seeking prompt care from a dentist is the only way to resolve a tooth abscess for good and prevent dangerous complications. Remember that excellent oral care, including regular checkups and good daily habits, is the best defense against abscessed teeth.
Taking care of your teeth is one of the best things you can do for your health. If you experience any tooth abscess symptoms, contact your dentist immediately. Your mouth and your body will thank you.