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Tooth Abscess

Last updated Feb. 20, 2018

Approved by: Maulik P. Purohit MD, MPH

A Tooth Abscess is a painful dental disorder in which there is collection of pus, due to a tooth infection. It is also commonly known as a Dental Abscess.

What are the other Names for this Condition? (Also Known as/Synonyms)

  • Dental Sepsis
  • Periapical Abscess
  • Tooth Infection

What is Tooth Abscess? (Definition/Background Information)

  • A Tooth Abscess is a painful dental disorder in which there is collection of pus, due to a tooth infection. It is also commonly known as a Dental Abscess
  • The tooth may be infected, due to decay, or the tooth may be partially broken. It may also be caused by any disease that affects the gums (gingiva) and tissues surrounding the tooth
  • An early treatment of this condition is highly advisable, for a lack of treatment (or a delay in treatment) may cause significant complications, such as bacterial infections, bone marrow infection, etc.
  • The prognosis is good with early intervention and in such cases, the tooth may not need to be removed

Based on the location of pus-formation and collection, there are 2 different types of Tooth Abscess:

  • Periapical Abscess - most common type, when the pus (abscess) accumulates under the tooth
  • Periodontal Abscess - when pus forms in the adjoining gums and bones

Who gets Tooth Abscess? (Age and Sex Distribution)

  • Any individual, regardless of age or sex, may suffer from a Tooth Abscess
  • However, the condition is not very common among young children

What are the Risk Factors for Tooth Abscess? (Predisposing Factors)

Following are a few risk factors for Tooth Abscess:

  • Lack of good oral hygiene
  • Regularly consuming food and drinks that are rich in carbohydrates and sugars
  • Decayed tooth, which is left untreated

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Tooth Abscess? (Etiology)

  • The most frequent cause of a Tooth Abscess is severe dental caries (or tooth decay), which has been left untreated for a while
  • Any injury leading to a broken/cracked tooth, which permits bacteria to enter and infect it, causing abscess formation
  • Sometimes a  dental procedure (e.g. root canal treatment), may cause trauma to the adjoining teeth, leading to a Dental Abscess

What are the Signs and Symptoms of Tooth Abscess?

The most common indication of a Tooth Abscess is constant and intense (sometimes mild) toothache. The other signs and symptoms are:

  • Bad odor from the mouth; bitterness in the mouth
  • Experiencing pain while eating, chewing, clenching the teeth
  • Extreme tooth sensitivity to hot or cold substances
  • Swollen mouth, gums, or jaws
  • Fever
  • Swelling of the glands on the neck; cheeks may appear puffy
  • Unable to open one’s mouth, due to pain

How is Tooth Abscess Diagnosed?

Diagnostic tests performed to diagnose Tooth Abscess include:

  • An oral examination by the dentist
  • On gently tapping the tooth with a blunt instrument, sensitivity or a sharp pain may be felt
  • Sensitivity tests (to check for tooth sensitivity to temperature)
  • Dental x-rays

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Tooth Abscess?

Complications usually develop, when Dental Abscess is left untreated, or the treatment is delayed. These may include:

  • A severe type of soft tissue bacterial infection, called facial cellulitis, may occur. This condition may progressively worsens to develop into Ludwig’s angina, a life-threatening disorder in which there is swelling in the floor of mouth and neck, causing difficulty breathing
  • Osteomyelitis, a bone marrow infection of the jawbone
  • Infection spreading to the blood (termed sepsis)
  • The infection may spread to other vital organs of the body, such as the brain, lung, or heart
  • The swollen pus-filled protrusion/boil could burst, leading to drainage (external) of the fluid
  • Any drainage (internal) into the underlying tissues, which requires urgent medical attention
  • There may be excessive and severe pain

How is Tooth Abscess Treated?

Quick and appropriate action to treat the infection and save the tooth is the prime focus of the treatment. This can prevent unwanted complications, leading to life-threatening situations.

  • Orally administered antibiotics are effective in treating the infection; medications may also be taken to relieve pain and fever
  • Keep the area clean; use salt water gargling or warm compresses to soothe the condition
  • Surgical intervention in the form of a root canal may be necessary to clean the infection and restore/retain at least a part of the teeth
  • If the teeth cannot be saved, then it is removed - a dental surgeon will decide on the treatment, after appropriate evaluations
  • Any abscess  needs to be incised and drained; additional treatments may be required, if they recur or do not heal, due to several other reasons

How can Tooth Abscess be Prevented?

A few tips to help prevent Tooth Abscess include:

  • Maintaining regular and proper oral hygiene can ensure that the mouth, tongue, and teeth remain clean
  • Good oral hygiene prevents common problems, such as tooth decay (dental cavity), gum inflammation caused due to gingivitis, bad breath, and so on
  • Dentists recommend periodic examinations and cleaning, to monitor oral health on a regular basis
  • Create an awareness of the importance of oral health in children, from an early age
  • Do seek early dental attention, if there are any teeth-related issues, like sensitivity, decay/cavity, loosened or chipped tooth

What is the Prognosis of Tooth Abscess? (Outcomes/Resolutions)

  • Dental (Tooth) Abscesses can be effectively treated and cured. If an early treatment is provided, in many cases, the dental surgeon can save the tooth
  • If the condition is ignored or is left untreated, then the infection can spread, making it painful, difficult to eat or speak, necessitating hospitalization
  • Some cases of untreated Tooth Abscess may turn into critical and at times fatal medical conditions, like sepsis, where the infection spreads to the blood stream

Additional and Relevant Useful Information for Tooth Abscess:

The structural damage caused to the teeth, leading to the formation of holes or cavities in the teeth, is termed as dental cavities. It is a common disorder responsible for tooth loss in young individuals.

The following article link will help you understand dental cavities:

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Aug. 7, 2014
Last updated: Feb. 20, 2018