A dental, or tooth, abscess is a pocket of pus, in the bone or surrounding tissue, that is caused by a bacterial infection. The abscess can occur at different areas around the tooth for different reasons. A periapical abscess occurs at the tip of the root, whereas a periodontal abscess occurs in the gums at the side of a tooth root. The information here refers specifically to periapical abscesses.

A periapical tooth abscess usually occurs as a result of an untreated dental cavity, from an injury, or prior dental work.

Dentists will treat a tooth abscess by draining it and getting rid of the infection. They may be able to save your tooth with a root canal treatment, but in some cases the tooth may need to be pulled. Know that leaving a tooth abscess untreated can lead to serious, even life-threatening, complications.

What are some signs of a dental abscess?

  • Severe, continuous, toothache that can radiate to different areas of the jaw, neck, or ear
  • Sensitivity to hot and cold temperatures
  • Sensitivity to the pressure of chewing or biting
  • Fever
  • Swelling in your face or cheek
  • Tender, swollen lymph nodes under your jaw or in your neck
  • Sudden rush of foul-smelling and foul-tasting, salty fluid in your mouth and pain relief, if the abscess ruptures
  • Difficulty breathing or swallowing
  • Persistent Sinus drainage

What causes an abscess?

A periapical tooth abscess occurs when bacteria invade the innermost part of the tooth that contains blood vessels, nerves and connective tissue. This is called the dental pulp.  Bacteria enters through either a dental cavity or a chip or crack in the tooth and spread all the way down to the root. The bacterial infection can cause swelling and inflammation at the tip of the root.

Risk factors

These factors may increase your risk of a tooth abscess:

  • Poor dental hygiene. Not taking proper care of your teeth and gums — such as not brushing your teeth twice a day and not flossing — can increase your risk of tooth decay, gum disease, tooth abscess, and other dental and mouth complications.
  • A diet high in sugar. Frequently eating and drinking foods rich in sugar, such as sweets and sodas, can contribute to dental cavities and turn into a tooth abscess.
  • Dry mouth. Having a dry mouth can increase your risk of tooth decay. Dry mouth is often due to the side effect of certain medications or aging issues.

Complications

A tooth abscess won’t go away without treatment. If the abscess ruptures, the pain may decrease significantly — but you still need dental treatment. If the abscess doesn’t drain, the infection may spread to your jaw and to other areas of your head and neck. You might even develop bacterial sepsis which is a life-threatening infection that spreads throughout your body.  If you have a weakened immune system and you leave a tooth abscess untreated, your risk of a spreading infection increases even more.

Prevention

Avoiding tooth decay is essential to preventing a tooth abscess. Take good care of your teeth to avoid tooth decay:

  • Use fluoridated drinking water.
  • Brush your teeth at least twice a day with a fluoride toothpaste.
  • Use dental floss or an interdental cleaner to clean between your teeth on a daily basis.
  • Replace your toothbrush every three or four months, or whenever the bristles are frayed.
  • Eat healthy by limiting sugary items and between-meal snacks.
  • Visit your dentist for regular checkups and professional cleanings.
  • Consider using an antiseptic or a fluoride mouth rinse to add an extra layer of protection against tooth decay.

See your dentist promptly if you have any signs or symptoms of a tooth abscess.  If you have a fever and swelling in your face and you can’t reach your dentist, go to an emergency room. Also go to the emergency room if you have trouble breathing or swallowing. These symptoms may indicate that the infection has spread deeper into your jaw and surrounding tissue or even to other areas of your body.