Tooth abscess 101 – everything you need to know
Worried that your toothache or worsening oral health symptoms might be turning into a tooth abscess?
Well… what even is a tooth abscess? And how do they form?
Let’s talk about the causes, symptoms, risks and treatment options for the different types of dental abscess.
In this article:
Start here – what even is a tooth abscess?
An ‘abscess’ anywhere on the body is a pocket on or within your body which fills with pus. A tooth abscess (also known as a dental abscess) is the same thing, but inside your mouth.
Tooth abscesses can form inside your teeth, on your gums or in the bones that hold your teeth where they’re meant to be.
Different types of dental abscess
There are three main types of dental abscess:
Periapical abscess: Which forms in the root of a tooth, where bacteria has entered through a crack or cavity in the enamel and infected the tooth pulp (that’s the soft bit inside your teeth).
Periodontal abscess: Which forms in the space between your gum and the base of a tooth, called a periodontal pocket. When these pockets form, often due to advanced gum disease and receding gums, bacteria is given a place to grow and thrive – leading to infection.
Gingival abscess: Which forms on the gum itself, oftentimes because food has gotten stuck and left an opening for bacteria to enter.
While different to one another, each of these types of tooth abscess are very serious and generally require medical treatment from a professional. As a common symptom of bacterial infection they can create other complications, leading to long-lasting (even permanent) damage in the mouth.
Tooth infection vs. tooth abscess
An abscess is often an advanced symptom of a tooth infection.
So, while a tooth infection may start differently, causing extra sensitivity to hot or cold, some swelling, pain and recurring bad breath, when left to advance it can form an abscess which may then lead to worsening symptoms.
A tooth infection can turn into an abscess within a matter of days, or it may take considerably longer – depending on the extent of infection, and your individual mouth.
Gum disease vs. tooth abscess
Dental abscesses are a symptom of periodontitis, an advanced form of gingivitis (both being terms for different stages of gum disease).
If damage to the gums due to infection causes them to pull back, they can form that periodontal pocket we mentioned earlier which in turn can form a periodontal abscess.
Tooth abscess vs. cavities and ulcers
A tooth abscess is a pocket filled with pus, caused normally by infection.
Cavities are cracks, holes and fissures which form in the teeth due to decay. If cavities allow bacteria to enter the soft inside of a tooth, this can lead to a periapical abscess.
Ulcers are sores caused by breaks in the sensitive lining of your gums, often looking like red craters or bumps. Sometimes they are one-offs, occasionally they reoccur, and they’ll usually heal by themselves.
Learn more: about mouth ulcers
Symptoms of an abscessed tooth
Toothache, often persistent and severe.
Pain radiating elsewhere in the face, including jaw, neck and ears.
Pain and pressure when lying down.
Swollen, tender gums around a particular area.
Chronic bad breath.
Taste of pus in the mouth.
Increased tooth sensitivity.
Stiffness or difficulty opening your mouth, swallowing or sleeping.
Tender lymph nodes under the jaw or in the neck.
Fever.
How to spot a tooth abscess in your mouth
First, if you have any of the symptoms we just listed above it’s possible you have an infection in your mouth – which may be a tooth abscess, or an alternate oral health issue (such as gum disease).
You may notice pus forming next to or draining from one of your teeth, or that your infection symptoms are clustered around a particular area. Depending on the type and severity of your abscess, you may find one of your teeth is a bit looser than normal.
Basically, abscessed teeth are very serious! If you have any of these symptoms, it’s important that you seek medical advice from your dentist as soon as possible.
What causes a tooth abscess?
The different types of tooth abscess can have a few causes. We’ve listed some of the more common ones here:
Tooth decay: Decaying teeth can open up cracks and fissures in your enamel, allowing bacteria to get inside.
Damaged teeth: Damage to your teeth due to injury can also provide a pathway for bacteria to get inside.
Formation of periodontal pockets: Periodontal pockets can fill with bacteria and cause an abscess. The pockets themselves can have a few causes, like receding gums, and plaque or tartar.
Untreated gum disease: Gum disease can allow for the formation of teeth abscesses because it erodes gum and bone tissue, and can encourage more bacteria to grow.
Impacted teeth: Sometimes teeth, like wisdom teeth, get stuck beneath the gums rather than popping through. If the conditions are right, this could enable bacteria to collect, grow and turn into an abscess.
Other risk factors which can lead to a tooth abscess
Compromised immune system: If you have a condition or prior disease which compromises your immune system, this may affect your body’s ability to fight off infection.
Diet: Certain dietary choices can increase the likelihood of bacteria forming and turning into tartar. These include high-sugar and high-alcohol diets.
Smoking: Smoking is connected to a range of oral health issues, one of which is risk of infection.
Dry mouth: People with chronic dry mouth sometimes find they are at higher risk of infection because saliva is one of the body’s natural defence mechanisms. Without it, bacteria may have more chances to thrive.
Stress: There is a link between stress and oral health problems. While we can’t say it causes infections in the mouth, it appears to be a contributing risk factor.
How do the symptoms of a tooth abscess progress?
Early stages
In the early stages, you may not be able to detect very much at all.
Early-stage decay and disease can be mild in nature, including only a bit of swelling or inflammation, extra sensitivity, the beginnings of discolouration, and some aches and pains – particularly when chewing.
These symptoms are signs that bacteria is trying to thrive, either by damaging your enamel or infecting your gum tissue.
Middle stages
Here some of the symptoms will likely be getting worse. Those aches could be turning into throbbing pains which are more severe, and the swelling will likely have grown – and could also be affecting your cheeks and jaw too.
If your issue is tooth decay, you may find that your sensitivity has gotten even worse – especially if the bacteria has burrowed past your enamel into the dentin (the layer beneath your enamel) and the pulp below.
You may notice your gums being pulled away from the affected tooth, a sign that recession is occurring and a pocket may be forming.
Later stages
It is in the later stages that your abscess is most likely to form (though, a reminder that everyone’s mouth is different and this all can happen quite differently depending on the person).
Here the pain will likely be more severe, leading to a constant toothache deep inside the tooth. All the swelling, stiffness and tenderness will likely be more severe too.
Depending on where your tooth abscess is forming, you may notice pus seeping out from under your gums at this stage. Other signs of infection are also likely to occur, such as feverishness and feeling generally unwell.
What happens if I leave my dental abscess alone?
Infection of the mouth can lead to a number of worsening symptoms, as well as long-lasting damage. Some of these complications include:
Further decay: A decayed tooth may eventually lose the structure which holds it in place and fall out as a result.
Spreading infection: If the infection spreads, it can take all of its symptoms with it - that means swelling and pain might move to other parts of the mouth, jaw and face. This can cause more damage (not to mention discomfort!), leading to further tooth, gum and jaw problems.
Sepsis: Should your infection spread into your bloodstream, it can cause a condition known as sepsis. Sepsis is extremely serious, and can be life threatening.
Is a tooth abscess life-threatening?
A tooth abscess on its own is not generally life-threatening, though it is linked to a number of complications which can have a lasting impact on your oral health.
That said, connected conditions such as sepsis can be life-threatening.
Whether your tooth abscess is in its early stages or it has grown severe, either way the best course of action is generally to visit your dentist – it’s not something you can treat easily at home.
How to treat a tooth abscess
What to do immediately
If you notice any of the symptoms we’ve described above, it’s time to visit the dentist.
A tooth abscess cannot easily be treated at home, and typically requires a professional to safely drain and treat the issue - as well as diagnose and treat the broader oral health issues which led to its formation.
Will the dentist pull my abscessed tooth?
If caught early enough, it may not be necessary to pull an abscessed tooth. If the tooth is able to be saved through treating the infection or a procedure such as a root canal, you may be safe from having it removed.
When a dentist may recommend that a tooth is extracted is when the decay is severe enough that it cannot be safely treated.
Professional tooth abscess treatments
Every mouth is a bit different, so your dentist will need to examine your condition and make personal recommendations as to the best course forwards. That said, these are some of the common abscess treatments that dentists use:
General treatment
This involves finding the abscess, draining the pus, removing any debris and treating the infection site.
Filling cavities
If tooth decay led to your tooth abscess, your dentist may fill in those cavities or seal them over to prevent more bacteria from getting in.
Scaling and root planing
Scaling and root planing is a procedure which removes plaque and tartar from your teeth, and below the gum line. Plaque and tartar can be big contributors to teeth decay, so this is a bit of a ‘reset’ on the cleanliness of your mouth.
Root canal
A root canal treatment removes dead or dying tissue from inside your tooth and replaces it with a synthetic alternative. This could help save the tooth from further decay, ensuring that it does not need to be removed.
Capping the repaired tooth with a crown can further protect it from damage.
Tooth extractions, implants and bridges
If the tooth cannot be saved, it may need to be extracted.
To fill the gap where the tooth used to be, and ensure you can keep chewing the way you’re used to (and maintain the look of your smile!), your dentist may recommend either a dental bridge or implant.
All of the above are very common dental treatments which often sound scarier than they really are. Not sure about any of them? Talk to your dentist about your worries and they’ll help you out.
We also have some advice on dental phobia.
Home remedies and self care
Reminder: A dental abscess cannot generally be treated at home.
If you’re worried about infection, it’s very important you seek professional medical advice before trying anything at home. Your dentist will be able to recommend home-care tips if they’re relevant for your mouth.
Some of the treatments they may recommend include:
Pain relief
Non-steroidal antiinflammatory drugs (NSAIDs) such as ibuprofen may help if you’re experiencing aches and pains as a result of swelling.
Hot or cold compress
Hot and cold compresses can be quite soothing on an aching face or jaw.
Use a cold compress to soothe the symptoms of swelling and tenderness.
Use a hot compress for general aches and pains.
Salt water rinse
Rinsing the mouth with salt water is a common piece of advice from dentists, usually recommended to help the healing process after a dental procedure and to relieve some of the symptoms of inflammation or infection.
To make a rinse, add a teaspoon of salt to a cup of warm water and swoosh some of that about your mouth a couple of times daily, or as otherwise instructed.
Preventing a tooth abscess from coming back
So, let’s say you’ve done all the good work, you’ve seen your dentist and you’ve been treated for that abscess. How do we prevent it from coming back?
Well, the good news is that it’s not too difficult – given an abscess is typically a symptom of infection, you can reduce the chances of one coming back by maintaining best practice oral hygiene.
Best practice oral hygiene tips for preventing a tooth abscess
Brush your teeth twice a day, making sure to get the fronts, backs and chewing surfaces, as well as your gums and tongue.
Use a fluoride-containing toothpaste as this can help fight bacteria better.
Floss regularly in the morning, evening or after a meal – once a day is usually enough.
Consider switching to a soft-bristled toothbrush if you find your mouth is prone to irritation, or is feeling quite tender.
Consider switching to an electric toothbrush over a manual one.
Additionally, make sure to seek out a dental check-up at least once a year – though you might want to go twice a year if you’re a person at a higher risk of developing oral health issues.
This will ensure your dentist can stay on top of your oral health, and guide you if they spot any developing symptoms.
Need that appointment? Come in to see us
Our team of friendly dental experts are here for you when you need help with your oral health. Book an appointment online, call us on 09 430 0707, or come in to see us on Maunu Road in Whangārei.