Tooth Abscess: Symptoms, Causes, & Treatment

By Chesney Fowler, MD
Medically reviewed checkmarkMedically reviewed
September 9, 2020

A dental infection or abscess is a localized pocket of pus that forms in soft tissue as the result of an infection. Abscesses can develop on the skin, particularly around the trunk, underarms, and genitals, and on the hands and feet. They can also develop on internal organs like the stomach, kidneys, brain, and inside the mouth.

A dental abscess is a collection of pus that forms in or around someone’s teeth as the result of a dental infection. Dental abscesses can develop inside a tooth, inside the gums, or inside the jaw bone. If an abscess is inside any part of the tooth, it can also be called a tooth abscess.

Dental abscess symptoms can vary from patient to patient but may include throbbing pain, tooth sensitivity, shiny, red or swollen gums, fever, and facial swelling. Tooth abscess symptoms may also include a discolored or loose tooth, bad breath, or a bad taste in your mouth. In rare, severe cases, patients may experience difficulty opening their mouths, breathing, or swallowing.

In this article, I’ll answer questions like: What is an abscessed tooth? What does an abscessed tooth look like? What causes an abscessed tooth in the first place? I’ll also answer other basic questions about how to identify, manage, and most importantly, treat an abscessed tooth successfully.

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What Is an Abscessed Tooth?

A tooth abscess, sometimes called an abscessed tooth infection, is a localized pocket of pus that has formed somewhere in or around a tooth. It occurs when bacteria find a way to enter the tooth, either through a cavity, a chip or crack in the tooth, or because of improper dental work. The bacteria spread to the soft interior or “pulp” of the tooth, and travel from there to its root, causing redness, swelling, and tenderness in the tooth, gum, or jaw. An abscess can form in or around any tooth, though wisdom teeth are particularly prone to infection because they are harder to clean and are more susceptible to decay. A wisdom tooth abscess can make it especially difficult to chew or swallow without pain.

Symptoms of an Abscessed Tooth

Dental infection symptoms, like the ones people experience when they have a tooth abscess, are notoriously painful and can significantly impact quality of life. The signs of abscessed tooth pain include:

  • Pain that begins near a tooth or in the gums, and radiates outward
  • Throbbing pain that comes on suddenly and advances rapidly
  • Pain that adversely affects the face, jaw, ear, and neck
  • Pain that makes it difficult to eat, breathe, or lay down comfortably

In addition to tooth abscess pain, other symptoms may include:

  • Facial swelling, warmth, or redness
  • Tooth sensitivity, particularly when eating and drinking hot or cold food and fluids
  • Tooth discoloration
  • Loose teeth
  • Red, shiny, or swollen gums
  • Bad breath or a bad taste in your mouth
  • Tender or swollen lymph nodes under your jaw or in your neck
  • Fever

Sometimes a dental abscess on gum tissue can present as a small blister or boil. If you find a bump on your gums that is tender to the touch or leaks liquid (pus) when you press on it, you may have a tooth abscess that requires treatment. Seek medical attention right away.

Dental infections like abscessed teeth do not go away on their own. If left untreated, they can lead to blood infections, brain abscesses, shock, and even death if the infection becomes widespread. Even at the earliest of abscessed tooth stages, the infection is considered an emergency and requires immediate care. If you suspect you are suffering from a tooth abscess, call your dentist or seek emergency treatment immediately.

What Causes an Abscessed Tooth?

Teeth abscesses are caused when bacterial microorganisms enter and spread through a tooth’s crown, to its soft pulp interior, and finally to the tip of its roots, the patient’s gums, and jaw. The body’s immune system sends white blood cells to fight off the bacterial infection, which in turn induce swelling in the affected area and kills the surrounding tissue. Pus, a mixture of white blood cells, bacteria, tissue, and fluid fills the newly-formed pocket and the site of the infection becomes acutely painful, swollen, and tender.

The factors that lead to tooth decay also make teeth more susceptible to infection and abscess. They include:

  • Poor dental hygiene: Inadequate care of your teeth can lead you to develop cavities or gum disease that in turn allow bacteria to enter your teeth and gums more easily.
  • An injury or incomplete dental care: Any event that chips, cracks, or creates an opening in a tooth can lead you to develop a bacterial infection.

Diagnosing an Abscessed Tooth

If you believe you are suffering from a tooth abscess, it’s important to seek treatment right away, either at your dentist’s office or at the nearest emergency medical center.

When diagnosing your condition, your dentist will examine your mouth, including teeth, lips, gums, and tongue. They may tap lightly on your teeth to identify where you are most tender since abscessed teeth are sensitive to touch. They may also order an x-ray or CT-scan if they suspect that your infection has spread to other areas of your face, head, or neck and need to determine a broader course of treatment.

If your dentist can’t diagnose your tooth abscess, they might send you to an endodontist, a skilled specialist who focuses on treating tooth pain. Your endodontist will be able to give you a proper diagnosis and treatment plan to relieve your symptoms and treat your condition.

How to Treat an Abscessed Tooth

Once you are diagnosed, your dentist will determine an appropriate tooth abscess treatment plan to relieve your symptoms and clear your infection. That may include:

  • Tooth abscess drainage: Your dentist will make an incision in the abscess that will allow the pus to drain from the infection site and relieve your swelling and pain. They will then rinse the area with saline solution (saltwater) to clear away any lingering bacteria.
  • A root canal procedure: Your dentist will drill into your tooth to remove the infected pulp and save the rest of your tooth. After draining the abscess, your dentist will fill, seal, and cap the tooth so that no bacteria can re-establish itself once the procedure is finished.
  • Tooth removal: If your tooth is too damaged, your dentist might recommend pulling it out completely before draining the abscess. You may be offered the option to replace the missing tooth with a temporary or permanent partial denture, dental implant, or bridge.
  • Foreign object removal: If the source of your infection is a piece of food or a part of your toothbrush that got stuck in your gums, your dentist will try to remove it before flushing the area with saline solution to deter future infection.
  • Tooth abscess antibiotics: Dentists prescribe antibiotics for dental infection patients when an infection is significant, has spread to other areas of the face and jaw, or when a patient has a weakened or compromised immune system that puts them at high-risk. A full course of antibiotics is usually used in addition to one or more dental procedures, as a way of ensuring against future infection.

A tooth abscess is considered an emergency condition and can lead to dangerous complications. Any dental abscess drainage procedure or other courses of treatment must be performed correctly by a licensed dental professional. While you are waiting for your dental appointment, you may find some relief by taking over-the-counter pain medication like ibuprofen (Advil), gargling with salt water, and temporarily avoiding very hot and very cold foods until you are treated.

In general, tooth abscess home remedies are not reliable and should not be used to delay treatment. If you are wondering how to bring an abscessed tooth to a head on your own or how to drain a tooth abscess at home, please refrain and call your dentist immediately. Even if your tooth abscess has ruptured on its own, it’s important to get the site professionally cleaned to deter any future infection.

How to Prevent an Abscessed Tooth

The best way to prevent a tooth abscess is to avoid decay or injury that could lead to a dental infection. Take care of your teeth by:

  • Visiting your dentist for regular check-ups and cleanings
  • Brushing for two full minutes each morning and night
  • Using floss, dental tape, or an interdental cleaner at least once a day
  • Replacing your toothbrush (or the head of an electric one) after 3-4 months
  • Eating healthy foods like whole fruits and vegetables, and avoiding starchy or sugary snacks and soft drinks
  • Drinking plenty of fluoridated water

Risk Factors and Complications

Anyone, from children to elderly adults can develop a tooth abscess that requires treatment. If you do not take regular care of your teeth, have a poor, sugar-heavy diet, or suffer from dry mouth, you are more likely to suffer from tooth decay, and in turn, more likely to develop a tooth infection and abscess.

Abscessed teeth do not heal on their own. If you have a tooth abscess and do not seek treatment, receive improper treatment, or have a weakened immune system, you are at risk for developing certain complications, including an infection that spreads through parts of your face, neck, head, and jaw, enters the bloodstream and causes sepsis, leads to abscesses in other areas of the body, like the brain, and in rare cases, causes death.

When to See a Doctor

Tooth and dental abscesses are considered emergency conditions. If you believe you are suffering from the symptoms of a dental abscess, seek treatment with your dentist immediately.

If you have an abscessed tooth and are experiencing other signs of serious infection, including high fever, a rapid heart rate, confusion, significant or rapid facial swelling, difficulty breathing, swallowing or opening your mouth, go to the emergency room immediately.

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How K Health Can Help

It’s important to understand what’s causing your tooth pain so you can get the appropriate treatment.

Did you know that you can get online dental prescriptions for tooth infections? 

Download the K Health app to check your symptoms using our symptom checker and text with a doctor in minutes. 

K Health’s board-certified, U.S.-based doctors can provide a treatment plan and, if required, a prescription to resolve your symptoms as soon as possible. Clinicians are available 24/7.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Chesney Fowler, MD

Dr. Fowler is an emergency medicine physician and received her MD from George Washington University. She completed her residency in emergency medicine at Christiana Care Health System. In addition to her work at K Health, Dr. Fowler is a practicing emergency medicine physician in Washington, DC.

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