Dental abscess: Symptoms, treatment, and causes

A dental abscess, or tooth abscess, is a buildup of pus that forms inside the teeth or gums.

The abscess typically comes from a bacterial infection, often one that has accumulated in the soft pulp of the tooth.

Bacteria exist in plaque, a by-product of food, saliva, and bacteria in the mouth, which sticks to the teeth and damages them and the gums.

If the plaque is not removed by regular and proper brushing and flossing, the bacteria may spread inside the soft tissue of the tooth or gums. This can eventually result in an abscess.

Fast facts on dental abscesses

Here are some key points about dental abscesses. More detail and supporting information is in the main article.

There are three types of dental abscess: Gingival, periodontal and periapical.

Symptoms of dental abscesses include pain, a bad taste in the mouth and fever.

Dental abscesses are caused by a bacterial infection.

Treatment for an abscess may involve root canal surgery.

To minimize pain, it is best to avoid cold drinks and food and use a softer toothbrush.

Symptoms

A man holding his mouth, suffering with dental pain
Pain is the main symptom of a dental abscess.

Signs and symptoms of a dental abscess include:

pain in the affected area when biting or when touching the affected area

sensitivity to cold or hot food and liquids

a foul taste in the mouth

fever

a generally unwell feeling

difficulties opening the mouth

swallowing difficulties

insomnia

The main symptom of a dental abscess is pain. This may be a throbbing pain and is often intense. The pain usually starts suddenly and becomes more intense over the following hours or days. In some cases, the pain may radiate to the ear, jawbone, and neck.

Types

There are three types of dental abscess:

Gingival abscess: The abscess is only in the gum tissue and does not affect the tooth or the periodontal ligament.

Periodontal abscess: This abscess starts in the supporting bone tissue structures of the teeth.

Periapical abscess: this abscess commences in the soft pulp of the tooth.

The type of abscess will dictate the severity and location of symptoms.

[Cross section of a tooth]
Surgery may be necessary for some abscesses.

Any person with symptoms linked to a dental abscess should see a dentist immediately. Dental abscesses are easily diagnosed by a qualified dentist.

People who have swallowing and breathing problems should go straight to the emergency department of their local hospital.

If you cannot get to a dentist immediately, visit a family doctor.

A doctor cannot treat an abscess, but they may prescribe medication and advise on self-care and pain management and are also likely to know the fastest way of getting emergency treatment if required.

Incision: The abscess needs to be cut out and the pus, which contains bacteria, drained away. The doctor will administer a local anesthetic.

Treating a periapical abscess: Root canal treatment will be used to remove the abscess. A drill is used to bore a hole into the dead tooth so that the pus can come out. Any damaged tissue will be removed from the pulp. A root filling is then inserted into the space to prevent subsequent infections.

Treating a periodontal abscess: The abscess will be drained and the periodontal pocket cleaned. The surfaces of the root of the tooth will then be smoothed out by scaling and planing below the gum line. This helps the tooth heal and prevents further infections from occurring.

Surgery

People with a periapical abscess and a recurring infection may need to have diseased tissue surgically removed. This will be done by an oral surgeon.

Those with a periodontal abscess and a recurring infection may have to have their gum tissue reshaped and the periodontal pocket removed. This procedure will be performed by an oral surgeon.

If a dental abscess comes back, even after surgery, the tooth may be taken out.

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