A tooth abscess is an enclosure of pus formed from a bacterial infection. It can be quite painful and, left untreated, will spread to other teeth or tissues in the body.
Rampant infections can cause fatal conditions if allowed to spread. Therefore, it is essential to understand tooth abscesses and how to deal with them.
Tooth or dental abscesses can be of three types:
Periapical abscesses form just outside the tooth’s root. The infection starts inside the tooth’s soft pulp and follows the blood flow through the tip, infecting the bone.
Periodontal abscesses form on the gum next to the root. The infection starts in the bone and the tooth’s supporting ligament. This type is prevalent among adults.
Gingival abscesses form on the gum away from the tooth. They do not directly affect a specific tooth, but they can spread.
Symptoms of Tooth Abscess
Tooth abscesses have several common symptoms. The sooner a person recognizes the minor symptoms, the less likely they will suffer the major ones.
Excessive Pain
The most common symptom of an abscess is pain. It can throb or stab and become worse when lying down or chewing. The pain may spread to the ears, jaw, and neck in time. In addition, infected teeth generally become very sensitive to hot and cold, making eating and drinking difficult.
Foulness in mouth
Minor but unpleasant symptoms include discolored or loose teeth, foul taste, and bad breath. The unpleasant taste may indicate that the abscess has ruptured, releasing pus into the mouth. Such drainage will reduce the pain considerably in moments but does not mean the infection has gone.
Swelling
Swelling is a common symptom, and some types may indicate a dangerous condition. The area around the abscess and the lymph nodes will swell as the body reacts to infection. Swelling along the jawline is frequent but swelling around the eyes and near the windpipe is very dangerous.
Anyone who experiences swelling in the upper face or throat should seek immediate medical attention.
If you experience the following symptoms from a tooth abscess, you should seek medical attention immediately. You should go to the emergency room if you cannot access a dentist.
These infections can spread to the heart or brain.
Danger Signs: See a Doctor If You Have the Following:
- High fever
- Swollen face/eyes
- Trouble swallowing
- Trouble breathing
Causes of Tooth Abscess
Anything that exposes the inside of a tooth may cause a periapical abscess. Sports-related injuries that crack or chip teeth are common causes of this type of abscess. General tooth decay is the most common culprit, however.
When bacteria break down sugars in the mouth, they leave an acid byproduct that attacks tooth enamel. The damage causes cavities, a prime target for infectious bacteria.
Periodontitis, known widely as “gum disease,” is the leading cause of tooth abscesses. Any injury that damages the gum tissue can also cause infection. As it progresses, this infection gains access to deeper tissues, eventually causing the abscess.
Any foreign body that lodges in gum tissue can cause an infection. Frequent culprits are popcorn kernels, tiny seeds, and rough brushing.
If someone has a weak immune system, they are more likely to become infected by things that would give most others no problem.
Tooth Abscess: Diagnosis
The infections that cause dental abscesses will not go away on their own. In time, they will destroy the mouth’s tissues and spread to other body parts.
A dentist may press or tap on teeth to test sensitivity while checking for an abscess. Some dentists will also perform thermal testing to check for irregular reactions in the interior of the teeth.
X-rays are also common when searching for an abscess. They can reveal the source of an infection or indicate that it has spread beyond the tooth and gums.
If a dentist suspects but cannot prove an abscess, they may send a patient to an endodontist specializing in tooth abscesses.
Finally, if the infection has spread to other parts of the body, a CT scan may show the extent of the infection.
Tooth Abscess: Treatment
The type of treatment depends on the severity and spread of the infection.
1. Removal of the Pus
Dentists will focus on curing the infection, addressing its cause, and relieving the patient’s discomfort. They often drain the abscess, cutting it open to release the pus. They will then clean the area with a saline solution.
Some dentists may install a rubber drain into the pocket to prevent reinfection.
2. Root Canal
Root canals are the most well-known treatment for an abscess.
First, the dentist or surgeon will drill into the tooth to drain the pus. They will then disinfect and refill the chamber with synthetic material. After they shut the opening, they may recommend a crown to strengthen the tooth’s integrity and prevent other abscesses.
Teeth do not need the interior pulp once grown, so removing and replacing the infected pulp is safe.
3. Removal of the Infected Tooth
Dentists will remove the tooth if the infection causes enough damage to it. They will then drain and clean the abscess. Only surgery will repair the damage to bones and tissue for some severe periodontal abscesses.
4. Antibiotics
Antibiotic ointments and medications may be useful when treating tooth abscesses. However, they do not address the initial cause of infection. Therefore, doctors and endodontists will only use them to supplement other treatments.
For example, a dentist may treat a gingival abscess by removing the embedded matter from the gum. Then they will drain the abscess and clean the area with saline. Finally, they may prescribe antibiotics to ensure no spread or new infection can occur.
Possible Outcomes
The extent of infection determines the outcome of a tooth abscess. If left untreated, the infection will spread and can become fatal. The scope of tissue damage may require tooth removal if too much time has passed. A tooth abscess can clear up in days when detected early.
Who Can Treat a Tooth Abscess?
The severity and spread of infection determine which specialist is best suited to treat an abscess.
A dentist can perform all the procedures if you seek medical attention early. They can drain the abscess and disinfect the tissue. Dentists also routinely perform root canals and tooth extractions.
Endodontists and oral surgeons both perform surgical procedures in the mouth. However, an endodontist focuses on minute surgeries within teeth. They are root canal specialists and are focused on preserving teeth if possible.
Oral surgeons operate in a broader area and could be the best choice for extractions and replacements. They are best suited when the infection has killed a tooth and damaged the nearby bone and other tissues.
If the infection has spread to other parts of the head, an emergency room physician or ENT specialist can help. They have the training and resources to perform surgeries and treat areas outside the mouth. Therefore, they may be the only option if the tooth abscess causes a life-threatening condition.
Tooth abscesses can happen in children, and pediatric dentists can provide appropriate care. They can perform root canals if necessary or extract damaged teeth. In addition, they are well-trained in dealing with baby teeth.
Home Remedies for Tooth Abscesses
Anti-inflammatory medications like ibuprofen can help reduce swelling and pain. Warm salt water can also soothe the area around the abscess.
But it does not mean the home treatment has worked if the pain goes away. The reduction of pain could be due to a rupture, which does not address the underlying infection.
Furthermore, it could also be due to the death of the tooth’s nerves, which certainly requires medical attention.
How to Prevent Tooth Abscess
Consult a Dentist
The most important prevention for all oral conditions is routine visits to the dentist. These visits allow your dentist to perform thorough examinations and deep cleaning. It is difficult to overstate their preventive efficacy for many issues, including tooth abscesses.
Take Care of Your Teeth Regularly
Beyond routine visits, if you experience tooth injury or looseness, you should make an appointment immediately. Regular care will ensure that no avenues for infection have opened and may prevent much suffering later.
There are several effective day-to-day habits to prevent dental abscesses. Drinking fluoridated water keeps the enamel of teeth strong and reduces the formation of cavities.
You should brush your teeth at least twice per day with fluoride toothpaste. You should also change your toothbrush as soon as the bristles fray.
Flossing once per day is a proven way to avoid gum disease and only takes a few minutes. It removes debris and food particles between teeth and prevents the growth of bacteria.
In addition, an antiseptic mouthwash kills bacteria and makes a practical addition to daily oral hygiene.
Change Eating Habits
Good dietary habits are crucial in all areas of health. For example, removing sugary foods is particularly good for the teeth. It will prevent cavities from developing, reducing the chance of teeth infections.
You may also want to consider limiting snacks between meals. Infrequent eating allows the mouth’s pH to normalize and has an antibacterial effect.
Is it possible to get an abscess after wisdom tooth extraction?
Abscesses after wisdom teeth extractions are uncommon in healthy patients. They become symptomatic 3-4 days after the extraction when they do occur. Some infections happen late, even 3-4 weeks after the extraction.
The typical cause of these abscesses is food debris entering the sockets and causing an infection.
A dentist will treat these abscesses by opening and irrigating the socket. Once sterilized, the dentist may pack the socket with an antibacterial and anesthetic-soaked gauze.
If the infection has spread, they will also prescribe several days of antibiotics.
Can a tooth abscess cause facial swelling?
Tooth abscesses can cause facial swelling. The swelling is a natural inflammatory response to infection and can be painful. Someone experiencing swelling around a tooth should immediately visit a dentist.
If there is swelling near the eyes or threatening the airway, go to the emergency room as soon as possible. It may be a sign of a life-threatening condition.
Can an abscessed tooth kill you?
Abscessed teeth can be fatal. The underlying infection can spread to vital organs, causing irreparable harm. A tooth abscess may take several months before it spreads infection. However, once the infection hits an essential system, it can be fatal in a few days.
Some fatal conditions that a tooth abscess can cause are:
Sepsis – An extreme inflammatory response to severe infection. It can damage and destroy vital organs.
Necrotizing Fasciitis – Also known as “flesh-eating disease.” It destroys soft tissues and is highly lethal.
Cavernous Sinus Thrombosis – A blood clot in the sinuses located under the brain and behind the eyes. It is fatal without immediate medical attention.
Brain Abscess – Fatal if left untreated.
Can a tooth abscess heal on its own?
Tooth abscesses cannot heal on their own. Instead, they require a medical professional to address the underlying cause of infection. Even if the pain of an abscess goes away, the infection is still present and may spread to other tissues. A tooth abscess can go on for months and eventually spread the infection to other body parts.
What happens if an abscess pops in your mouth?
When a tooth abscess ruptures, it releases pus into your mouth. The taste is very foul, as is the odor. The pain may recede quickly due to reduced pressure on the nerves. A warm salt water rinse will encourage drainage and further soothe the pain. However, the tissue inside the abscess is still infected, and a dentist should address it immediately.
Can you get a tooth abscess after a root canal?
A tooth abscess could occur after a root canal if the surgeon did not seal the tooth’s interior properly. A small crack or fracture could also appear during the root canal procedure. Any exposure to the tooth’s interior is a target for new infection.
Sources
- National Health Service (NHS). “Dental abscess.”
- Healthline. “Abscessed Tooth: What You Need to Know.”
- Cleveland Clinic. “Abscessed Tooth.”
- American Association of Endodontists. “Abscessed Teeth.”
- Oxford Academic. “Bacteriology of Dentoalveolar Abscesses in Patients Who Have Received Empirical Antibiotic Therapy.”
- The University of Florida Health. “Tooth Abscess.”
- The University of Alberta School of Dentistry. “When toothaches go untreated.”
