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Tooth Abscess

(Dental Abscess; Abscessed Tooth)

Definition

A tooth abscess is a sac of infected material called pus in a tooth or the gums.

Abscess Between Tooth and Gum

Causes TOP

A tooth abscess is caused by bacteria. It begins when bacteria invade and infect the tissue around a tooth. This results in pus build-up. When the pus is unable to drain, an abscess results.

Conditions that allow bacteria to invade a tooth include:

Severe tooth decay
Break or crack in a tooth that lets bacteria invade the pulp
Failed root canal treatment
Advanced periodontitis
Dental trauma

Risk Factors TOP

Factors that may increase your chance of a tooth abscess include:

Build up of tartar or calculus beneath the gum line
Poor dental hygiene leading to cavities and periodontal diseases

Symptoms TOP

A tooth abscess may cause:

Throbbing/lingering pain in a tooth or gum area
Pain when biting
Pain from hot or cold
Sudden tooth pain
Redness, tenderness, or swelling of the gums
Fever
Bad breath or foul taste in mouth
Open, draining sore on the gums
Loose tooth

If left untreated, complications of tooth abscess include:

Loss of tooth and surrounding tissues or bone
Spread of infection to surrounding tissue or bone

Diagnosis TOP

Your dentist will ask about your symptoms and medical history. A detailed exam of your teeth and gums will be done.

Images may need to be taken of the tooth and surrounding bone. This can be done with x-rays.

A sample of the abscess fluid may be taken and tested.

Treatment TOP

Drainage of Abscess

If an abscess results from infection between the tooth and gum:
- The abscess is drained and thoroughly cleaned.
- The root surface of tooth is cleaned and smoothed.
- In some cases, surgery to reshape the gum is done to prevent a repeat infection.

Removal of Abscess Via Root Canal

If an abscess results from tooth decay or a break or crack in the tooth:
- The tooth and surrounding tissue is numbed and a hole is drilled through the top of the tooth.
- Pus and dead tissue are removed from the center of the tooth.
- The interior of the tooth and the root canals are cleaned and filled with a permanent filling.
- A crown is placed on the tooth to protect it.

Tooth Extraction (Removal) TOP

Tooth extraction may be required if:
- Tooth decay and/or tooth infection is too extensive for filling or root canal treatment.
- The break or crack in the tooth is too severe to be repaired.
- The infection or loss of tissue/bone between the tooth and gum is severe.
If the tooth is extracted, it will be replaced with a:
- Partial bridge
- Denture
- Tooth implant

Medication TOP

Antibiotics to fight residual infection of the tooth or gums
Over-the-counter pain relief drugs, such as ibuprofen or acetaminophen

Prevention TOP

To help reduce your chance a tooth abscess:

Brush your teeth with fluoride toothpaste after meals or at least twice per day.
Using a soft-bristled toothbrush or a powered toothbrush.
Floss between your teeth and gums every day.
Get regular dental check-ups and teeth and gum cleanings every 6 months.

RESOURCES:

Academy of General Dentistry
http://www.agd.org

Mouth Healthy—American Dental Association
http://www.mouthhealthy.org

CANADIAN RESOURCES:

Canadian Dental Association
http://www.cda-adc.ca

The Canadian Dental Hygienists Association
http://www.cdha.ca

References:

Abscess (toothache). Mouth Healthy—American Dental Association website. Available at:
...(Click grey area to select URL)
Accessed August 22, 2017.

Acute apical dental abscess. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated June 15, 20175. Accessed August 22, 2017.

Dental abscess. NHSinform website. Available at: https://www.nhsinform.scot/illnesses-and-conditions/mouth/dental-abscess. Updated April 13, 2017. Accessed August 22, 2017.

Toothache and Infection. The Merck Manual Professional Version website. Available at:
...(Click grey area to select URL)
Updated September 2016. Accessed August 22, 2017.

Last reviewed September 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 9/30/2013

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