A tooth abscess is a dental condition that develops as the result of a tooth infection that creates a collection of pus at the area around a tooth root or in the gums. Tooth abscesses can be caused either due to untreated tooth decay or due to advanced gum disease (periodontitis). They are the most common reason many patients visit their dentists with intense toothache.
There are 3 common types of dental abscess based on the area of the mouth where they form:
All types of tooth abscesses are the result of a pre-existing infection in the mouth. The pus formation that characterizes an abscess is a side-effect of the ‘battle’ of the body’s immune system with the bacteria that have caused the infection. Pus is actually a mixture of living and dead white blood cells and bacteria, cell fluids, and liquified dead tissue. The initial infection may be caused by:
Watch this video on how a tooth abscess is formed:
An abscess is typically painful, and it appears as a swollen area that is warm to the touch. The skin surrounding an abscess typically appears pink or red. The main symptoms associated with a tooth abscess are usually:
Other tooth abscess symptoms include:
Although the formation of a tooth abscess is always followed with intense toothache, it may be developing for a long time before the tooth pain starts, revealing its existence.
As more pus is accumulated, the pressure increases and the abscess becomes increasingly more painful. Sometimes the pus finds a way through the tissue to the surface forming a visible bump on the gum overlying the root (gumboil). The boil can then rupture, allowing the pus to drain in the mouth. If such a drainage channel (fistula) is formed, the abscess becomes chronic.
Every time the abscess is drained into the mouth, the pain often decreases significantly, but the infection remains and dental treatment is still necessary. Otherwise the tooth absess will gradually worsen as the infection continues to spread and destroy periodontal tissues.
Severe tooth abcess symptoms such as fever, chills, nausea, vomiting, or diarrhea, mean that the tooth infection has spread to other tissues or organs. The condition may become life-threatening; see your doctor immediately.
The type of treatment for a tooth abscess depends on the severity and extent of the infection. While tooth extraction remains an option, it is not the only one as it was until some decades ago. The dentist will always try to save the tooth with endodontic treatment before deciding a tooth extraction.
The goals of tooth abscess treatment are first to relieve the patient from pain, followed by the elimination of the infection and the restoration of the tooth (if possible). The treatment of dental abscesses is performed by a dentists or endodontist and it requires several dental visits.
The dentist will prescribe antibiotics for a few days before starting the treatment of the tooth abscess, especially if there is extensive swelling. However, an antibiotic will not clear the pus or eliminate the infection until the pus is drained. Antibiotics use for a few days after draining the pus could also help to clear any remaining infection.
Pus drainage releases the pressure from the tissues around the tooth abscess, providing a significant relief from the acute pain. Draining the abscess is the first step of the tooth abscess treatment. It can be done either through an opening made through the top of the tooth in case of a periapical abscess or through an incision to the gums in case of a periodontal abscess.
If you can not visit the dentist immediately, you can try the following for temporary pain relief:
Performing a root canal therapy (endodontic treatment) can in most cases clear the infection and preserve the tooth. The procedure involves the removal of bacteria and infected tissues from the pulp chamber and the root canals. The tooth is then sealed and restored with a filling or crown.
A tooth extraction becomes necessary when the tooth is badly damaged and it can not be saved with a root canal treatment. Modern dentistry considers tooth extraction only as a last option and not as an alternative of root canal treatment. An extracted tooth due to tooth abscess should be replaced with a dental bridge or a dental implant.
A tooth abscess can cause serious health complications, that in some severe cases may become life threatening. The most common complications of tooth abscesses include:
Tooth abcess symptoms such as fever, chills, nausea, vomiting, or diarrhea, are indications of severe tooth abscess complications; see your doctor immediately. In the years before WWII and the discovery of penicillin, it was not uncommon for patients to die from complications of tooth infections.