What are the signs of a dental abscess. How can you relieve dental abscess pain at home. What treatments are available for dental abscesses. How can you prevent dental abscesses from forming.

Understanding Dental Abscesses: Types and Formation

A dental abscess is a pocket of pus that forms due to bacterial infection in the mouth. There are two main types of dental abscesses:

• Periapical abscess: Forms at the tip of a tooth’s root
• Periodontal abscess: Develops in the gum tissue

Dental abscesses can cause significant discomfort and potentially lead to serious health complications if left untreated. They occur when bacteria invade the dental pulp (the soft tissue inside teeth) or the space between the teeth and gums.

How do dental abscesses form?

Dental abscesses typically form as a result of:

1. Untreated tooth decay
2. Gum disease (periodontitis)
3. Trauma to the tooth
4. Failed dental procedures

When bacteria penetrate the tooth enamel or gum tissue, they multiply and create an infection. The body’s immune response leads to inflammation and the accumulation of pus, forming an abscess.

Recognizing the Symptoms of a Dental Abscess

Identifying a dental abscess early is crucial for prompt treatment and prevention of complications. Common symptoms include:

• Severe, throbbing pain in the affected tooth or gum
• Pain that radiates to the ear, jaw, and neck
• Increased pain when lying down
• Facial swelling and redness
• Tooth discoloration or looseness
• Swollen, shiny gums
• Sensitivity to hot and cold temperatures
• Bad breath or unpleasant taste in the mouth
• Fever and general malaise in severe cases

Can a dental abscess cause difficulty in opening the mouth or swallowing?

In severe cases, a dental abscess can indeed cause trismus (difficulty opening the mouth) and dysphagia (difficulty swallowing). These symptoms indicate that the infection may be spreading and require immediate medical attention.

Seeking Professional Help for a Dental Abscess

If you suspect you have a dental abscess, it’s crucial to seek professional help promptly. Here are some steps to take:

1. Contact your regular dentist for an emergency appointment
2. If unavailable, call NHS 24 111 service for guidance
3. Check with your local clinical commissioning group (CCG) for dental access helplines
4. Visit an A&E department if experiencing severe symptoms or difficulty breathing

Remember, dental abscesses do not resolve on their own and require professional intervention to prevent complications.

Why should you avoid visiting your GP for a dental abscess?

General practitioners are not equipped to treat dental abscesses effectively. Dentists have the specialized tools and expertise necessary to diagnose and treat oral infections properly. Visiting a GP may delay appropriate treatment and potentially allow the infection to worsen.

Home Remedies for Temporary Dental Abscess Pain Relief

While waiting for professional treatment, you can try these methods to alleviate pain and discomfort:

• Take over-the-counter pain relievers (preferably ibuprofen)
• Rinse with warm salt water to reduce swelling
• Apply a cold compress to the outside of your cheek
• Avoid hot or cold foods and drinks
• Eat soft, cool foods
• Use a soft-bristled toothbrush
• Temporarily avoid flossing around the affected area

Is it safe to combine paracetamol and ibuprofen for dental pain?

For adults, combining paracetamol and ibuprofen can provide more effective pain relief than using either medication alone. However, it’s crucial to follow the recommended dosages on the packaging. This combination is not recommended for children under 16 years old.

Professional Treatment Options for Dental Abscesses

Dental professionals employ various treatments to address dental abscesses, depending on the severity and location of the infection:

1. Tooth extraction: Removal of the affected tooth if it cannot be saved
2. Root canal treatment: Removal of the infected pulp, followed by filling and sealing the tooth
3. Incision and drainage: Creating a small cut in the gum to drain the abscess (often a temporary solution)
4. Antibiotics: Prescribed in cases of severe infection or when the infection has spread

How is local anesthesia used in dental abscess treatments?

Local anesthesia is typically administered to numb the affected area before performing dental procedures. This ensures patient comfort during treatments such as tooth extractions or root canals. In more complex cases, general anesthesia may be necessary, particularly for extensive surgical interventions.

Understanding the Causes and Risk Factors of Dental Abscesses

Several factors contribute to the development of dental abscesses:

• Poor oral hygiene leading to plaque buildup
• High sugar and starch consumption
• Previous dental injuries or surgeries
• Weakened immune system
• Dry mouth (xerostomia)
• Genetic predisposition to dental problems
• Smoking or tobacco use

How does a weakened immune system increase the risk of dental abscesses?

A compromised immune system makes it harder for the body to fight off bacterial infections. Conditions such as diabetes, HIV/AIDS, and certain medications (like chemotherapy or corticosteroids) can weaken the immune response, making individuals more susceptible to dental abscesses and other oral infections.

Preventing Dental Abscesses: Essential Oral Care Practices

Maintaining good oral hygiene is crucial in preventing dental abscesses. Here are some essential practices:

1. Brush teeth twice daily with fluoride toothpaste
2. Floss or use interdental brushes daily
3. Use an antiseptic mouthwash
4. Limit sugary and acidic foods and drinks
5. Quit smoking or using tobacco products
6. Visit your dentist regularly for check-ups and cleanings
7. Address dental issues promptly
8. Consider dental sealants for added protection

How often should you replace your toothbrush to maintain optimal oral health?

It’s recommended to replace your toothbrush or electric toothbrush head every 3-4 months, or sooner if the bristles become frayed. A worn-out toothbrush is less effective at removing plaque and bacteria, potentially increasing the risk of dental problems, including abscesses.

The Importance of Early Intervention in Dental Abscess Cases

Prompt treatment of dental abscesses is crucial for several reasons:

• Prevents the spread of infection to other parts of the body
• Reduces the risk of complications, such as sepsis
• Alleviates pain and discomfort more quickly
• Increases the chances of saving the affected tooth
• Minimizes the need for more extensive and costly treatments

What potential complications can arise from untreated dental abscesses?

If left untreated, dental abscesses can lead to serious complications, including:

• Osteomyelitis (bone infection)
• Ludwig’s angina (severe infection of the floor of the mouth)
• Brain abscess
• Sinus infection
• Endocarditis (heart infection)
• Sepsis (life-threatening systemic infection)

These potential complications underscore the importance of seeking prompt dental care for suspected abscesses.

Dental Abscess Management in Special Populations

Certain groups may require special considerations when dealing with dental abscesses:

1. Pregnant women: Some treatments and medications may need to be modified
2. Elderly individuals: May have complex medical histories affecting treatment options
3. Children: Require age-appropriate pain management and treatment approaches
4. Immunocompromised patients: May need more aggressive treatment and follow-up care

How does pregnancy affect dental abscess treatment?

Pregnancy can complicate dental abscess treatment due to concerns about medication safety and potential risks to the fetus. Dentists may opt for less invasive treatments and avoid certain antibiotics. It’s crucial for pregnant women to inform their dentist of their pregnancy and work closely with both their obstetrician and dentist to ensure safe and effective treatment.

The Role of Diet in Dental Health and Abscess Prevention

Diet plays a significant role in maintaining oral health and preventing dental abscesses. Consider the following dietary recommendations:

• Limit sugary and acidic foods and beverages
• Consume calcium-rich foods for strong teeth and bones
• Eat crunchy fruits and vegetables to stimulate saliva production
• Choose sugar-free gum with xylitol to reduce bacterial growth
• Stay hydrated to maintain proper saliva flow
• Consider probiotics to promote a healthy oral microbiome

How do probiotics contribute to oral health?

Probiotics can help maintain a balanced oral microbiome by promoting the growth of beneficial bacteria. This can potentially reduce the risk of tooth decay and gum disease, which are precursors to dental abscesses. Some studies suggest that certain probiotic strains may help prevent the growth of harmful bacteria associated with dental infections.

Advanced Diagnostic Techniques for Dental Abscesses

Dentists use various diagnostic tools to accurately identify and assess dental abscesses:

1. Visual examination and tactile exploration
2. Dental X-rays (periapical and panoramic)
3. Cone Beam Computed Tomography (CBCT)
4. Vitality testing to check tooth pulp health
5. Bacterial culture and sensitivity testing

What advantages does CBCT offer in diagnosing dental abscesses?

Cone Beam Computed Tomography (CBCT) provides detailed 3D images of dental structures, allowing dentists to visualize the extent of the abscess and its relationship to surrounding anatomical structures. This advanced imaging technique can help in planning more precise treatments, especially in complex cases or when conventional X-rays are inconclusive.

Long-term Management and Follow-up Care for Dental Abscess Patients

After initial treatment of a dental abscess, ongoing care is essential to prevent recurrence and maintain oral health:

• Attend follow-up appointments as scheduled
• Complete the full course of prescribed antibiotics, if applicable
• Maintain rigorous oral hygiene practices
• Address any underlying dental issues that may have contributed to the abscess
• Consider additional preventive measures, such as dental sealants or fluoride treatments
• Monitor for any signs of recurrence or new infections

How long does it typically take for a dental abscess to heal completely?

The healing time for a dental abscess can vary depending on the severity of the infection and the treatment method used. In general, patients may experience significant improvement within a few days to a week after treatment begins. However, complete healing, especially after surgical interventions or root canal treatments, may take several weeks to months. Regular follow-up appointments allow the dentist to monitor the healing process and address any potential complications promptly.

By understanding the causes, symptoms, and treatment options for dental abscesses, individuals can take proactive steps to maintain their oral health and seek timely care when needed. Remember, prevention through good oral hygiene practices and regular dental check-ups is key to avoiding painful and potentially serious dental infections.

Dental abscess | NHS inform

A dental abscess is a collection of pus that can form inside the teeth, in the gums, or in the bone that holds the teeth in place. It’s caused by a bacterial infection.

An abscess at the end of a tooth is called a periapical abscess. An abscess in the gum is called a periodontal abscess.

Dental abscesses are often painful, but aren’t always. In either case, they should be looked at by a dentist.

It’s important to get help as soon as possible, because abscesses don’t go away on their own. They can sometimes spread to other parts of the body and make you ill.

This page covers:

Symptoms of a dental abscess

What to do if you have a dental abscess

Relieving your symptoms

Treatments for a dental abscess

What causes dental abscesses?

Preventing dental abscesses

Symptoms of a dental abscess

Symptoms of an abscess in your tooth or gum may include:

• an intense, throbbing pain in the affected tooth or gum that may come on suddenly and gets gradually worse
• pain that spreads to your ear, jaw and neck on the same side as the affected tooth or gum
• pain that’s worse when lying down, which may disturb your sleep
• redness and swelling in your face
• a tender, discoloured and/or loose tooth
• shiny, red and swollen gums
• sensitivity to hot or cold food and drink
• bad breath and/or an unpleasant taste in your mouth

If the infection spreads, you may also develop a high temperature (fever) and feel generally unwell. In severe cases, you may find it hard to fully open your mouth and have difficulty swallowing or breathing.

What to do if you have a dental abscess

You should see a dentist as soon as possible if you think you have a dental abscess. Avoid visiting your GP, as there is little they can do to help.

You can get help from:

• your registered dentist – if it’s out of hours, they should have an answerphone message with details of how to access out-of-hours dental treatment
• NHS 24 111 service – who can give you details of dental services in your area
• your local clinical commissioning group (CCG) – who can tell you the phone number of your local dental access helpline
• your local accident and emergency (A&E) department – if there are no other options or you’re having difficulty breathing

You may have to pay for emergency NHS dental treatment, depending on your circumstances. Read about NHS dental charges.

Relieving your symptoms

While you’re waiting to see a dentist, painkillers can help control your pain.

Ibuprofen is the preferred painkiller for dental abscesses, but if you’re unable to take it for medical reasons, you can take paracetamol instead. Aspirin shouldn’t be given to children under 16.

If one painkiller doesn’t relieve the pain, taking both paracetamol and ibuprofen at the doses shown in the medicine leaflet may help. This is safe for adults, but not for children under 16.

It may also help to:

• avoid hot or cold food and drink if it makes the pain worse
• try eating cool, soft foods if possible, using the opposite side of your mouth
• use a soft toothbrush and temporarily avoid flossing around the affected tooth

These measures can help relieve your symptoms temporarily, but you shouldn’t use them to delay getting help from a dentist.

Treatments for a dental abscess

Dental abscesses are treated by removing the source of the infection and draining away the pus.

Depending on the location of the abscess and how severe the infection is, possible treatments include:

• removing the affected tooth (extraction) – this may be necessary if root canal treatment isn’t possible
• root canal treatment – a procedure to remove the abscess from the root of an affected tooth before filling and sealing it
• incision and drainage – where a small cut (incision) is made in the gum to drain the abscess (this is usually only a temporary solution and further treatment may be needed)

Local anaesthetic will usually be used to numb your mouth for these procedures. More extensive operations may be carried out under general anaesthetic (where you’re asleep).

Antibiotics aren’t routinely prescribed for dental abscesses, but may be used if the infection spreads or is particularly severe.

What causes dental abscesses?

Your mouth is full of bacteria, which form a sticky film on your teeth called plaque.

If you don’t keep your teeth clean, acids produced by the bacteria in plaque can damage your teeth and gums, leading to tooth decay or gum disease.

The following can increase your chances of developing a dental abscess:

• poor oral hygiene – plaque can build-up on your teeth if you don’t floss and brush your teeth regularly
• consuming lots of sugary or starchy food and drink – these can encourage the growth of bacteria in plaque and may lead to decay that can result in an abscess
• an injury or previous surgery to your teeth or gums – bacteria can get into any damaged parts of the teeth or gums
• having a weakened immune system – this includes people with certain underlying health conditions, such as diabetes, and those having treatment, including steroid medication or chemotherapy 

Preventing dental abscesses

You can reduce your risk of developing dental abscesses by keeping your teeth and gums as healthy as possible.

To do this, you should:

• use floss or an interdental brush at least once a day to clean between your teeth and under the gum line
• brush your teeth with a fluoride toothpaste twice a day – spending at least two minutes each time
• avoid rinsing your mouth with water or mouthwash after brushing because this washes the protective toothpaste away – just spit out any excess toothpaste
• cut down on sugary and starchy food and drinks – particularly between meals or shortly before going to bed
• visit your dentist regularly – your dentist can suggest how often you should have a check-up, based on your oral health 

Read more on how to keep your teeth clean and dental check-ups.

Tooth abscess Information | Mount Sinai

Periapical abscess; Dental abscess; Tooth infection; Abscess – tooth; Dentoalveolar abscess; Odontogenic abscess

A tooth abscess is a pocket of pus caused by a bacterial infection.

The structure of the tooth includes dentin, pulp and other tissues, blood vessels and nerves imbedded in the bony jaw. Above the gum line, the tooth is protected by the hard enamel covering.

A collection of infected material (pus) resulting from bacterial infection of the center (pulp) of a tooth.

Causes

A tooth abscess may form if there is tooth decay. It may also occur when a tooth is broken, chipped, or injured in other ways. Openings in the tooth enamel allow bacteria to infect the center of the tooth (the pulp). Infection may spread from the root of the tooth to the bones supporting the tooth.

Infection results in a buildup of pus and tissue swelling within the tooth. This causes a toothache. The toothache may stop if pressure is relieved. But the infection will remain active and continue to spread. This will cause more pain and can destroy tissue.

Symptoms

The main symptom is a severe toothache. The pain is continuous. It does not stop. It can be described as gnawing, sharp, shooting, or throbbing.

Other symptoms may include:

• Bitter taste in the mouth
• Breath odor
• General discomfort, uneasiness, or ill-feeling
• Fever
• Pain when chewing
• Sensitivity of the teeth to hot or cold
• Swelling of the gum over the infected tooth, which may look like a pimple
• Swollen glands of the neck
• Swollen area of the upper or lower jaw, which is a very serious symptom

Exams and Tests

Your dentist will closely look at your teeth, mouth, and gums. It may hurt when the dentist taps the tooth. Biting or closing your mouth tightly also increases the pain. Your gums may be swollen and red and may drain thick material.

Dental x-rays and other tests can help your dentist determine which tooth or teeth are causing the problem.

Treatment

The goals of treatment are to cure the infection, save the tooth, and prevent complications.

Your dentist might prescribe antibiotics to fight the infection. Warm saltwater rinses may help ease the pain. Over-the-counter pain relievers may relieve your toothache and fever.

Do not place aspirin directly on your tooth or gums. This increases irritation of the tissues and can result in mouth ulcers.

A root canal may be recommended in an attempt to save the tooth.

If you have a severe infection, your tooth may need to be removed, or you may need surgery to drain the abscess. Some people may need to be admitted to the hospital.

Outlook (Prognosis)

Untreated abscesses may get worse and can lead to life-threatening complications.

Prompt treatment cures the infection in most cases. The tooth can often be saved.

Possible Complications

These complications can occur:

• Loss of the tooth
• Blood infection
• Spread of infection to soft tissue
• Spread of infection to the jaw bone
• Spread of infection to other areas of the body, which can cause brain abscess, inflammation in the heart, pneumonia, or other complications

When to Contact a Medical Professional

Call your dentist if you have a throbbing toothache that does not go away, or if you notice a bubble (or pimple) on your gums.

Prevention

Prompt treatment of dental decay reduces the risk of developing a tooth abscess. Have your dentist examine any broken or chipped teeth right away.

Hewson I. Dental emergencies. In: Cameron P, Little M, Mitra B, Deasy C, eds. Textbook of Adult Emergency Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 17.

Pedigo RA, Amsterdam JT. Oral medicine. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 60.

Last reviewed on: 1/24/2022

Reviewed by: Michael Kapner, DDS, General Dentistry, Norwalk Medical Center, Norwalk CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Tooth abscess: causes, symptoms, diagnosis, treatment

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What is an abscessed tooth?

An abscessed tooth is a pocket of pus that can form in different parts of the tooth as a result of a bacterial infection. It is sometimes called a dental abscess. An infected tooth causes moderate to severe pain that can sometimes radiate to the ear or neck. Left untreated, an abscessed tooth can become a serious, life-threatening condition.
Read on to learn more about the different types and how to recognize them.

What are the types of abscess?

The three most common types are:

• Periapical abscess. This is an abscess at the tip of the root of a tooth.
• Periodontal abscess. This is an abscess on the gum near the root of the tooth. It may also spread to surrounding tissues and bones.
• Gingival abscess. It’s an abscess on the gums.

What are the symptoms of an abscess?

The main symptom of an abscessed tooth is throbbing pain near the tooth or in the gums. The pain usually comes on suddenly and gets worse over time.
Other symptoms include:

• pain that radiates to the ear, jaw, or neck
• pain that gets worse when you lie down
• pain when eating.
• redness and swelling of the face
• swollen red gums
• tooth sensitivity
• discolored or missing teeth
• bad breath
• bad taste in the mouth
• swollen lymph nodes in the neck

If the pus sac ruptures, you will almost immediately feel pain relief. You may also notice a bad taste in your mouth as pus begins to seep into your mouth.

What causes an abscess?

Bacteria entering teeth or gums leads to tooth abscess. However, how this happens depends on the type of abscess:

• For periapical abscess
  Bacteria enters the pulp in your tooth, usually caused by a carious lesion of the tooth, but cases caused by a bruise are not excluded
  (microcrack, fracture, fracture of the tooth root).
• For periodontal abscess
  Gum disease is a common cause of this type of abscess, but it can also be the result of trauma.
• For gingival abscess
  A foreign body, such as hard popcorn or toothbrush bristles, gets lodged in the gums.

How is this tooth infection treated?

Treatment of an abscessed tooth is aimed at eliminating the infection and relieving pain. Depending on your symptoms, your dentist may start with x-rays. This will help you see if the infection has spread to other areas. Depending on the type and severity of your abscess, treatment options include:

• Abscess drain.
  Your dentist will make a small incision in the abscess to drain the pus. You will only need to be careful to clean the affected area.
  with a saline solution.
• Root canal treatment.
  This method involves drilling into the affected tooth to clear the abscess from the tooth and remove the infected pulp.
  Your dentist will then fill and seal the pulp chamber and root canal. Most likely, your tooth is recommended to be covered with a crown in order to strengthen it, since the entire crown part of the tooth usually suffers from purulent pulpitis.
• Extraction of a tooth.
  If your tooth is too damaged, the only option is to extract the tooth and then drain the abscess.
  After tooth extraction, the best rehabilitation is a single tooth prosthetics on an implant.
• Antibiotics.
  If the infection has spread beyond the abscess area or if you have a weakened immune system,
  your dentist may prescribe antibiotics to treat the infection.
• Removal of foreign objects.
  If your abscess is caused by a foreign object in your gums, your dentist will remove it by cleaning the area with saline.
  If you can’t get to your dentist right away, you can take an over-the-counter anti-inflammatory medicine, such as ibuprofen, to help relieve pain. Gargling with warm salt water may also help.

Are there complications from a tooth abscess?

It is important that any abscessed tooth is treated by a dentist. Even if it is already torn, you will need to inspect and clean the infected area in the dental chair to make sure the infection is not spreading. If left untreated, the infection can spread to your jaw and other parts of your head and neck, including your brain. In rare cases, it can even lead to sepsis. This is a life-threatening complication of the infection. If you have an abscessed tooth with this symptom:

• High temperature
• Facial edema
• Difficulty swallowing
• Palpitations
• Violation of diction

These are all signs of a serious infection that needs immediate treatment.
In conclusion about abscess.
An abscess tooth should be cleaned within a few days of a professional dental intervention.
Even if you think it’s going down on its own, it’s important to check with your dentist to make sure the infection isn’t spreading to another area.
You can reduce the risk of an abscessed tooth by practicing good oral hygiene and having regular dental checkups every six months.

Cyst.

A dental cyst is perhaps the most common problem that brings people to the dentist for emergency treatment,
because it can suddenly and unexpectedly cause severe pain and inflammation in the jaw area (abscess).
With a superficial examination, it is almost impossible to detect a dental cyst. An x-ray or MRI may be needed to look for a cyst.
Growth in the area of ​​the tooth is easily visible. The cyst should be found as early as possible so that you can heal more easily and without the risk of further damage to the tooth.

What is a dental cyst?

A dental cyst is an abnormal cavity that contains fluid, cells and other organic matter and is surrounded by a solid wall.
A dental cyst usually develops at the tip of the tooth, near the apex, due to inflammation of the nerve (Fig. 1)
In other cases, a cyst may appear around a tooth that has undergone root canal treatment but the bacteria has not been completely removed (Figure 2).
The unfortunate thing is that over time, a dental cyst grows in size and can cause gradual destruction of the bone and adjacent teeth (Fig. 3) or affect more sensitive tissues such as the mandibular nerve (Fig. 4) (marked with a yellow line). This is the reason why a dental cyst should be removed as soon as possible.

Dental cyst treatment.

Once a dental cyst is found, the cyst itself and the associated tooth must be removed. This means that in this area we will have a significant deficit of hard tissues,
which can also cause an aesthetic problem. Using digital imaging techniques, we can now estimate the size of the cyst and the extent of damage before we even begin treatment.
After removing the cyst, we can regenerate the lost bone using guided bone regeneration or bone augmentation techniques,
and then restore the missing tooth with an implant

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