A dental abscess, or tooth abscess, is an accumulation of pus that forms inside the teeth or gums.
The abscess typically originates 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, as well as the gums.
If the plaque is not removed by regular and proper tooth brushing and flossing the bacteria may spread within the soft tissue inside the tooth or gums, eventually resulting in an abscess.
Contents of this article:
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
- If the symptoms of a dental abscess appear, the individual should visit a dentist immediately
- Treatment for an abscess may involve root canal surgery
- If a dental abscess recurs after treatment, the tooth may be extracted
- To minimize pain, it is best to avoid cold drinks and food and use a softer brush
- If untreated, an abscess can lead to worse conditions such as cysts or maxillary sinusitis.
What is a dental abscess?
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.
A dental abscess usually requires treatment; otherwise it can worsen and result in the destruction of bone tissue.
Symptoms of a dental abscess
Pain is the main symptom of a dental abscess.
Signs and symptoms of a dental abscess include:
- Pain in the affected area when biting
- Touching the affected area may be painful
- Sensitivity to cold or hot food and liquids
- A foul taste in the patient's mouth
- General malaise (the patient feels generally unwell)
- Trismus - the patient finds it harder to open his/her mouth
- Dysphagia - swallowing difficulties
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 subsequent hours or days. In some cases the pain may radiate to the ear, jawbone and neck.
Causes of a dental abscess
A dental abscess in most cases is a complication of a dental infection. Bacteria, often bacteria present in plaque, infect and make their way into a tooth.
Bacteria enter the tooth through tiny holes caused by tooth decay (caries) that form in the tooth enamel (hard outer layer of the tooth). The caries eventually break down the softer layer of tissue under the enamel, called dentine. If the decay continues, the hole will eventually penetrate the soft inner pulp of the tooth - infection of the pulp is called pulpitis.
As the pulpitis progresses the bacteria make their way to the bone that surrounds and supports the tooth, called the alveolar bone, and a periapical abscess is formed.
When bacteria which are present in plaque infect the gums the patient has periodontitis. The gums become inflamed, which can make the periodontal ligament (tissue surrounding the root of the tooth) separate from the base of the tooth.
A periodontal pocket, a tiny gap, is formed when the periodontal ligament separates from the root. The pocket gets dirty easily and is very hard to keep clean. As bacteria build up in the periodontal pocket, periodontal abscess is formed.
Patients can develop periodontal abscesses as a result of a dental procedure which accidentally resulted in periodontal pockets. Also, the use of antibiotics in untreated periodontitis, which can mask the symptoms of an abscess, can result in a periodontal abscess. Sometimes gum damage can lead to periodontal abscesses, even if no periodontitis is present.
Dental abscess symptoms? What to do
Any person with symptoms linked to a dental abscess should see a dentist immediately. Dental abscesses are easily diagnosed by a qualified dentist. In the UK the National Health Service (NHS) advises people to visit either their usual registered dentist, a local Dental Access Centre, or the emergency department of their local general hospital.
People who have swallowing and/or breathing problems should go straight to the emergency department of their local hospital.
If for some reason you cannot get to a dentist immediately you could visit your GP (general practitioner, primary care physician). A doctor cannot treat an abscess, but he/she may prescribe medication and advise on self-care and pain management, and is also likely to know the fastest way of getting emergency treatment, if required.
On the next page, we look at the treatments for a dental abscess, including dental procedures, surgery options and what you can take to reduce the pain from an abscess.