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A dental abscess, also known as an oral or tooth abscess, is a localized bacterial infection resulting in a collection of pus.
A long-term buildup of pus inside the gums or in the bone surrounding the teeth triggers an abscess. The infection can affect the surrounding structures and cause persistent toothaches and uncomfortable symptoms.
Three main types of dental abscesses form in different regions around a tooth. They are:
Depending on the type of dental abscess and how long it has been progressing, common symptoms may include:
If the abscess ruptures, you may notice a foul taste (salty fluid) and smell in your mouth. You may also experience pain relief in the infected tooth. If this occurs, call your general dentist immediately.
If you experience spreading facial swelling or difficulty breathing, call your local emergency department or 911.
A tooth abscess is one of the later stages of tooth decay. The infection commonly starts as decay, dental trauma, leakage from previous dental work, or a broken tooth. It evolves into an abscess when left untreated. The stages of abscess formation may include:
The first stage is damage to the enamel or outer layer of the tooth. Plaque buildup on a tooth can often lead to enamel decay.
Some people may not experience symptoms. This is because the decay is far from the nerve inside the tooth. Others develop tooth sensitivity or decalcified white spots prone to enamel breakdown.
If you don't treat your enamel decay, it will progress to the dentin layer of your tooth. Dentin is a bone-like, yellow-hued structure under the tooth's enamel layer. Many people experience increased tooth sensitivity in this stage of decay. For others, a small hole in the tooth may develop.
If untreated, the decay will progress to the pulp, the innermost layer of your tooth. This layer contains nerves, blood vessels, specialized cells, and connective tissues.
If bacteria reach this layer, they can attack the tooth's nerve, causing severe pain. Eventually, the tooth's nerve dies, and an abscess forms.
Once the bacteria reach your pulp, they can spread deeper into your gums or jawbone. Your gums may begin to swell, and you may notice a pimple-like bump on your gums. The abscess formation may cause throbbing pain in your teeth, gums, and surrounding tissues.
Leaving your tooth abscess untreated could lead to serious complications, including:
Good oral hygiene is the best way to prevent most oral conditions and diseases. The best means of avoiding an abscess include:
Bacteria buildup from neglected oral hygiene is the primary cause of a dental abscess.
Other risk factors include:
Injuries, dental damage, or deep tooth cracks allow bacteria to spread to deeper parts of the teeth or gums. This leads to an abscess.
People with weaker immune systems or those taking medications for severe health conditions are at a higher risk of developing abscesses. This includes people:
Long-term use of antibiotics, a dry mouth, and a weakened immune system can all upset the healthy balance of bacteria in the mouth. They can also lead to mouth sores, infections, decay, and, eventually, abscesses.
Eating sugary and processed foods results in the buildup of dental plaque. Plaque eventually hardens into calculus. Without proper brushing and flossing, gum disease and tooth decay may develop. If left untreated, this can eventually evolve into an abscess.
Three treatment options are available, depending on the type and severity of the infection. They are:
Incision and drainage is typically recommended if the abscess is treated early and hasn’t progressed. A dentist will make a small incision to drain the pus from the abscess during the procedure before cleaning the infected area and prescribing antibiotics.
Root canal treatment is necessary when the bacteria spread to the dental pulp and tooth roots. It is also required if there is an abscess at the root of a tooth (periapical abscess).
During the procedure, a dentist removes the infected dental pulp in the person’s tooth. They then clean, shape, and seal the root canal system. Finally, they cover the tooth with a dental crown.
Tooth extractions may be necessary after a tooth gets damaged from an injury, disease, or decay. If an abscessed tooth cannot be saved, extraction is necessary.
Local anesthesia is administered during the procedure, and the tooth is removed using surgical instruments. After extraction, the tooth socket is covered with sterile gauze, and pressure is applied for about 30 minutes.
After an extraction, the infection will drain through the empty socket. The area can take ten days to a few weeks to fully recover after treatment.
Your dentist will schedule check-ups with you to ensure proper recovery. You may still have an infection if you are experiencing:
Occasionally, antibiotics are recommended after the root canal or extraction is complete. This is to clear the infection. Taking antibiotics without removing the infected tooth will not cure a dental abscess.
Commonly prescribed antibiotics for dental abscesses include amoxicillin and penicillin. Other antibiotics prescribed to people with tooth abscesses include:
The course of treatment for most antibiotics is 7 to 10 days. Antibiotics must be taken for the entire treatment duration to ensure complete recovery, even if your symptoms disappear sooner.
While Ibuprofen and similar over-the-counter (OTC) painkillers cannot treat a dental abscess, they help control pain related to the infection. Only use OTC medications as necessary. Long-term use of OTC painkillers can lead to organ damage.
Many dentists recommend taking OTC painkillers while you wait for treatment. You can also take them after treatment alongside the antibiotics your dentist may prescribe.
Dental abscesses should be treated promptly to avoid the risk of serious complications. If left untreated, serious complications include:
A tooth abscess will not go away on its own. If a dentist does not drain the abscess, it can spread to other areas of your body, including the jaw, head, neck, and bloodstream.
Never try to pop or squeeze a dental or gum abscess. Doing so can push the infection into deeper tissues in your mouth and cause a secondary infection.
You cannot drain a gum abscess at home. However, you can minimize the pain by applying a warm compress to the area four times daily for 30 minutes.
Symptoms that a tooth abscess has spread to other parts of your body include fever, swelling, dehydration, increased heart rate, and increased breathing rate.
Predicting how a dental infection will spread is difficult. It’s best to assume a tooth abscess is an emergency. Any visible swelling in the gums, whether painful or not, could be dangerous. Seek urgent dental care.
Most abscesses are warm and soft to the touch. In some cases, they can be firm to the touch.
Antibiotics alone cannot treat a tooth abscess. An abscess has to be professionally drained by a dentist and the offending tooth must be treated. A dentist may prescribe antibiotics if the infection has spread or is very severe.
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