Disease, Condition & InjuryHead & neck conditionsMouth

Tooth abscess

(Dental Abscess; Abscessed Tooth)

Tooth abscess – Definition

A tooth abscess is a sac of pus (infected material) in a tooth or the gums. There are two types of tooth abscesses:

  • Abscess of the pulp (blood and nerve supply inside the tooth)
  • Abscess between the tooth and gum

Tooth abscess – Causes

Bacteria cause a tooth abscess. It begins when bacteria invade and infect 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:

  • Severe tooth decay
  • Break or crack in a tooth that lets bacteria invade the pulp

Food or other foreign matter that becomes trapped between the tooth and gum may lead to a bacterial infection in the area around the tooth.

Tooth abscess – Risk Factors

These factors increase your chance of developing a tooth abscess. Tell your dentist if you have any of these risk factors:

  • Build up of tartar or calculus beneath the gum line
  • Poor fluoride application to teeth via fluoridated water, toothpaste, or mouthwash
  • Poor dental hygiene (leading to cavities and periodontal diseases)
  • Malnutrition, including severe vitamin and mineral deficiencies

Tooth abscess – Symptoms

If you have any of these symptoms do not assume it is due to a tooth abscess. These symptoms may be caused by other conditions. Tell your dentist if you have any of these:

  • Throbbing/lingering pain in a tooth or gum area
  • Pain when biting on a tooth
  • Spontaneous tooth pain
  • Redness, tenderness, or swelling of the gums
  • Fever
  • Swollen neck glands
  • Tooth discoloration
  • Bad breath or foul taste in mouth
  • Open, draining sore on the gums

If left untreated, complications of tooth abscess include:

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

Tooth abscess – Diagnosis

Your dentist will ask about your symptoms and medical history and perform a detailed exam of your teeth and gums.

Your dentist will test the tooth for pain and sensitivity by:

  • Lightly tapping on the tooth
  • Stimulating the tooth nerve with heat or cold
  • Stimulating the tooth nerve with a low electrical current
  • Sliding a probe between the tooth and gum to measure gaps or tissue loss

Your dentist will also take an x-ray of the tooth and surrounding bone.

Tooth abscess – Treatment

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 top of the tooth.
  • Pus and dead tissue are removed from the center of the tooth.
  • The interior of the tooth and the root (nerve) canals are cleaned and filled with a permanent filling.
  • A crown is placed on the tooth to protect it.

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 recurrence of infection.

Tooth Extraction (Removal)

Removal of the tooth 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

Antibiotics to fight residual infection of the tooth or gums

Nonprescription pain relief drugs (ibuprofen or acetaminophen) and warm salt water rinses

Tooth abscess – Prevention

To help reduce your chance of getting a tooth abscess, take the following steps:

  • Proper dental hygiene, including:
    • Brushing teeth with fluoride toothpaste after meals or at least twice per day
    • Daily flossing between teeth and gums
    • Regular dental check-ups (every six months)
    • Regular professional teeth and gum cleaning (every six months)

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