Tooth Abscess

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is a tooth abscess?

A tooth abscess is a bacterial infection inside a tooth. The infection leads to a buildup of pus inside the center of the tooth, and it can be very painful. The infection can originate as a result of poor dental hygiene or injury to the tooth, which allows bacteria to penetrate deep inside.

A tooth abscess can be a serious condition because the infection, particularly when left untreated, may spread and cause complications elsewhere in the body. The infection can extend directly into adjacent tissues or spread through the bloodstream and cause serious infections of the jaw, brain, heart or lungs. Therefore, a tooth abscess should be immediately treated by a dentist.

Tooth abscesses are typically treated with antibiotics. Depending on the extent of the infection, a root canal or other dental work may also be performed.

Seek immediate medical care (call 911) if you experience symptoms indicating a severe or spreading infection, such as painful swelling of the jaw, difficulty breathing, vomiting, fever, or nausea associated with a tooth abscess.

Seek prompt medical care if you think you may have a tooth abscess, as timely treatment may prevent more serious complications.

What are the symptoms of a tooth abscess?

Symptoms of a tooth abscess include toothache, as well as pain and swelling around the infected tooth. Left untreated, a tooth abscess can infect the surrounding tissue, including the jawbone, or cause a serious systemic (body-wide) infection that may lead to fever, chills, nausea and vomiting.

Common oral symptoms of a tooth abscess

Symptoms of a tooth abscess may worsen over time, resolve on their own, or come and go. At times, any of these tooth abscess symptoms can be severe. Symptoms may be localized to the mouth or involve the entire body. Common oral symptoms of a tooth abscess include:

  • Bad breath (halitosis)

  • Bitter taste in the mouth

  • Draining pus from a tooth

  • Pain when biting, chewing, or clenching the teeth

  • Sensitivity to hot or cold foods and beverages

  • Swelling of the tissues surrounding the tooth, including the jaw

  • Toothache

  • Trismus (inability to fully open mouth)

Other symptoms of a tooth abscess

Other symptoms of a tooth abscess may have widespread effects on your body. These can include:

  • Earache

  • Fever

  • Malaise

  • Nausea

  • Swelling of the lymph nodes of the neck

  • Vomiting

Serious symptoms that might indicate a life-threatening condition

In most cases, a tooth abscess is not a serious condition. In rare cases, a tooth abscess left untreated can cause a life-threatening infection. Seek immediate medical care (call 911) if you, or someone you are with, have any of these serious symptoms including:

  • Difficulty breathing

  • Dizziness or vertigo

  • Fever and chills

  • Nausea, which may be described as feelings of wooziness, queasiness, retching, sea-sickness, car-sickness, or an upset stomach

  • Severe swelling of the jaw

  • Vomiting

What causes a tooth abscess?

A tooth abscess is caused by bacteria that infect the inside of a tooth. Poor dental hygiene, which leads to dental caries (cavities) or periodontal disease (gum disease), is the most common cause of a tooth abscess. A tooth abscess can also result from bacteria invading tissue in the mouth after dental work or other causes of injury to the teeth, such as chipping and breaking of the teeth.

What are the risk factors for a tooth abscess?

A number of factors increase your risk of developing a tooth abscess. Not all people with risk factors will get a tooth abscess. Risk factors for a tooth abscess include:

  • Dry mouth
  • Gingival recession
  • Heavily restored dentition
  • Inadequate access to dental care
  • Inadequate fluoride
  • Low socioeconomic status
  • Poor dental and oral hygiene
  • Poor nutrition including high level of sugary foods and drinks
  • Recent injury to the mouth or teeth, including chipped teeth
  • Recent oral surgery
  • Smoking

Reducing your risk of a tooth abscess

You may be able to lower your risk of a tooth abscess by:

  • Brushing your teeth regularly
  • Eating less sugar
  • Flossing your teeth regularly
  • Having regular dental examinations to monitor your oral health
  • Using antiseptic mouthwash

How is a tooth abscess treated?

Treatment of a tooth abscess begins with seeking care from your dentist. A tooth abscess can usually be diagnosed by a simple examination by your dentist. An X-ray may be helpful in identifying the extent and location of the infection.

Medications for treatment of a tooth abscess

An abscess is typically treated with antibiotics to fight the bacteria causing the infection. Over-the-counter pain-relieving medication may be helpful in limiting discomfort.

Examples of medical treatments for tooth abscess include:

  • Antibiotics, such as penicillin or erythromycin
  • Over-the-counter medications to relieve pain and fever, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol)

In addition to medical treatment, dental work such as a root canal may be required to repair damage to the tooth. In some cases, the affected tooth may need to be removed. Severe abscesses or an infection that has spread to surrounding tissue may require surgery to drain the area of infection.
Prompt treatment of a tooth abscess and taking all the medication prescribed by your dentist are important in preventing the spread of the infection into deeper tissues and limiting additional complications or recurrence.

What you can do to improve your tooth abscess

Contact your dentist if you think you may have a tooth abscess. Before seeing your health care provider, you may be able to reduce the discomfort associated with your tooth abscess by:

  • Rinsing your mouth with warm salt water
  • Taking over-the-counter pain relievers

What are the potential complications of a tooth abscess?

Left untreated, infection from a tooth abscess can spread to the jawbone, brain, heart or lungs and can lead to serious, even life-threatening complications. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of a tooth abscess may include:

  • Adverse effects of treatment
  • Cellulitis (infection of the skin)
  • Chronic dental pain or discomfort
  • Cosmetic disfigurement
  • Development of an abscess in another part of the body, including the brain
  • Endocarditis (infection of the heart chambers or valves)
  • Gum abscess
  • Inability to enjoy a normal diet
  • Mediastinitis (infection of the area around the lungs and heart)
  • Meningitis (infection or inflammation of the sac around the brain and spinal cord)
  • Osteomyelitis (bone infection)
  • Pneumonia
  • Sepsis (life-threatening bacterial blood infection)
  • Tooth loss
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 18
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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