Tooth Abscess

A tooth abscess is a collection of pus caused by a bacterial infection in or around a tooth. The two most common types are a periapical abscess, which forms at the tip of the root after the pulp has become infected, and a periodontal abscess, which forms in the gum and bone beside the root.

Why It Matters

An abscess does not resolve on its own. If it drains through the gum, the pain may ease for a while, but the source of the infection is still there and it usually flares up again. Left untreated, the infection can spread into the jawbone and the soft tissues of the face and neck.

Clinical Details

• Periapical abscess: Starts inside the tooth. Deep decay, a crack or trauma lets bacteria reach the pulp; the pulp dies and the infection exits through the root tip into the bone.
• Periodontal abscess: Starts in a deep gum pocket, usually in someone with periodontal disease. The tooth itself may still have a healthy pulp.
• Pericoronal abscess: Forms in the gum flap over a partially erupted tooth, most often a lower wisdom tooth.
• Typical symptoms: Throbbing pain that may spread to the ear, jaw or neck; pain when biting; swollen gum or face; a bad taste; and sometimes a pimple-like bump on the gum (sinus tract) that leaks pus.
• Diagnosis: Clinical examination, tapping and bite tests, pulp sensibility testing and a dental X-ray to locate the source.
• Treatment: The infection is drained and its source removed: root canal treatment or extraction for a periapical abscess, and cleaning of the pocket for a periodontal abscess.

FAQ

Can a tooth abscess go away on its own?

No. The pain can stop if the abscess drains or the nerve dies, but the infection remains in the tooth or gum. It needs dental treatment to remove the source.

Will antibiotics cure a tooth abscess?

Antibiotics do not remove the cause. They may be prescribed when the infection is spreading or you have signs of systemic illness, but drainage and treatment of the tooth or gum are still required.

When is a tooth abscess an emergency?

Seek urgent care if facial swelling is spreading, your eye or neck is swelling, you have difficulty swallowing, breathing or opening your mouth, or you feel generally unwell with a fever.