A tooth abscess is a very painful and serious condition that must be dealt with. If you’ve had one, you know this to be true. If you have a tooth abscess, it needs to be treated soon. It may worsen or spread to other areas of the body if left untreated. Worsening or spreading of the abscess develops in stages, yet can result in an emergency dental appointment.

At Sninski & Schmitt Family Dentistry, we have a lot of experience seeing patients who have an abscess. In this article, we explain what a tooth abscess is, the various stages of developing an abscess, the symptoms of an abscess, the diagnosis, and the available treatments.

Tooth Abscess Defined

A tooth abscess is a pocket of pus and inflamed tissue that is caused by a bacterial infection. It can occur in different areas near the tooth such as the gums either at the surface (“gingival”), at the side of a tooth root (“periodontal”), or at the tip of the tooth (“periapical”). A tooth abscess won’t go away on its own; it must be treated. 

3 types of Tooth Infections Can Cause Abscesses:

1.) Gingival Abscess

A gingival abscess forms on the surface of the gum tissue. It is visible but small.

2.) Periodontal Tooth Abscess

A periodontal tooth abscess is a painful, pocket filled with pus that forms deeper within the gum tissue mainly at the gum pockets at the side of a tooth root. It can easily spread to surrounding bone and tissue since the pus has nowhere to drain. Periodontal abscesses should be considered dental emergencies that require immediate treatment by a dentist.

3.) Periapical Tooth Abscess

A periapical tooth abscess occurs when bacteria move into the dental pulp, also called the root. The pulp is the soft tissue that makes up the inner structure of a tooth. It is located in the center of the tooth, directly beneath the dentin layer, and contains blood vessels, nerves, and connective tissue. Once the infection reaches the dentin, it can easily attach to the soft inner pulp where the nerves are located and cause severe pain.

Causes of Tooth Abscesses

Possible causes of a tooth abscess include:

  • Poor oral hygiene
  • Untreated dental decay
  • Gum disease
  • Dental trauma

Even common dental procedures can cause a tooth infection. When you have dental decay or trauma, bacteria enter the tooth pulp through an opening like decay, a crack, or a chip in the enamel. With gum disease, an infection starts in the gum tissue and spreads either to the root of your tooth or to an opening in the enamel along the gumline.

Abscessed Tooth Risk Factors:

There are lifestyle factors that may make you more likely to get an abscessed tooth, including:

  • Not getting regular dental care – When you aren’t getting regular teeth cleaning, the tartar and plaque can build up and result in inflamed gums.
  • Poor dental habits – When you don’t brush your teeth at least twice a day and floss, you will have more issues such as tooth decay and gum disease.
  • Too much sugar in your diet – When you frequently eat food and drink beverages with a lot of sugar content, you are more likely to get cavities. 
  • Dry mouth – Certain medications and aging can cause dry mouth, which increases the risk of tooth decay.

Stages of a Tooth Abscess

An abscessed tooth usually happens gradually and there are a series of dental problems with clear stages that occur. That being said, abscesses can also develop relatively quickly, as little as one or two days after the first signs of infection. If an abscess progresses undetected and is left untreated for months or even years, there is a danger of losing not only the tooth but also the bone. Since early detection is critical, you should see a dentist for regular dental checkups. Contact us at the first sign of an infection.

1. Enamel Decay

First, bacteria build up in the mouth. Usually, this is caused by plaque. By brushing your teeth regularly and thoroughly, as well as maintaining routine dental cleanings, you eliminate the plaque along the gum line and your teeth. When plaque builds up, acid can form and erode the tooth enamel, which causes tooth decay and cavities. The accumulation of bacteria leads to the development of pus and then a dental abscess. 

2. Dentin Decay

Allowing a cavity to go untreated, bacteria continue to progress through the enamel and enter the dentin.

3. Tooth Pulp Infection

After the bacteria destroy the dentin, they can enter the inner pulp of the tooth. This causes the nerves in the tooth to die and the body’s immune system begins to attack the infection. Pus develops around the dying roots, resulting in dental abscesses.

4. Abscess Formation

After the bacteria enters the pulp of the tooth or progresses deeper into the gums or jawbone, you will notice pain surrounding the tooth, along with gum redness and swelling. You may also experience a fever.

5. Tooth Loss

At this stage, throbbing pain indicates that a dental abscess has developed and that you should see a dentist. This is a critical point at which the abscess should be treated at once so that it doesn’t worsen. If left untreated, the abscess can erode the bone and lead to tooth loss. 

Symptoms of a Tooth Abscess

A tooth abscess can exhibit various symptoms, including:

  • Tooth pain when chewing
  • Pain that radiates to your jaw
  • Increased dental sensitivity to hot or cold food and drink
  • Bad breath
  • Bitter taste
  • Gum tissue swelling
  • Fever
  • Swollen lymph nodes
  • Difficulty opening and closing your mouth

You can experience an intense, throbbing pain in the affected tooth or gum that can come on suddenly and becomes gradually worse. You may feel pain that spreads to your ear, jaw, and neck on the same side as the affected tooth or gum, as well as a pain that gets worse when you lie down. You can also experience difficulty swallowing or breathing.

When you experience any of these symptoms, contact your dentist immediately. Without treatment, the bacteria causing the infection can spread to the bloodstream and can result in a serious and potentially life-threatening infection called sepsis.

Tooth Abscess Diagnosis

A dentist will recommend one or a combination of the following:

  • Recommend a dental X-ray – An X-ray can help identify sources of dental disease that may have led to the abscessed tooth. The X-ray can also determine if the infection has spread and may be affecting other areas.
  • Recommend a CT scan – If the infection has spread to other areas within your neck, the CT scan will help to identify the extent of the infection.
  • Tap and press on your teeth – An abscessed tooth will probably be sensitive to touch or pressure.
  • Do thermal tests – Thermal tests will help determine the health of your tooth pulp.

Tooth Abscess Treatment

Options for tooth abscess treatment are:

Incise and Drain the Abscess

The dentist makes a small cut into the abscess, allowing the pus to drain out. Then, the dentist washes the area with salt water (saline). Sometimes, a small rubber drain is placed to keep the area open for drainage while the swelling goes down.

Root Canal

Performing a root canal can help get rid of the infection and save the tooth. The dentist drills down into your tooth, removes the diseased central tissue (pulp), and drains the abscess. Then, the dentist fills and seals the tooth’s pulp chamber and the root canals. Afterward, the tooth may be capped with a crown to make it stronger, especially if it is a molar located in the back of the mouth.

Tooth Extraction

In the case where the tooth can’t be saved, your dentist will extract the tooth and drain the abscess to get rid of the infection.

Prescribe Antibiotics

If the infection is limited to the abscessed area, you may not need antibiotics. But, if the infection has spread to nearby teeth, your jaw, or other areas, the dentist will prescribe antibiotics to stop it from spreading further. If you have a weakened immune system, the dentist will likely prescribe antibiotics.

Contact Sninski & Schmitt Family Dentistry to Schedule a Dental Cleaning and Checkup.

If you are experiencing any of the symptoms described in this article, you should schedule an appointment with our dental team at Sninski & Schmitt Family Dentistry without delay. The prospect of a tooth abscess is serious and should be dealt with as soon as possible. Avoid letting the abscess worsen and compromise the tooth health. We can help you with expert diagnosis and treatment. Call our Holly Springs dentist office at (919) 600-6262 or our Cary, NC dentist office at (919) 467-2203 or use the form below to schedule an appointment.

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