A dental abscess, also known as an abscessed tooth, occurs when a pocket of pus forms in or around an infected tooth root. Abscessed teeth are very painful, and they do not resolve on their own without treatment from a dentist. Gum disease, untreated cavities, and cracks in the teeth all increase your risk of a dental abscess, but they can truly happen to anyone.
What Causes Dental Abscesses?
Dental abscesses are caused by the same species of bacteria that cause gum disease and tooth decay. When these bacteria work their way into the inner tissues of the tooth root, known as the tooth pulp, the body starts sending white blood cells to the area to fend off the bacteria. The white blood cells start to accumulate, forming a pocket of pus. There are a number of ways that bacteria can become introduced to the tooth root and lead to an abscess.
Untreated Tooth Decay
One reason to always have your cavities filled promptly is to prevent dental abscesses. Cavities begin in the enamel, which is the hard outer covering of your teeth. However, as the cavity grows larger, it eventually extends into the deeper tooth issues. Decay is caused by oral bacteria, so once the cavity becomes deep enough, these bacteria are introduced to the tooth pulp and an abscess tooth develops.
Cracked Teeth
If you crack a tooth while playing sports or biting into something hard, bacteria can work their way down into the crack and cause an abscess. Patients don’t always notice they have cracked a tooth until pain sets in a few days or weeks later; this delayed pain is typically due to an abscess.
Gum Disease
Gum disease is caused by the same oral bacteria as tooth decay. When gum disease is becomes severe, pockets may form in the gums, and the tooth roots may become excessively exposed. It’s then easy for bacteria to work their way down into the inner tooth root tissue and lead to an abscess.
Abscess Tooth Symptoms
The most obvious symptom of a dental abscess is severe tooth pain. Often, this pain has a sharp, piercing quality, though some patients experience more of a dull, persistent ache. The pain may be localized in a single tooth, or it may feel like an entire side of your jaw is hurting. Often, the pain is worse if you lay down, so you may have trouble sleeping. Sometimes the pain may seem to be in a different tooth than the one that is actually infected; this is called referred pain.
In addition to tooth pain, patients with abscess teeth often experience swelling of the jaw, gum soreness, and extreme sensitivity to hot and cold foods. You might develop a mild fever. If the abscess is close to the surface of your gums, you might notice what looks like a pimple on your gums. This pimple may rupture if you press against it with your tongue, releasing a smelly liquid.
Treatment for Abscess Tooth Pain
If you believe you have a dental abscess, don’t delay seeking treatment from your dentist. Abscesses that are left untreated can spread infection to a neighboring tooth, into your jaw bone, or even into your brain or blood tissue, which may have serious or deadly consequences. The sooner your dentist is able to treat the abscess, the greater the chances of saving your tooth. Abscesses can be detected with a simple set of dental x-rays, which only take your dentist a few minutes to produce.
The abscess tooth treatment your dentist recommends will depend on the severity and location of the infection. Here are the most common treatment options.
Draining From the Gums
If the abscess is minor and is located near the surface of the gums, your dentist may drain the pus by making a small incision in your gums. You may be given local anesthesia to numb the treatment area during this procedure. Draining alone is not usually sufficient to treat an abscess. It relieves the pressure in your gums and can therefore help ease your tooth pain, but it does nothing to address the infected tissue inside your tooth.
Root Canal
Usually, your dentist will need to perform a root canal procedure to remove the infected tissue inside your abscess tooth. Root canals are not nearly as painful as you may have heard. Your tooth and gums will be numbed prior to the procedure. Then, the dentist will drill through the tooth to access the pulp inside your tooth roots. A special suction device or laser is used to clear away the infected tooth pulp. Then, your tooth roots are filled with a synthetic material, and the access hole is filled. Usually, your tooth is then covered with a crown to prevent future cracks and damage.
A root canal procedure and subsequent crown placement usually take place across at least two appointments. At the first appointment, the root canal is performed and a temporary crown is placed over your tooth. At the second appointment, a permanent crown made from porcelain or metal amalgam is cemented over your tooth.
A tooth that has been treated with root canal therapy is technically dead since its nerves and blood supply have been removed. However, this treated tooth can remain in your mouth for many years if you continue to care for it properly with good oral hygiene and dental care.
Extraction
If your tooth is badly decayed or cracked, or if the infection is extensive, your dentist may need to remove the infected tooth completely. You’ll be given local anesthesia, and then a dental elevator and forceps are used to remove the tooth from your jaw. After your socket heals for a few weeks, your dentist may insert a dental implant to replace the missing tooth.
Antibiotics
Antibiotics, such as amoxicillin and penicillin, are often used on conjunction with one of the treatments above. They help your body fight off the bacteria that caused the abscess and also help keep the infection from spreading to other teeth. You’ll typically be prescribed antibiotics for 7 to 10 days. It’s important to take them for the entire prescribed time, even if your dental pain goes away before you’ve taken all of the pills.
If a condition such as extensive tooth decay, a large cavity, or advanced gum disease contributed to the formation of your dental abscess, your dentist will also recommend treating these predisposing conditions to prevent future abscesses from forming. Cavities should be filled, and gum disease can be treated with a procedure called root scaling, which cleans the portions of your teeth beneath your gums.
How Can You Prevent Dental Abscesses?
Dental abscesses can be quite painful and may lead to tooth loss, so it’s important to do all you can to prevent them. Some of the best strategies to prevent abscesses include:
Practice Good Oral Hygiene
Make sure you thoroughly brush your teeth twice per day, and floss daily. This helps keep oral bacteria at bay, reducing your risk of cavities, gum disease, and abscesses.
Get Regular Dental Checkups
Most patients need to visit the dentist for a checkup every 6 months. If you have a history of serious gum disease or tooth decay, you may need to go more often. Regular checkups ensure that minor issues like cavities and cracks are diagnosed and treated before they can progress to causing an abscess.
Wear Your Mouthguard When Playing Sports
If you play contact sports, wear a mouthguard during practice and games. This reduces your risk of cracked teeth and the abscesses that sometimes result.
Avoid Sugary Foods and Drinks
Sugary foods and drinks feed oral bacteria, increasing your risk of tooth decay, gum disease, and tooth abscesses. Opt for healthy, low-sugar snacks like cheese, veggies, and nuts. Steer clear of fruit juice and soda, and opt instead for sugar-free choices like water, black coffee, and unsweetened tea.
