Dental Infections and Abscesses
A dental abscess is a pocket of pus that’s caused by a bacterial infection. The abscess can occur at different regions of the tooth for different reasons. A periapical abscess occurs at the tip of the root, whereas a periodontal abscess occurs in the gums at the side of a tooth root. The information here refers specifically to periapical abscesses.
A periapical tooth abscess usually occurs as a result of an untreated dental cavity, an injury or prior dental work. Dentists will treat a tooth abscess by draining it and getting rid of the infection. They may be able to save your tooth with a root canal treatment, but in some cases the tooth may need to be pulled. Leaving a tooth abscess untreated can lead to serious, even life-threatening, complications.
Symptoms
Signs and symptoms of a tooth abscess include:
Severe, persistent, throbbing toothache that can radiate to the jawbone, neck or ear.
Sensitivity to hot and cold temperatures
Sensitivity to the pressure of chewing or biting
Fever
Swelling in your face or cheek
Tender, swollen lymph nodes under your jaw or in your neck
Sudden rush of foul-smelling and foul-tasting, salty fluid in your mouth and pain relief, if the abscess ruptures
Difficulty breathing or swallowing
When to see a Doctor
See your dentist promptly if you have any signs or symptoms of a tooth abscess.
If you have a fever and swelling in your face and you can’t reach your dentist, go to an emergency room. Also go to the emergency room if you have trouble breathing or swallowing. These symptoms may indicate that the infection has spread deeper into your jaw and surrounding tissue or even to other areas of your body.
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Causes
A periapical tooth abscess occurs when bacteria invade the dental pulp — the innermost part of the tooth that contains blood vessels, nerves and connective tissue.
Bacteria enter through either a dental cavity or a chip or crack in the tooth and spread all the way down to the root. The bacterial infection can cause swelling and inflammation at the tip of the root.
Risk Factors
These factors may increase your risk of a tooth abscess:
Poor dental hygiene. Not taking proper care of your teeth and gums — such as not brushing your teeth twice a day and not flossing — can increase your risk of tooth decay, gum disease, tooth abscess, and other dental and mouth complications.
A diet high in sugar. Frequently eating and drinking foods rich in sugar, such as sweets and sodas, can contribute to dental cavities and turn into a tooth abscess.
Dry mouth. Having a dry mouth can increase your risk of tooth decay. Dry mouth is often due to the side effect of certain medications or aging issues.
Complications
A tooth abscess won’t go away without treatment. If the abscess ruptures, the pain may decrease significantly — but you still need dental treatment. If the abscess doesn’t drain, the infection may spread to your jaw and to other areas of your head and neck. You might even develop sepsis — a life-threatening infection that spreads throughout your body.
If you have a weakened immune system and you leave a tooth abscess untreated, your risk of a spreading infection increases even more.