Tooth Abscess

(Dental Abscess; Abscessed Tooth)

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Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention | Organizations

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Definition

A tooth abscess is a sac of pus (infected material) in a tooth or the gums that results from bacterial infection. There are two types of tooth abscesses:

• Abscess of the pulp (inside) of the tooth
• Abscess between the tooth and gum

Causes

A tooth abscess begins when bacteria invades and infects a tooth, resulting in the build up of pus. When the pus is unable to drain, an abscess results.

Conditions that allow bacteria to invade a tooth include:

• Severe tooth decay
• Break or crack in a tooth that allows bacteria to invade the pulp of the tooth

Food or other foreign matter that becomes trapped between the tooth and gum may lead to a bacterial infection in that location.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Build-up of tartar beneath the gum line
• Inadequate fluoride application to teeth, via fluoridated water, toothpaste, or mouthwash
• Poor dental hygiene leading to untreated caries and periodontal diseases
• Malnutrition, including severe vitamin and mineral deficiencies

Symptoms

Symptoms include:

• Throbbing/lingering pain in a tooth or gum area
• Pain when biting on a tooth
• Redness or swelling of the gums
• Swollen glands in the neck
• Discoloration of a tooth
• Bad breath or foul taste in mouth
• Open, draining sore on the gums

If left untreated, complications of tooth abscess can include:

• Loss of tooth
• Spread of infection to surrounding tissue or bone

Diagnosis

A dentist will ask about your symptoms and medical history and perform a detailed exam of your teeth and gums.

The examination will include testing the tooth for pain and sensitivity by:

• Lightly tapping on the tooth
• Placing ice on the tooth
• Stimulating the tooth nerve with a low electrical current
• Sliding a probe between the tooth and gum

Your dentist will also take an x-ray of the tooth and surrounding bone.

Treatment

Treatment includes:

Removal of Abscess Via Root Canal

• If abscess results from tooth decay or a break or crack in the tooth:
  • The tooth is numbed and a hole is drilled through top of the tooth.
  • Pus and dead tissue are removed from the tooth.
  • The interior of the tooth and the root (nerve) canals are cleaned and filled with a permanent filling.
  • A crown is placed on the tooth to protect it.
• If abscess results from infection between the tooth and gum:
  • The abscess is drained and thoroughly cleaned.
  • The surface of tooth is smoothed.
  • In some cases, surgery to reshape the gum is performed to prevent recurrence of infection.

Tooth Extraction (Removal)

• Removal of the tooth may be required if:
  • Tooth decay and/or tooth infection is too extensive for filling or root canal.
  • The break or crack in the tooth is too severe to be repaired.
  • The infection between the tooth and gum is extensive.
• If the tooth is extracted, it will be replaced with:
  • A partial bridge
  • A denture
  • A tooth implant

Medication

• Antibiotics to fight residual infection of the tooth or gums
• Non-prescription pain relief drugs (ibuprofen or acetaminophen) and warm salt water rinses

Prevention

Most tooth abscesses can be prevented with:

• Proper dental hygiene, including:
  • Brushing teeth with fluoride toothpaste after meals or at least twice per day
  • Daily flossing between teeth and gums
  • Regular dental check ups (every 6 months)
  • Regular professional teeth and gum cleaning (every 6 months)
• Limiting the amount of sugar you eat to prevent cavities

Organizations

American Dental Association
http://www.ada.org

SOURCES:

The Merck Manual of Medical Information—Home Edition. Simon and Schuster, Inc., 2000.

American Dental Association

U.S. National Library of Medicine

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Last reviewed September 2001 by Medical Review Board