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InfectiousICD-10: K04.7Dental infections account for over 2 million emergency department visits per year in the U.S.

Tooth Abscess (Dental Abscess)

A tooth abscess is a pocket of pus caused by a bacterial infection that can occur at different areas around a tooth. A periapical abscess occurs at the tip of the root, while a periodontal abscess occurs in the gums at the side of a tooth root. Dental abscesses do not resolve on their own and require prompt treatment to prevent the infection from spreading to the jaw, head, neck, or even becoming life-threatening through sepsis.

Symptoms

Severe, persistent, throbbing toothache that may radiate to the jawbone, neck, or ear
Sensitivity to hot and cold temperatures
Pain when chewing or biting
Swelling in the face, cheek, or neck
Tender, swollen lymph nodes under the jaw or in the neck
Fever
Foul-tasting or foul-smelling drainage if the abscess ruptures
Sudden rush of salty fluid with pain relief if the abscess drains

Causes

  • Untreated dental cavities allowing bacteria to reach the tooth pulp
  • Cracked, chipped, or broken teeth exposing the inner tooth to bacteria
  • Gum disease (periodontitis) creating deep pockets where bacteria accumulate
  • Previous dental procedures or trauma to the tooth

Risk Factors

  • Poor dental hygiene including infrequent brushing and flossing
  • High-sugar diet promoting tooth decay
  • Dry mouth conditions from medications or medical disorders
  • Weakened immune system from diabetes, chemotherapy, or other conditions
  • Lack of regular dental care and check-ups

Diagnosis

  • Dental examination including tapping on the affected tooth (percussion test)
  • Dental X-rays (periapical radiographs) to identify the abscess and extent of infection
  • CT scan if the infection has spread to the neck or other areas
  • Pulp vitality testing to assess whether the tooth nerve is alive

Treatment

  • Incision and drainage of the abscess to remove pus
  • Root canal therapy to save the affected tooth
  • Tooth extraction if the tooth cannot be saved
  • Antibiotics (amoxicillin, clindamycin, metronidazole) for spreading infections
  • Pain management with NSAIDs and acetaminophen
  • Drainage of any associated facial space infections

Prevention

  • Brush teeth twice daily with fluoride toothpaste
  • Floss daily to remove plaque between teeth
  • Visit a dentist regularly for check-ups and professional cleanings
  • Reduce sugary food and drink consumption
  • Replace your toothbrush every 3-4 months
  • Address dental problems like cavities or cracks promptly

When to See a Doctor

  • You have a severe toothache with facial swelling or fever
  • You have difficulty breathing or swallowing due to dental swelling
  • Symptoms persist or worsen despite over-the-counter pain medications

Frequently Asked Questions

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

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