A dental abscess is a bacterial infection in the space between your gums and teeth or around the tooth. It is a severe disease that can damage the tooth and its surrounding tissues, with the infection potentially spreading to other body parts if left untreated. It is a dental emergency that can result in severe pain, swelling, and discomfort, and its treatment cannot wait until your next dental checkup. The experienced Carson dentists at Washington Dental can first prescribe painkillers to manage symptoms. From there, we can diagnose the condition and recommend a dental treatment based on your dental goals and needs.

Defining Tooth Abscess

A tooth abscess is a pocket of pus caused by bacterial infections. It is a type of odontogenic infection (an infection that originates within the tooth).

The abscess can happen in various areas near your tooth. For instance, a periapical abscess occurs at the tooth’s tip, while a periodontal abscess happens in the gums at the root’s side.

Different Stages of Tooth Abscess

A tooth abscess is a later stage of tooth decay, and its phases include the following:

1. Enamel decay — It comprises damage to your tooth’s outermost layer. If you fail to brush thoroughly or frequently to eliminate plaque from your mouth and along your gum line, plaque can build up on your tooth surfaces and gums. Acid can form and erode your enamel, causing a cavity. Some patients do not experience signs and symptoms, while others have increased sensitivity to cold and heat. Enamel decay could lead to a white spot on your tooth.
2. Dentin decay — It encompasses decay to the dentin (the layer beneath your tooth’s enamel). Some patients experience tooth sensitivity or pain, while others have a visible cavity or hole in their teeth.
3. Pulp decay — It happens when bacteria go deep into your tooth’s innermost layer. Bacteria in your tooth pulp can attack your tooth’s nerves, leading to severe pain. Sometimes nerve damage causes the patient to feel intense pain, then nothing at all.
4. Abscess formation — A tooth abscess happens in the later tooth decay stage after bacteria travel deeper into your jawbone, gums, or pulp. You can notice pain near your tooth and redness and swelling of the gums.
5. Tooth loss —An untreated abscess can erode the bone, causing a severely damaged tooth to fall out or break.

Symptoms of Tooth Abscess

Common symptoms include the following:

• Sensitivity to cold or hot temperatures.
• Halitosis (bad breath).
• Bitter taste in the mouth.
• Gum swelling and redness.
• The affected tooth loosening.
• Open, draining sore on your gums’ side.
• Swollen area in the lower or upper jaw.
• Fever.
• Discomfort, ill feeling, or uneasiness.
• Swollen lymph nodes.
• Discolored tooth.

You can describe tooth abscess-related pain as:

• Shooting or sharp.
• Throbbing or gnawing.
• Radiating to your ear, neck, or jawbone.
• Persistent or only when chewing.

Please note that only dental abscesses that develop a gum boil or fistula are visible, and it is possible to have no visible signs that the abscess has formed.

Many abscesses have a warm and soft touch. Occasionally, they can feel stiff and firm. Consult your dentist immediately if you suspect an abscess or have a toothache, jaw swelling, or a hard lump in your mouth.

When Should You Seek Emergency Dental Attention?

If you have a tooth abscess or a suspected abscess and the following symptoms, manifest, you should seek immediate medical care:

• An abscess that feels large or is at least a centimeter in diameter.
• Hard lumps or severe swelling on your face or gums.
• Bleeding in your mouth or gums.
• Body temperature of at least 101.4 Fahrenheit or a fever.
• Tender lymph nodes in your neck.
• Pain that painkillers cannot control.
• Challenges with breathing or shortness of breath.
• Dehydration caused by challenges drinking liquids.
• Difficulty swallowing due to swelling.
• Challenges opening the mouth.
• Mouth secretion that you cannot handle due to swallowing challenges.

You can visit an emergency healthcare facility because seeing your dentist on time is impossible. The doctor will manage the condition by offering pain relief and antibiotics until you can see your dentist.

Dentists are not part of the standard staff in many hospital emergency departments. A doctor’s treatment cannot replace consulting your dentist. The doctor is not specialized in handling dental health conditions and can only manage pain and infection.

What Causes Abscess?

Anything that creates an opening for bacteria to get into the tooth or its neighboring tissues can result in an abscess. Nevertheless, the way it happens depends on the type of abscess:

Periodontal Abscess

When bacteria present in plaque infect your gums, you have periodontitis. Your gums will become inflamed, separating the tissues surrounding your tooth’s root from the tooth’s base.

A periodontal pocket, a small gap, is formed when your periodontal ligament separates from the tooth root. The pocket gets dirty quickly and is challenging to clean. As bacteria build up in the pocket, a periodontal abscess is formed.

You can develop a tooth abscess due to a dental treatment that accidentally leads to periodontal pockets.

Additionally, using antibiotics for untreated periodontitis, which can mask abscess symptoms, can cause a periodontal abscess.

Sometimes gum damage can result in a periodontal abscess, even when you do not have periodontitis.

Periapical Abscess

Bacteria enter your teeth via small holes caused by caries or tooth decay that form in your tooth’s hard outer layer. Caries break down the softer layer of tissue (dentine). If the decay continues, a hole will penetrate the soft inner pulp of your tooth and become infected.

It is pulpitis, and as it progresses, the bacteria will make their way to the alveolar bone (the bone that surrounds and supports your tooth), where a periapical abscess is formed.

Other causes include:

• You are having chemotherapy or radiotherapy.
• You have injured your mouth, gums, and teeth.
• You have chipped, cracked, or broken teeth.

Risk Factors

Some factors that increase the risk of developing a dental abscess include the following:

• Poor oral care and habits — Failing to take suitable care of your gums and teeth, like flossing and brushing, can increase the likelihood of suffering from dental problems and complications like gum disease, abscesses, and tooth decay.
• Eating foods and drinking beverages high in sugar, like sodas and sweets, can cause dental cavities that can become tooth abscesses.
• Having a dry mouth makes you more vulnerable to tooth decay. Typically, dry mouth is a side effect of specific medications or aging-related issues. Bacteria flourish in the mouth with little saliva.
• Weak immune system — Medications and disease can affect your immunity, making fighting off infections and germs hard. People at risk include patients with HIV/AIDS, sickle cell anemia, splenectomy, severe autoimmune health conditions, using steroids, and taking immunosuppressive drugs following a transplant.
• You are a smoker — Cigarettes and tobacco products reduce your mouth’s blood flow and deprive it of oxygen and nutrients that allow your mouth to maintain its health. It also affects the attachment of bone and soft tissue to your teeth. Finally, smoking weakens your immune system and the body’s ability to fight off infections, making you susceptible to infections. Once you have gum damage, smoking makes it more difficult for the gums to recover.

Diagnosing Dental Abscess

On top of checking your tooth for signs and symptoms of an abscess, your dentist can diagnose the condition by:

• Performing thermal tests to determine the health of your tooth’s pulp.
• Tapping and pressing on the teeth — Teeth with abscesses are sensitive to pressure and touch.
• Performing a dental X-ray — The X-ray can identify the source of the dental condition that could have resulted in the abscessed teeth. Also, the dentist can use this imaging test to determine whether the infection has spread and could be affecting other body areas.
• Recommending a computerized tomography scan — If your infection has spread to other regions within the neck, a CT scan can help identify the degree of the bacterial infection.

Dental Abscess Treatment

Tooth abscesses do not go away on their own. You might not feel pain if an infection causes your pulp to die and the nerve is not functioning anymore. The bacteria will continue to spread and destroy the surrounding tissues, wreaking havoc on your general and oral health.

It can take weeks or even months for the infection to spread, making it hard to tell how long the abscess can go untreated. Therefore, it is wise to see a dentist immediately.

Treatment options are designed to eliminate the abscess and prevent any complications. They include the following:

Incision and Drainage Procedure

The dentist will make a tiny incision in the tooth abscess during this treatment. The incision drains the pus (infection) out. Finally, they will flush the treatment area using a sterile saline solution.

Sometimes, the dentist can place a rubber drain in your incision, allowing the remaining infection to drain over the next few days. You can experience a strange taste in your mouth while your drain is in place.

Using Antibiotic Medication

Your dentist can prescribe an antibiotic to prevent the abscess from spreading. The antibiotic will not prevent the infection from recurring, and you should treat your tooth.

Some of the antibiotics dentists prescribe include the following:

• Penicillin — Penicillin antibiotics include amoxicillin, penicillin, and amoxicillin/potassium clavulanate. Amoxicillin is the first choice for abscess treatment. However, if the infection is more severe, the dentist can prescribe a combination of clavulanate and amoxicillin.
• Clindamycin — If your abscess-causing bacteria are resistant to amoxicillin, your dentist will prescribe clindamycin. The doctor can also prescribe this antibiotic if you are allergic to penicillin.
• Metronidazole — Your doctor cannot use metronidazole alone. Typically, dentists prescribe it alongside penicillin to eliminate bacteria resistant to penicillin. Avoid alcohol and alcohol-containing products like mouthwash while taking this drug. Alcohol can make you severely ill.

Root Canal

Your dentist can recommend root canal therapy to save the tooth. The procedure involves the following steps:

1. First, the dentist will administer local anesthesia to numb your affected teeth and the neighboring gums.
2. Before beginning the treatment, the dentist will place a rubber dam over the treatment area to separate your tooth and ensure it is dry.
3. Next, the dentist will open your tooth’s crown to access your pulp. They will use small tools to remove the tooth's damaged tissues, blood vessels, and nerves.
4. After removing your pulp, the medical professional will clean, disinfect, and shape your root canals and pulp chamber.
5. Next, they will temporarily fill your empty canals with gutta-percha by placing a dental filling. The filling seals your teeth and prevents bacteria from entering.

Sometimes, dentists recommend a crown to protect the tooth and restore its bite.

Tooth Extraction

If your tooth is too severely damaged to be saved, your dentist can recommend tooth extraction.

The dentist will first numb the tooth and its neighboring gums. Using dental instruments, the dentist will loosen the affected tooth and gently lift it from the socket. Sometimes the dentist can make an incision in the gums to access the tooth, particularly if it has broken off at the gum line or is severely damaged. After removing the tooth, they will clean and disinfect the socket. Finally, they will stitch the area to promote recovery.

Sometimes dentists place bone grafts to prevent jaw bone loss. 

Your dentist should also discuss tooth replacement options with you, like dental implants and bridges.

Tooth Scaling and Root Planing

Also known as deep cleaning, tooth scaling, and root planing involve removing tartar (hardened minerals) from your teeth. Your dentist can recommend these procedures if periodontitis has caused a tooth abscess.

Tooth scaling removes tartar visible on your teeth whenever you smile. On the other hand, root planing removes tartar from your teeth’s roots below the gum line.

a) Follow-Up Dental Care

As with every disease, abide by your dentist’s guidelines for follow-up dental care. Cooperating with your dentist will ensure you have the best possible dental health.

The follow-up care will involve the following:

1. Reassessments.
2. Several dental appointments.
3. Referrals to specialists.

b) How Soon After Treatment Will You Feel Better?

Your abscess should clear up following the treatment. Tooth sensitivity is normal and should stop within a couple of days.

Remember, every patient is unique, and their recovery time varies. Ask your dental health provider for guidelines and instructions after the treatment.

Do Dental Abscesses Have Complications?

In many cases, tooth infections are treatable. However, if you delay treatment, you risk developing the following complications:

Ludwig’s Angina

Ludwig’s angina is an infection of the mouth’s floor that occurs when the abscess bacteria spread. You will experience intense pain and swelling in the neck and under the tongue. In serious cases, you can experience breathing challenges. X-rays and needle aspiration diagnose it.

Treating Ludwig’s angina involves draining any pus via antibiotics and surgery. If left untreated, your dentist can use a tracheostomy to open your swollen airways.

Facial Cellulitis

Cellulitis is an infection of the fat and skin beneath your skin. Its symptoms include the following:

• Fever.
• A swollen, painful tongue.
• Burning and itching of your affected skin.
• Swollen, red skin on your face, particularly the cheek.

Dental Abscess Can Also Cause Sepsis

Sepsis is a life-threatening condition caused by the body’s response by releasing chemicals and proteins to an infection. It happens when your immune system gets out of control, causing extensive inflammation.

Its symptoms include difficulty breathing, a rapid heart rate, and a fever. Severe sepsis can cause sepsis shock, a medical emergency linked with organ failure, a drop in blood pressure, and tissue damage.

Maxillary Sinusitis

The bacteria can spread into the tiny spaces behind your cheekbones, causing maxillary sinusitis. The condition is not severe but can be painful. You can develop tender cheeks and a fever. It can sometimes resolve itself on its own. Depending on its severity, your dentist can prescribe antibiotics.

Dental Cysts

A dental cyst is a fluid-filled cavity that develops at the bottom of your tooth’s root if the abscess is left untreated.

Dentists treat it with surgery and antibiotics.

Cavernous Sinus Thrombosis

The spread of bacteria can cause a blood clot in your cavernous sinus, a vast vein at the base of the brain. Dentists treat the condition with surgery and antibiotics. While it is rare, this complication can be fatal.

Osteomyelitis and Dental Abscess

Osteomyelitis happens when the bacteria in the tooth abscess enter your bloodstream and infect your bone. Usually, the affected bone is near the abscess site, but it can also be any other bone after spreading. Its symptoms include severe pain in the affected bone and increased temperatures. Its treatment involves either intravenous or oral antibiotics.

Preventing Tooth Abscess

Preventing abscesses is not challenging. Complying with a proper oral hygiene routine can go a long way toward maintaining good dental health. Some of the preventive measures you can take include the following:

• Brushing your teeth — Ensure you brush twice daily using a soft-bristled toothbrush and fluoride toothpaste. Hard or medium bristles can hurt your tooth enamel and gums. Place the toothbrush at a 45-degree angle toward the gums to remove bacteria and plaque at the gum line. Also, ensure you brush every tooth surface, including sides and backs. Remember to brush your tongue.
• Use an antibacterial mouthwash daily— An antibacterial mouthwash prevents bacteria. It also removes food debris and particles, reducing plaque buildup. Ensure you use an alcohol-free mouthwash to avert dry mouth.
• Floss— Since you cannot reach all the spaces between your teeth with brushing alone, you should consider flossing.
• Avoid tobacco products and smoking — Smoking can cause periodontitis and abscesses. It is wise to avoid these products altogether. If you are a smoker and want to quit, ask your dentist for practical recommendations.
• Visit your dentist every six months. However, you will require frequent dental appointments if you are more likely to develop a tooth abscess. During the visit, the dentist will conduct dental cleaning and examination to identify potential signs of abscesses and reduce the risk.
• Drink a lot of tap water with fluoride.
• Eat a well-balanced diet, limiting between-meal snacks and sugary foods and drinks.

How to Ease Tooth Abscess Pain at Home

If you cannot visit your dentist immediately, here are some pain relief home remedies. They can get you through a couple of hours or days until you can see your dentist for a permanent solution.

Over-the-Counter PainKillers

You can use painkillers as your first defense against abscess-related pain. The medication can reduce inflammation in your tooth.

Do not place an oral tablet directly on your affected tooth or gum. It can burn the tissue and result in increased pain.

Rinse Your Mouth with Saltwater

Rinsing the mouth with salty water is a cost-effective and easy option for temporary pain relief. It also promotes healthy gums and wound healing.

When rinsing your mouth, swish the salty water around in the mouth for more than two minutes before spitting the water.

Rinse your mouth three times a day.

Baking Soda

Baking soda has antibacterial properties, making it exceptional for removing plaque.

How is how to use this home remedy:

1. Mix 1/2 cup of salty water with ½ a teaspoon of baking soda.
2. Swish your mixture in your mouth for more than five minutes.
3. Then spit out.

You should use the baking soda solution twice a day.

Cold Compress

Using a cold compress can reduce swelling and pain.

Place ice cubes in a towel and hold your compress against the skin near your abscessed tooth. You can use the compress at fifteen-minute intervals.

Use Garlic Paste

Garlic is a natural remedy with many therapeutic uses.

Crush a garlic clove to make a paste, then rub it on your infected tooth.

Use a Hydrogen Peroxide Solution

Hydrogen peroxide is antimicrobial when used in the mouth and can reduce inflammation, bleeding gums, and plaque.

Mix three percent hydrogen peroxide with two parts of water. Swish this solution in your mouth before spitting.

Do not swallow the solution.

Use Thyme Oil

Thyme essential oil has antioxidant characteristics and can reduce swelling and fight bacteria. Before use, dilute it with a carrier oil like black seed, avocado, coconut, or jojoba oil.

There are several ways to use this home remedy, including:

• Applying diluted thyme oil to your affected tooth using a cotton swab or ball.
• Making a mouthwash by adding your diluted thyme oil to a glass of water.

Find a Compassionate Emergency Dentist Near Me

Leaving a tooth infection untreated for an extended duration can result in a dental abscess. It is painful and should be treated immediately. At Washington Dental, we recognize that you are in distress and can treat you like family. We do not rush treatment; instead, we are committed to finding the right diagnosis before offering the best treatment option to realize a successful outcome. Contact us at 310-217-1507 to hear about us and how we can treat tooth abscesses and experience the difference a seasoned Carson-based dental practice can make in your life.