Tooth Abscess
(Dental Abscess, Abscessed Tooth)
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 (blood and nerve supply inside the tooth) Abscess between the tooth and gum
A tooth abscess begins when bacteria invade and infect 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 the area surrounding the tooth.
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors include:
Build up of tartar or calculus 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 include:
Throbbing/lingering pain in a tooth or gum area Pain when biting on a tooth Spontaneous tooth pain Redness, tenderness, or swelling of the gums Fever 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 and surrounding tissues or bone Spread of infection to surrounding tissue or bone 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 Stimulating the tooth nerve with heat or cold Stimulating the tooth nerve with a low electrical current Sliding a probe between the tooth and gum to measure gaps or loss of tissue
Your dentist will also take an
x-ray
of the tooth and surrounding bone.
Treatment includes:
If an abscess results from tooth decay or a break or crack in the tooth:
The tooth and surrounding tissue is numbed and a hole is drilled through top of the tooth. Pus and dead tissue are removed from the center of 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 an abscess results from infection between the tooth and gum:
The abscess is drained and thoroughly cleaned. The root surface of tooth is cleaned and smoothed. In some cases, surgery to reshape the gum is performed to prevent recurrence of infection.
Removal of the tooth may be required if:
Tooth decay and/or tooth infection is too extensive for filling or root canal treatment. The break or crack in the tooth is too severe to be repaired. The infection or loss of tissue/bone 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 Antibiotics to fight residual infection of the tooth or gums Nonprescription pain relief drugs (ibuprofen or acetaminophen) and warm salt water rinses
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 six months) Regular professional teeth and gum cleaning (every six months) Academy of General Dentistry
American Dental Association
Canadian Dental Association
The Canadian Dental Hygienists Association
The Merck Manual of Medical Information—Home Edition . Simon and Schuster, Inc.; 2000.
October 2007
