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A dental abscess is no fun. You may not know you have one, but you’ll surely know that something is wrong when you do.

How does an abscess form? It all begins when unwelcome bacteria take hold in the mouth, often due to lapsed oral care. Dental decay can extend deep into the pulp of the tooth, where the blood supply and nerves of a tooth are located.

Bacteria then enter the gums or jawbone and encourage the formation of a pocket of pus at the base of a tooth (apologies if the word makes you squeamish).

Symptoms of a dental abscess

A dental abscess is often exquisitely painful. The pain is caused by swelling and inflammation within the pocket of pus, and your immune system’s response to the infection. The area of the gum involved is usually red and swollen, making it difficult to eat or even talk. Sometimes the pain and swelling extend beyond the gum to the face or neck.

Why is an abscessed tooth a concern? The biggest risk is that the abscess will spread beyond the gums to the jawbone or other structures. Signs of such spread could include facial swelling, redness, headache, or a fever.

Can a tooth abscess heal without treatment?

An abscessed tooth requires speedy treatment to limit the spread of infection to the deeper gum tissue or jawbone. Rarely, infection from a dental abscess can enter the bloodstream and cause a life-threatening infection. This is more common in people with a suppressed immune system and those who don’t seek treatment.

An abscess will not heal on its own. Instead, it will worsen over time without treatment. Depending on the cause, treatment might include a root canal to clean out the infected tooth and remove the pulp where the nerves are. In some cases, root canal therapy will cure the abscess without removing the tooth. If that’s not possible, tooth extraction is the only option. But before treatment, you’ll need antibiotics to calm the infection and inflammation.

Once the swelling, pain, and underlying infection have died down, a dentist or dental surgeon can commence with the appropriate treatment. If antibiotics and treatment are delayed, bacteria and inflammation can spread to the bone that supports the tooth. This is called a periapical abscess and needs treatment, as it won’t resolve on its own.

What to do if you suspect a tooth abscess

If you have tooth or gum pain, swelling, or redness, see your dentist immediately. Home treatments to stop the pain won’t correct the underlying infection. Although antibiotics temporarily suppress the infection, it will recur unless root canal therapy or extraction removes the source.

How to prevent a dental abscess

It’s always best to prevent a dental abscess, since it can lead to loss of a tooth. How can you avoid an abscessed tooth? Practice good dental hygiene by brushing and flossing your teeth twice per day (you’ve heard this before). Use a toothpaste that contains fluoride, since it helps mineral-ize your teeth and lower the risk of tooth decay. That’s important since deep tooth decay is the most common cause of an abscessed tooth.

See your dentist (us) regularly, too. With consistent brushing and flossing, you remove plaque that contributes to dental decay and gum disease, but you can’t remove hardened deposits of plaque called tartar. When tartar builds up, it irritates the gum line and contributes to gum disease (gingivitis) and dental decay. That is where your dentist comes in — to get rid of the tough stuff.

The bottom line on an abscess

Dental abscesses are painful and can lead to the loss of a tooth. Do what you can to prevent them by practicing good oral hygiene and visiting your dentist regularly. If you have symptoms of an abscessed tooth, get therapy as quickly as possible.

See you at your next checkup!

References:

“Tooth abscess – Diagnosis and treatment – Mayo Clinic.” 01 Mar. 2019, mayoclinic.org/diseases-conditions/tooth-abscess/diagnosis-treatment/drc-20350907.
Shweta, Prakash SK. Dental abscess: A microbiological review. Dent Res J (Isfahan). 2013 Sep;10(5):585-91. PMID: 24348613; PMCID: PMC3858730.
Sanders JL, Houck RC. Dental Abscess. [Updated 2021 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: ncbi.nlm.nih.gov/books/NBK493149/
“Dental Abscess Workup: Laboratory Studies, Imaging Studies ….” 22 Jan. 2019, //emedicine.medscape.com/article/909373-workup.