A tooth abscess is one of the dental problems that should never be left to “see if it goes away.” It is an infection, and infections in the mouth can spread. The good news is that with prompt treatment, most abscesses clear up and the tooth can often be saved. This guide explains what an abscess is, the warning signs, when it becomes an emergency, how dentists treat it and how to lower your risk.
Key takeaways
- An abscess is a pocket of pus from a bacterial infection in or around a tooth.
- Severe, throbbing pain, a gum bump, fever and swelling are common signs. Jaw or facial swelling is serious.
- Pain that suddenly stops does not mean the infection is gone.
- Treatment targets the source, often with a root canal, drainage or extraction, sometimes with antibiotics.
What is a tooth abscess?
MedlinePlus defines a tooth abscess as a pocket of pus caused by a bacterial infection in or around a tooth (MedlinePlus: Tooth abscess). The ADA explains that tooth decay, gum disease or a cracked tooth can let bacteria reach the pulp, the soft tissue in the center of the tooth that contains nerves, blood vessels and connective tissue. That can lead to the pulp dying. When pus builds up at the tip of the root in the jawbone, it forms an abscess (ADA MouthHealthy: Abscess).
How it develops
- Decay. An untreated cavity can work its way into the pulp. Our guide to cavities and their stages explains how.
- A broken or chipped tooth. MedlinePlus notes that an abscess may form when a tooth is broken, chipped or otherwise injured, because openings in the enamel let bacteria in. See our article on a cracked or chipped tooth.
- Gum disease. The ADA lists periodontal disease among the causes. Deep gum pockets can trap bacteria next to the root. Our article on deep cleaning for gum disease covers treatment.
MedlinePlus adds that infection can spread from the root to the bones that support the tooth.
Signs and symptoms
According to MedlinePlus, the main symptom is a severe, continuous toothache that may feel gnawing, sharp, shooting or throbbing. Other symptoms it lists include:
- A bitter taste in the mouth or bad breath
- Pain when chewing
- Sensitivity to hot or cold
- Swelling of the gum over the infected tooth, which can look like a pimple
- Fever, or a general sense of feeling unwell
- Swollen glands in the neck
- A swollen area of the upper or lower jaw, which MedlinePlus calls a very serious symptom
When the pain suddenly stops
This trips a lot of people up. MedlinePlus explains that the toothache may stop if pressure is relieved, for example if the abscess drains, but the infection remains active and keeps spreading. Relief is not a reason to cancel your appointment.
When it is an emergency
MedlinePlus warns that untreated abscesses can get worse and lead to life-threatening complications. Possible complications it lists include tooth loss, infection spreading to the jawbone or nearby soft tissue, blood infection, and spread to other parts of the body, which can cause problems such as a brain abscess, inflammation of the heart lining (endocarditis) or pneumonia.
- Call 911 or go to an emergency room if you have trouble breathing or swallowing, swelling that is spreading toward your eye, down your neck or under your tongue, a high fever, confusion, or if you feel very ill.
- Call a dentist the same day for facial or jaw swelling, a pimple-like bump on the gum, fever, or a throbbing toothache that does not go away. MedlinePlus specifically advises contacting your dentist for a throbbing toothache that does not stop or a bubble or pimple on the gums.
Not sure where your symptoms fit? Try our dental emergency checker or read our guide to what counts as a dental emergency. For other kinds of tooth pain, see toothache causes and when it is urgent.
How dentists diagnose an abscess
MedlinePlus describes the exam: the dentist looks closely at the teeth, mouth and gums. Tapping on the tooth may hurt, and biting down or closing the mouth tightly can increase the pain. The gums may be red and swollen and may drain thick material. Dental X-rays and other tests help identify which tooth or teeth are involved.
Treatment
MedlinePlus says the goals of treatment are to cure the infection, save the tooth and prevent complications. Depending on how severe the infection is, options include:
- Antibiotics, which a dentist may prescribe to fight the infection. Antibiotics alone do not remove the source, so they are usually paired with dental treatment. Take them exactly as prescribed.
- Root canal treatment to clean out the infected pulp and save the tooth. The ADA explains that root canals are used to repair and save a tooth instead of removing it, and that you may be referred to an endodontist, a specialist in the pulp and the tissues around the root (ADA MouthHealthy: Root Canals). Our root canal guide explains what affects cost.
- Draining the abscess, sometimes surgically, in more severe infections.
- Extracting the tooth if it cannot be saved.
- Hospital care for some people with severe infections, as MedlinePlus notes.
The good news, according to MedlinePlus: prompt treatment cures the infection in most cases, and the tooth can often be saved.
What you can do until you are seen
Home care can make you more comfortable, but it does not treat the infection.
- MedlinePlus says warm saltwater rinses may help ease the pain, and over-the-counter pain relievers may help with the toothache and fever. Follow the label, and check with a pharmacist if you have health conditions or take other medicines.
- Do not place aspirin directly on the tooth or gums. MedlinePlus warns it irritates the tissues and can cause mouth ulcers.
- Do not try to pop or drain a gum swelling yourself.
- Avoid chewing on the affected side, and stick to soft, lukewarm foods.
Lowering your risk
MedlinePlus notes that prompt treatment of decay reduces the risk of an abscess, and that any broken or chipped tooth should be examined right away. The ADA adds that good daily oral hygiene and routine dental exams significantly reduce the risk, and that if a tooth is loosened or chipped by trauma, you should see a dentist as soon as possible. Our guide to how often to see the dentist covers checkup timing.
If cost is holding you back
An abscess is not something to postpone because of cost. If you do not have a dentist or insurance, our guide to low-cost dental care, our Medicaid dentist finder and our article on dental school clinics list options. For a severe or spreading infection, go to an emergency room regardless of cost.
What recovery usually looks like
After treatment, it is common for the area to feel tender for a few days. Follow your dentist’s instructions about pain relief, eating and any prescribed medicine, and finish antibiotics exactly as directed if you were given them. If you had a root canal, the ADA notes that a temporary filling is usually placed until a permanent filling or crown can be made, so keep any follow-up appointments. Call your dentist if swelling returns, pain gets worse instead of better, or you develop a fever.
Frequently asked questions
Can a tooth abscess go away on its own?
No. The pain may ease if the abscess drains, but MedlinePlus says the infection stays active and continues to spread. It needs dental treatment.
Are antibiotics enough?
Antibiotics can help control the infection, but the source, usually the infected pulp or a gum pocket, still needs treatment such as a root canal, drainage or extraction.
Is a pimple on my gum an abscess?
It can be. MedlinePlus lists gum swelling that looks like a pimple as a symptom and advises contacting your dentist if you notice one.
Can I save the tooth?
Often, yes. MedlinePlus says the tooth can often be saved with prompt treatment, commonly a root canal.
Sources
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
Featured image: “Dental picks” by Senior Airman Anthony Sanchelli, U.S. Air Force, via Wikimedia Commons, public domain (see file page). Resized and compressed for the web.
Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.