What Is an Abscessed Tooth?

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One cause of a painful toothache is an abscessed tooth. A tooth abscess occurs when the pulp, the soft tissue inside the root canal, dies and becomes inflamed. This allows bacteria to enter the pulp and infect the root of the tooth. A pocket of pus can then form around the root, creating an abscess.

This article discusses the causes and symptoms of an abscessed tooth. It covers when you should see a doctor, along with how a tooth abscess is diagnosed and treated.

Pain Relief for an Abscessed Tooth

Verywell / Joshua Seong

Abscessed Tooth Symptoms

The most common symptom of an abscess is an ache in the bone around the tooth. You may also have swelling in your gums or pain when chewing.

You might also experience these additional symptoms:

  • You may have a throbbing toothache that can radiate to your jaw, neck, or ear.
  • Your teeth may be sensitive to hot, cold, and the pressure of chewing.
  • You may develop a fever.
  • You might have swelling in your face, cheek, and the lymph nodes of your jaw or neck.
  • Your gums may be red and swollen.
  • If the abscess ruptures, you might get a rush of bad-tasting and smelling discharge in your mouth and have an open, draining sore.
  • If left untreated, the pain can become severe, often excruciating.

Many people with a toothache report pain in one area of their mouth, but they aren't sure which tooth is causing it. You'll need to see a dentist to find out where the pain is coming from.

Causes

Some things that can cause a painful, abscessed tooth include:

  • Untreated tooth decay
  • A cracked or broken tooth or filling
  • A gum infection, especially in advanced gum disease

Your mouth always has bacteria, but it is kept out of the tooth by the solid tooth enamel. If tooth decay erodes that enamel or you have a cracked tooth, bacteria can get into the living pulp inside the tooth. Your immune system fights back, sending in white blood cells to kill the bacteria. Pus forms from white blood cells, dead tissue, and bacteria.

There isn't any extra room inside your hard tooth, so it tries to drain out the tip of the tooth root in the jaw. A pocket of pus can form at the root tip. The abscess can appear on a dental X-ray. The pressure and inflammation from this abscess can be very painful.

Recap

There's always bacteria in your mouth. If your tooth is injured or decays, that bacteria can infect the root of your tooth. An abscess forms at the root as your immune system tries to fight the infection. Common symptoms include a toothache, sensitive teeth, and swollen gums.

Diagnosis

If you have a toothache or any other signs of a tooth abscess, make an appointment with your dentist right away. You need to get treatment before bigger issues arise. You might get some relief from the pain if the abscess ruptures. But whether it does or not, the infection can spread to your jaw.

Your dentist will examine your teeth and locate the abscess. You may need an X-ray or even a CT scan to see the exact location of the abscess and whether the infection has spread.

Treatment

A dental abscess is usually treated with root canal treatment or endodontic surgery.

The dentist will first remove the bacteria from the empty canals in your tooth. Then they will clean, shape, and fill the root canals, and seal the space.

Later, you will return to your dentist, who will place a crown on the tooth to protect and restore it to full function. After the new restoration, the tooth should function like any other tooth.

In some cases, the tooth can't be saved. Your dentist will need to pull out the infected tooth and drain the abscess to eliminate the infection. You may be given antibiotics if the infection has a chance of spreading or if you have a weakened immune system.

Pain Relief for an Abscessed Tooth

A toothache that is caused by an abscess may come and go, but don't be fooled if the pain does subside.

Until you are able to get to the dentist, here are some ways to relieve a toothache caused by an abscessed tooth or dental infection:

  • Avoid foods and drinks that are very cold or very hot. Since the dentin layer of the tooth has likely been invaded by tooth decay, extremes in temperature may cause pain. Avoid cold drinks, juices, ice creams, coffee, tea, or hot soups. These may trigger the exposed dentin and cause extreme pain. 
  • Avoid foods and beverages that are very high in sugar, or are very acidic. Common acidic foods are soft drinks or juices. These reduce the pH in your mouth, causing the layer of minerals that shield your teeth to wear away (demineralization). Teeth with dental abscesses are highly sensitive, so any changes in pH should be avoided.
  • Use an over-the-counter pain relief medicine. Most toothaches are caused by inflammation, so a pain reliever that reduces inflammation might help. Never put pain relief medication on the tooth or gum tissue, as this could burn the tissue.
  • Floss between the teeth that are painful. Removing food particles and plaque may help reduce the pain from a toothache. It might help reduce inflammation in the periodontal area, where pain transmits to the rest of the infected tooth.
  • Seal a hole in the tooth temporarily. Some pharmacies have over-the-counter temporary filling material that may be used to seal the hole created by decay or a cracked tooth temporarily.
  • Sleep with your head elevated. Elevating your head when resting may ease some pain from the toothache.
  • Rinse with warm saltwater. Rinsing with warm saltwater two to three times a day may help to relieve a toothache if the abscess was caused by a gum infection. Saltwater works as an antiseptic to remove bacteria from the infected area.

Recap

The longer you wait to have the abscess treated, the greater your chances of serious complications. You may lose a tooth that could have been saved, and you risk getting an advanced infection.

Summary

A tooth abscess can develop after your tooth cracks or starts to decay. The natural bacteria in your mouth can seep through your tooth's pulp and infect its root. A pocket filled with pus forms as your immune system tries to clear the infection. This abscess causes pain, swelling, and other signs of infection like fever.

You will need to see a dentist to resolve your tooth abscess. You may need a root canal to save your tooth. If you don't get the abscess treated quickly, further issues may arise, and you may need to have the tooth removed.

A Word From Verywell

As soon as you develop a toothache, see your dentist immediately. An abscessed tooth isn't something that is going to go away on its own. You will save yourself days to weeks of pain by getting the problem diagnosed and treated so you can smile again painlessly.

Frequently Asked Questions

  • What is a periapical abscess?

    A periapical abscess is a tooth abscess that appears at the end of a tooth. It can cause similar symptoms to a periodontal abscess, in which the abscess appears in the gums. Treatment may differ based on the severity of the abscess and its location.

  • Can you die from a tooth infection?

    Yes, it is possible to die from a tooth infection. This is uncommon in the US due to effective handling of antibiotics and skilled personnel who can quickly treat the issue. Since 2007 there have been at least four cases in which a dental infection has been life-threatening. Each of these four people required an extended hospital stay to receive treatment, but were discharged between seven to 15 days after admission.

  • What should you do if a dental abscess bursts on its own?

    If a dental abscess bursts open on its own, you should visit a healthcare provider immediately. Even though any pus contained inside has leaked out, the abscess is still vulnerable to further infection. Fast treatment can help prevent further damage.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Siqueira JF, Rôças IN. Microbiology and treatment of acute apical abscesses. Clin Microbiol Rev. 2020;26(2):255-73. doi:10.1128/CMR.00082-12

  2. Kumarswamy A. Multimodal management of dental pain with focus on alternative medicine: A novel herbal dental gel. Contemp Clin Dent. 2016;7(2):131-9. doi:10.4103/0976-237X.183066

  3. National Health Service (NHS). Dental Abscess.

  4. Amponsah E, Donkor P. Life-threatening Oro-facial infectionsGhana Med J. 2007;41(1):33-36.

By Shawn Watson
Shawn Watson is an orthodontic dental assistant and writer with over 10 years of experience working in the field of dentistry.