How to Identify a Tooth Abscess

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A tooth abscess is a painful bacterial infection that causes pus to gather at the root of the tooth or between the tooth and the gums through a small hole resulting from the bone infection. Abscesses result from severe tooth decay, ignored cavities, or trauma to the tooth. [1] Periapical abscesses form at the tip of a tooth's root, whereas periodontal abscesses impact your surrounding bone and gums. [2] Although you might not experience any symptoms initially, a tooth abscess can cause serious medical problems. It's best to recognize it early before the infection spreads further.

Part 1
Part 1 of 2:

Identifying a Tooth Abscess

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  1. A toothache is one of the most common symptoms of an abscess. It often occurs as pus produced by bacteria that reached your pulp compresses the nerves in your teeth. You may notice a constant, throbbing pain around the tooth. [3] Biting might be painful. Your tooth pain could cause sleeplessness.
    • The pain may be localized around the tooth, but it can also radiate to the ears, jaws, neck, or cheeks. [4] You may not be able to tell exactly where the pain is coming from. You might also feel irritated after spending a night in pain and struggling to sleep.
    • The pain may be accompanied by a sense that your tooth is moving. The entire area around the tooth may look red and swollen.
    • If you have a severe toothache that goes away, do not assume the abscess is gone. It is more likely that the abscess has killed the pulp and the infection remains. The pain may go for a while, especially if you have taken painkillers or an anti-inflammatory medication, but the infection will form an abscess again in no time.
  2. An abscess can make chewing painful. [5] Abscesses also can make your teeth sensitive to hot and cold temperatures. If these symptoms last, seek treatment. [6]
    • A pericoronitis abscess is one that can be located near the lower wisdom teeth. This type of abscess can cause your masseter muscles to block (also known as trismus), making it almost impossible to open or close your mouth. [7]
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  3. As an infection grows, it can cause swelling and pain inside your mouth. Your gums may appear red and swollen and feel tender. You may also notice that your cheek looks swollen. [8]
    • Your gum also might swell over the impacted tooth. This could resemble a pimple. [9]
  4. If your abscess has ruptured, you will be able to smell or taste the pus. The taste will be bitter but never swallow it. [10] Rinse with chlorhexidine mouthwash or even salt water to get rid of the taste. See your doctor immediately.
  5. As an abscess worsens, you might suffer a fever, and you might notice pus discharging from your gums. [11] You also could have trouble opening your mouth, breathing, or swallowing. Swollen glands or a swollen upper or lower jaw can appear. Feeling generally sick is common. [12] If these symptoms appear, see your dentist immediately.
  6. If you have noticed the above symptoms, see a dentist. He or she will tap your tooth to see if it is sensitive. You likely will receive an x-ray. Then your dentist can know for sure whether you have an abscess. [14]
    • An abscess is a serious problem. You should visit the dentist as soon as possible. A dentist can identify the source of the abscess, prescribe painkillers and antibiotics, and treat the abscess itself (i.e. through draining, root canal, or tooth extraction).
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Preventing a Tooth Abscess

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  1. Brush your teeth twice daily. Also, try to floss once daily. If you neglect your teeth, you have a higher risk of developing tooth abscesses. [15]
  2. If you constantly eat foods high in sugar (e.g. candy, chocolate), you can increase your risk for cavities. Cavities can lead eventually to abscesses. Some sugary foods are fine but eat them in moderation. [16] If possible, brush afterwards.
  3. If you have an untreated cavity or a tooth fracture that reaches the dental pulp (inner part of your tooth), you risk developing an abscess. This happens when bacteria reaches your dental pulp, which is the inside of your tooth. See a dentist as soon as possible, and watch for any symptoms. [17]
    • Cavities and trauma typically lead to a “periapical abscess.”
  4. An injury to the gums can cause an abscess. Gum disease causes the space between the tooth and the gum to widen, which allows bacteria to enter. This bacteria can cause an abscess, even if the teeth are healthy and cavity-free. If you have any issues with your gums, watch for symptoms of an abscess. [18]
    • Gum injuries and gum disease typically lead to a particular kind of infection known as a “gingival abscess” (or “gum abscess”). If the infection extends to the gum pockets, and the draining of pus is blocked by the swallowed gum, it is then called a “periodontal abscess.”
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Expert Q&A

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  • Question
    What happens if the abscess ruptures and you swallow the pus?
    Cristian Macau, DDS
    Doctor of Dental Surgery
    Dr. Macau is a Doctor of Dental Surgery based in London, England. Dr. Macau is an oral surgeon, periodontist, and aesthetician at Favero Dental Clinic where he is known for his cosmetic dentistry and facial aesthetics work. He is actively involved in scientific research in the field of dentistry and he received his DDS from Carol Davila University of Medicine in 2015.
    Cristian Macau, DDS
    Doctor of Dental Surgery
    Expert Answer
    The bacteria will be destroyed by the acid in your stomach so there is not much of a risk. A part of it may also be retained by your tonsils which can cause tonsillitis. The danger is on the upper teeth where an abscess can reach up to your brain causing meningitis or even death in a worst case scenario.
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  • Question
    What are some symptoms of an abscessed tooth?
    Pradeep Adatrow, DDS, MS
    Board Certified Dentist & Oral Surgeon
    Dr. Pradeep Adatrow is the only board certified Dentist, Periodontist, and Prosthodontist in the southern United States. With over 15 years of experience, Dr. Adatrow specializes in dental implants, TMJ treatments, periodontal plastic surgery, surgical and non-surgical periodontics, bone regeneration, laser treatments, and soft tissue and gum graft procedures. He received a BS in Epidemiology and Biostatistics from the University of Alabama and earned his Doctor of Dental Surgery (DDS) degree from the University of Tennessee College of Dentistry. Dr. Adatrow then completed a three-year postgraduate program in periodontics and implantology at Indiana University and went on to complete another three-year postdoctoral program in advanced prosthodontics from the University of Tennessee. He also serves as a full-time professor and the Director of Surgical Prosthodontics at the University of Tennessee. Dr. Adatrow received the Dean's Junior Faculty Award and the John Diggs Faculty Award, and he was inducted into the Deans Odontological Society. He is board certified by the American Board of Periodontology and is a Fellow of the prestigious International College of Dentistry – a feat that only 10,000 others worldwide can claim.
    Pradeep Adatrow, DDS, MS
    Board Certified Dentist & Oral Surgeon
    Expert Answer
    Typically, you'll experience a significant, constant, pulsating toothache that may radiate into your jaw, neck, or ear. Your teeth may be sensitive to hot and cold temporatores, and you may notice pain or sensitivity when you bite or chew. You may also have a fever, swelling of your face and cheek, swollen lymph nodes under your jaw or neck, or pus discharge from your gums.
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      Tips

      • Get regular dental check-ups to detect and prevent cavities. This will help reduce your risk of getting tooth abscesses.
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      Warnings

      • Do not attempt to treat an abscess yourself. Ultimately, you will need to see a dentist to resolve it.
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      • If you have severe pain or experience difficulty breathing or swallowing, go to an emergency room for immediate treatment.
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      References

      1. ↑ https://my.clevelandclinic.org/health/diseases/10943-abscessed-tooth
      2. ↑ https://www.nhs.uk/conditions/dental-abscess/
      3. ↑ Pradeep Adatrow, DDS, MS. Board Certified Dentist & Oral Surgeon. Expert Interview. 5 November 2020.
      4. ↑ Pradeep Adatrow, DDS, MS. Board Certified Dentist & Oral Surgeon. Expert Interview. 5 November 2020.
      5. ↑ https://medlineplus.gov/ency/article/001060.htm
      6. ↑ Pradeep Adatrow, DDS, MS. Board Certified Dentist & Oral Surgeon. Expert Interview. 5 November 2020.
      7. ↑ https://www.aafp.org/afp/2003/0201/p511.html
      8. ↑ Pradeep Adatrow, DDS, MS. Board Certified Dentist & Oral Surgeon. Expert Interview. 5 November 2020.
      9. ↑ https://medlineplus.gov/ency/article/001060.htm
      1. ↑ https://medlineplus.gov/ency/article/001060.htm
      2. ↑ https://www.healthdirect.gov.au/tooth-abscess
      3. ↑ Pradeep Adatrow, DDS, MS. Board Certified Dentist & Oral Surgeon. Expert Interview. 5 November 2020.
      4. ↑ Pradeep Adatrow, DDS, MS. Board Certified Dentist & Oral Surgeon. Expert Interview. 5 November 2020.
      5. ↑ https://my.clevelandclinic.org/health/diseases/10943-abscessed-tooth
      6. ↑ https://www.nhs.uk/conditions/dental-abscess/
      7. ↑ https://www.healthdirect.gov.au/tooth-abscess
      8. ↑ https://my.clevelandclinic.org/health/diseases/10943-abscessed-tooth
      9. ↑ https://ada.com/conditions/dental-abscess/

      About This Article

      Article Summary X

      If you’re concerned you might have a tooth abscess, check for pain in or around your tooth. You might feel it all the time or especially when you eat or drink, and it may radiate to your jaw, cheek, or ear. Additionally, look for redness or swelling of the gums around the affected tooth. You should also make note of a bad taste or smell in your mouth, which can happen if the abscess ruptures and drains into your mouth. If the infection is severe or begins to spread, you may also experience a fever, swollen lymph nodes, or difficulty swallowing. Call your dentist immediately if you have any of these symptoms. For more advice from our Dentist co-author, including how to prevent abscesses, keep reading!

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