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Tooth Abscess(Dental Abscess; Abscessed Tooth)
Definition

A tooth abscess is a sac of infected material called pus in a tooth or the gums.

Abscess Between Tooth and Gum

Abscess tooth

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Causes

A tooth abscess is caused by bacteria. It begins when bacteria invade and infect a tooth. This results in pus build-up. 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 lets bacteria invade the pulp
  • Failed root canal treatment
Risk Factors

Factors that may increase your chance of a tooth abscess include:

  • Build up of tartar or calculus beneath the gum line
  • Poor dental hygiene leading to cavities and periodontal diseases
Symptoms

A tooth abscess may cause:

  • Throbbing/lingering pain in a tooth or gum area
  • Pain when biting
  • Pain from hot or cold
  • Sudden tooth pain
  • Redness, tenderness, or swelling of the gums
  • Fever
  • Bad breath or foul taste in mouth
  • Open, draining sore on the gums

If left untreated, complications of tooth abscess include:

  • Loss of tooth and surrounding tissues or bone
  • Spread of infection to surrounding tissue or bone
Diagnosis

Your dentist will ask about your symptoms and medical history. A detailed exam of your teeth and gums will be done.

Images may need to be taken of the tooth and surrounding bone. This can be done with x-ray.

A sample of the abscess fluid may be taken and tested.

Treatment
Removal of Abscess Via Root Canal
  • 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 the top of the tooth.
    • Pus and dead tissue are removed from the center of the tooth.
    • The interior of the tooth and the root 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 done to prevent a repeat infection.
Tooth Extraction (Removal)
  • Tooth extraction 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 severe.
  • If the tooth is extracted, it will be replaced with a:
Medication
  • Antibiotics to fight residual infection of the tooth or gums
  • Over-the-counter pain relief drugs such as ibuprofen or acetaminophen
Prevention

To help reduce your chance a tooth abscess:

  • Brush your teeth with fluoride toothpaste after meals or at least twice per day.
  • Floss between your teeth and gums every day.
  • Get regular dental check-ups and teeth and gum cleanings every 6 months.

RESOURCES:

Academy of General Dentistry
http://www.agd.org

Mouth Healthy—American Dental Association
http://www.mouthhealthy.org

CANADIAN RESOURCES:

Canadian Dental Association
http://www.cda-adc.ca

The Canadian Dental Hygienists Association
http://www.cdha.ca

References:

Abscess (toothache). American Dental Association Mouth Healthy website. Available at: http://www.mouthhealthy.org/en/az-topics/a/abscess. Accessed March 18, 2013.

Beers MH, Fletcher AJ. The Merck Manual of Medical Information—Home Edition . New York, NY: Simon and Schuster, Inc.; 2000.

Dental abscess. NHSinform website. Available at: http://www.nhsinform.com/health-library/articles/d/dental-abscess/introduction. Updated October 4, 2011. Accessed March 18, 2013.

Root canals. American Dental Association Mouth Healthy website. Available at: http://www.mouthhealthy.org/en/az-topics/r/root-canals. Accessed March 18, 2013.



Last reviewed August 2014 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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