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Dental Abscesses: Things To Know

Updated: Nov 13

Did you just recover from a dental abscess or are you perhaps experiencing one right now? Surely, you're here because you want to learn more about these pesky oral infections.

abscess around crowns
abscess around crowns

Well, you're at the right place because we're going to walk you through everything that you need to know about them. There is a lot more to them than what meets the eye.


Table of Contents:


Overview

A dental abscess is an umbrella term that is used to describe any type of abscess which occurs in the mouth. Basically if you have an abscess, a swollen ball of pus, and it is located in or around the mouth, it will qualify as a dental abscess.


Are you picking up on the hint of where we're going with this? What we're trying to say is that there are different types of oral abscesses and they all require different treatments. It's not as simple as it seems but let us break it all down for you, starting with a visual diagram below.


Dental Abscesses - Categorization

Tooth abscess

A tooth abscess is an infection of endodontic origins.

  • Periapical abscess. The infection aggregates and proliferates near the root tip.

  • Endo-perio abscess. Source of infection is primarily of endodontic origins but with secondary periodontal involvement.


tooth abscess
tooth abscess

Periodontal abscess

A periodontal abscess is an infection of periodontic origins.

  • Gum abscess. Originating solely from the gums (gingiva).

  • Lateral periodontal abscess. Infection stems from the side of the tooth root.

  • Periodontitis-associated. Abscess was a result of untreated severe periodontitis.

  • Perio-endo abscess. Source of infection is primarily of periodontic origins but with secondary endodontic involvement.


Others types of oral abscesses

Aside from infections which originate from the tooth and its periodontium, abscesses can also occur in other oral structures such as the lip and tongue.

  • Lip abscess. Yes, your lip can get infected from injuries like lacerations or piercings.

  • Tongue abscess. A tongue injury such as a laceration may cause it to get infected.


 

Symptoms

Since a dental abscess encompasses every oral abscess in existence, the signs and symptoms will be fairly broad.

  • Bad taste. Stems from the taste of blood or pus.

  • Biting pain. Hurts to chew or bite down on food.

  • Fever. Your body will produce a fever if it is trying to fight an infection.

  • Inflammation. Mouth feels inflamed and tender.

  • Malodor. Thriving bacteria produce a lot of VSC (volatile sulfur compounds).

  • Pain. May be tooth pain, gum pain, or anything that is throbbing in your mouth.

  • Purulence. White fluid that oozes out. It is filled with dead white blood cells and bacteria.

  • Swelling. Area will be enlarged as it becomes filled with blood, pus, and bacteria.

  • Swollen lymph nodes. The ones under your jaw and neck may feel tender and swollen.

  • Trismus. Difficulty opening and closing the jaw due to severe inflammation.


When to seek care

Regardless of if you're feeling one of these symptoms or all of them, you should schedule a consultation with your dentist promptly. Even if you're unsure or if you think you have something, you should get it checked out. It is always better to be safe than sorry.


The consequence of NOT getting treatment if you have an abscess may be catastrophic. Delaying treatment for infections will only make it more complicated and expensive.


Diagnosis

As a general rule of thumb, if you're having oral swelling or visually see purulence, you've a dental abscess. However what type of abscess it is, you won't be able to tell unless you see a dentist to get a diagnosis.


What to expect for the evaluation with your dentist:

  • Oral examination. With visual and tactile examination.

  • Take an x-ray. A periapical (PA) x-ray will reveal infections which have spread to the bone. Other x-rays such as bitewings, panoramic, and cone beams may also be used.

  • Percussion and palpation test. Feeling for any tenderness by touching the tooth and jaw bone. Your dentist may also percuss the tooth by tapping it with the back end of a mirror.

  • Vitality test. Either with a cold test or electric pulp test, the vitality status of your tooth can be tested. Hopefully it is still alive because teeth can die.


 

Cause

There are almost too many ways to list how you can get an infection and develop an abscess. Here are some common ones.

  • Bacterial infection. The mouth is full of bacteria which can potentially infect it.

  • Foreign body. Hard foods or fish bones can become lodged in the gums or soft tissue.

  • Fractured tooth. A broken tooth usually leads to a tooth abscess eventually.

  • Impacted wisdom teeth. One of the most common emergency dental visits is a swollen face from fully or partially impacted wisdom teeth.

  • Lacerations. Unrepaired lacerations or cuts can easily get infected by oral bacteria.

  • Piercings. If you don't take care of your tongue, lip, or frenulum piercings, they can get infected. These type of emergency department visits are fairly common.

  • Tooth decay. When cavities are left unattended they will progress through the stages of tooth decay and eventually develop into an abscess.

  • Trauma. Receiving a forceful impact to your tooth can kill it and cause an infection. This is commonly found in sports injuries or unanticipated accidents.


fractured molar
fractured molar

Treatment

After receiving a diagnosis for what type of dental abscess that you have, you will need to proceed with treatment. The longer you delay it, the more complicated and expensive it will be. Insurance will only cover part of the treatment so you will be responsible for a copayment.


Treatments for dental abscesses:

  • Extraction - Tooth related abscesses where the restorative prognosis is poor, you may need it removed. Afterwards you should replace the missing tooth with an implant.

  • Root canal - Tooth related abscesses where the restorative prognosis is good, you can remove just the nerve. Root canals are more conservative since you keep your own tooth.

  • Incision and drainage - Diffuse and severe swellings will need to be drained but an incision needs to be made first. Afterwards you may leave with a penrose drain inside of the abscess to allow it to continue draining for the next 48-72 hours.

  • Antibiotics - If you've major swelling you should expect to leave with a full course of antibiotics after your appointment. This will be in addition to receiving either of the three treatments above.


extracted teeth
extracted teeth

Aftercare

If you were given any prescriptions, make sure you take them and follow the aftercare instructions to the T. Failure to do so or non-compliance may lead to a recurrence in the infection. You don't want to have to make a second trip back to the dentist do you?


You should also stick to a soft food diet for the next few days. You can slowly reintroduce slightly harder foods with each passing day. It all depends on your own comfort.


Make sure you rinse with salt water after every meal to help remove plaque and food for the surgical sites. Salt water rinses are the most gentle while you're healing.


Prevention

Sometimes the dental abscesses may be out of your control but good habits can help reduce the chances of them happening.

  • Brush your teeth for at least two minutes twice a day. Try to floss and use mouthwash prior to going to bed.

  • Get regular dental check ups every six months or at the very least once a year. More frequent visits can catch problems while they're small and potentially prevent a future abscess.

  • Wear a mouth guard if you actively engage in sports or physical activities. This may help prevent injuries or trauma to your teeth and mouth.

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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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