What Does An Abscess Tooth Look Like?

Updated: Oct 14

An abscessed tooth can have a wide range of clinical presentations and thus no two abscesses look identical. Sometimes the abscess can cause swelling while other times it does not. There are other times where the tooth looks normal or it could look like a big cavity. Last but not least, the tooth can also change colors.


That is why it is important to know what every variation of a dental abscess can look like so you can be sure if you have one or not. It is fairly common for patients to go in for a dental check up and get told that they have an abscess even though they never realized it.


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Here are some common clinical presentations for what an abscessed tooth can look like:



An abscessed tooth with facial swelling

The very last stage of a tooth abscess is usually accompanied by a swollen face. The affected side where the infected tooth is will swell up and make your face look bigger than the non-affected side. This is the most prominent and distinctive trait of a tooth abscess. If your face swells up from a tooth problem, that is a tell tale sign of an abscessed tooth.


Signs and symptoms:

  • Swelling on one side of the face

  • Tender and painful to the touch

  • Reddish in color

  • Warm to the touch

  • Fluctuant mass


Treatment: Will require multiple dental procedures to make this infection go away. If you try to implement just one of the three dental procedures, the abscess will return a few days later. You must undergo all three of these treatments in order to successfully eradicate the infection.

  1. Incision and drainage

  2. Tooth extraction or root canal

  3. Antibiotics


Tooth abscess with gum swelling

An abscess that is less severe than the facial swelling is one where just the gums around the tooth are swollen. This stage of the infection is one step behind that of a swollen face. The face may not be swollen but inside your mouth where the gums are will be extremely swollen. It may be severe enough that the size of the gums can nearly cover the entire teeth.


Signs and symptoms:

  • Swelling of the gums

  • Red and poofy looking

  • Bleeds easily when touched

  • Possible pus oozing out

  • Painful

  • Foul odor in breath


Treatment: The treatment for this kind of abscess is similar to the one with facial swelling. It will require three dental treatments in order to get rid of it.

  1. Incision and drainage for the swelling

  2. Root canal or tooth removal

  3. Course of antibiotics


Pimple on the gums from an abscess

Prior to the gums swelling up, a tooth abscess may have a pimple on the gums (gum boil). That pimple is your body's way of trying to drain the abscess naturally. If you pop it, you'll find a mix of pus and blood oozing out of the gums. These gum boils are typically associated with an infected tooth.



Signs and symptoms:

  • Small pimple on the gums near a tooth

  • Reddish and white in color

  • May be painful or could be painless

  • Oozes out white pus and red blood


Treatment: Unless the infection is very severe, a tooth extraction is not required. A root canal is usually sufficient in eliminating the infection which stems from the unhealthy tooth nerve.

  1. Root canal treatment

  2. Antibiotics

  3. Drainage may or may not be required since it is very small



Large cavitation with an abscess

Not all abscesses are accompanied by some type of swelling. The abscess usually starts forming at the root tip which is still in the bone. While the infection is developing and growing within the bone, you won't be able to visually see any swelling. The abscess will be completely contained within your jaw bone.


Therefore if you have a large cavity in one of your teeth, don't assume that it is not an abscess because it could very well be one. Here is a photo of what a large cavity looks like:


It may simply look like a regular big ole cavity but if your dentist takes an x-ray of it, you'll be able to see the abscess within the bone. What it looks like on the x-ray is a large black circle near the tip of the root.


abscess on x-ray

Signs and symptoms:

  • Large cavity

  • May or may not be painful (surprisingly)

  • Hole inside tooth looks black or dark brown

  • Food gets stuck in the hole


Treatment: Even though its a big cavity, in order for the abscess to form by the tip of the root, the nerve has to be infected as well. Otherwise the infection can't travel down the canal of the tooth and reach the tip. Therefore treatment is not simply a cavity filling but a root canal instead.

  1. Start root canal.

  2. Place medication inside the canal.

  3. Finish root canal.

  4. Core build up.

  5. Dental crown.



Discolored tooth that is abscessed

A discolored tooth with an abscess is a dead tooth. These teeth often die due to trauma or injury to the face many years ago. Its just that sometimes it takes the teeth a very long time to die and for the abscess to form. Most of the time this condition is painless and the patient won't even notice it at all.


Signs and symptoms:

  • PAINLESS

  • Grey tooth or discolored

  • May or may not have a pimple on the gums


Treatment: In order to get rid of the dead nerve the tooth will require a root canal. After that you would need a crown to cover up the color for aesthetic purposes.



X-ray of an abscess tooth

Most of the time, the dead grey teeth don't have a visible abscess that you can see in the mouth but it is present in the jaw bone. You can only see it if your dentist takes an x-ray of the root of the tooth. What it will look like on the x-ray is a radiolucent or black circle around the tip of the root, which signifies an abscess.


This is an x-ray of what an abscess in the bone looks like on a dental x-ray:




Takeaway

There are multiple ways that a tooth abscess can show up in the mouth. Sometimes it is accompanied by swelling but other times it is not so obvious since there isn't any swelling. Nonetheless, the only way to truly know if you have an abscessed tooth is to get diagnosed by a dentist. That means you will need to go in for a consultation or if you haven't had a check up in awhile, you should do that as well.


Having an active abscess in your mouth is not healthy and you should get it treated as soon as possible. Home remedies will not be able to get rid of it. You must seek medical help.



Author: Written by Dr David Chen a general dentist in Long Island City, NY.

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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!