What is a dental abscess? It is a pocket of pus that forms when bacteria infect a tooth or the gums around it. The pus is your body’s response to a bacterial infection: as white blood cells fight the bacteria, the dead cells, tissue and bacteria collect with nowhere to drain. The result is a swelling that is usually painful, warm and tender to touch.
The first question most people have is whether it will go away by itself. The short answer is no. A dental abscess will not clear up without treatment, and the infection can spread if you leave it. The earlier a dentist sees it, the more straightforward treatment tends to be.
What Are the Three Types of Dental Abscess?
There are three main types of dental abscess, grouped by where the infection takes hold. They share the same cause, a bacterial infection, but they begin in different places and are treated a little differently.
Periapical abscess (tooth abscess)
A periapical abscess forms at the tip of the tooth root, inside the bone. It is the most common type, and it is what most people mean by a tooth abscess. It usually starts when bacteria reach the soft centre of the tooth, the pulp, through a cavity or a crack, and the nerve inside dies.
Periodontal abscess (gum abscess)
A periodontal abscess sits in the gums beside a tooth rather than in the tooth itself. It is linked to gum disease, where deep pockets form between the gum and the tooth root and trap bacteria. A periodontal abscess often shows up as a tender, swollen lump on the gums.
Gingival abscess
A gingival abscess is the most contained of the three. It affects only the surface gum tissue, often after something like a popcorn husk or a stray toothbrush bristle lodges in the gum and causes a small, local infection. It does not involve the tooth or the deeper supporting structures.
Symptoms and Warning Signs
The clearest sign of a dental abscess is pain. It is often a throbbing pain that comes on suddenly and builds over hours or days, and it can spread to the jaw, ear or neck on the same side. Common symptoms include:
- A persistent, throbbing toothache that may keep you awake at night
- Swelling in the gums, face or jaw, sometimes with a tender, swollen lump
- Tooth sensitivity to hot and cold, and pain when biting or chewing
- A bad taste in the mouth or bad breath if the abscess starts to drain
- Red, tender gums and swollen lymph nodes under the jaw or in the neck
- Fever and feeling generally unwell
Some symptoms mean the infection may be spreading and need urgent attention. If you have a fever with facial swelling, swelling that closes an eye or reaches your neck, or any difficulty breathing or swallowing, treat it as a medical emergency: go to your nearest hospital emergency department or call 000.
One thing catches people out. Sometimes the pain stops suddenly, and it feels like the problem has fixed itself. It usually has not. When the pain disappears, it often means the nerve inside the tooth has died, while the infection underneath keeps spreading. A tooth abscess that has stopped hurting still needs treatment.
What Causes a Dental Abscess?
A dental abscess almost always starts with bacteria getting past the protective outer layers of a tooth or gum. Once they reach the pulp or the deeper gum tissue, an infection sets in, and pus begins to build. The usual culprits are:
- Tooth decay that has eaten through the enamel into the pulp, the most common route to a periapical abscess
- A cracked or chipped tooth that gives bacteria a path toward the tooth root
- A failed or leaking filling that lets bacteria back in
- Gum disease, which creates the deep pockets where a periodontal abscess can form
Some things make an abscess more likely. Poor oral hygiene and a high-sugar diet feed the bacteria behind tooth decay and gum disease. Smoking and a dry mouth lower your defences, and a weakened immune system makes a bacterial infection harder to shake off. Untreated tooth decay affects around one in three Australian adults, which is why decay is the cause we see most often.
An abscess will not heal on its own, because the source of the infection, usually a dead nerve or a deep gum pocket, stays put. Antibiotics alone do not fix it either. They can settle an infection for a while, but the abscess returns until a dentist removes the underlying cause.
How Dentists Treat a Dental Abscess
Treatment for a dental abscess has two goals: drain the pus and remove the source of the infection. How a dentist does that depends on the type of abscess and how much of the tooth can be saved.
Draining the abscess
The first step is usually drainage. The dentist makes a small opening to let the pus out, which relieves the pressure and eases the pain quickly. For a gum abscess, this may be done through the gum; for a tooth abscess, through the tooth itself.
Root canal or extraction
Once the infection is drained, the cause has to be dealt with. If the tooth can be saved, root canal treatment removes the infected pulp from inside the tooth root and seals it, often finished with a crown. If the tooth is too damaged, a tooth extraction may be the better option. Your dentist will talk you through which path suits your tooth.
Antibiotics and pain relief
Antibiotics are not a cure on their own, but a dentist may prescribe them when the infection has spread beyond the tooth, when there is a fever or facial swelling, or for patients with certain health conditions. Simple pain relief and warm salt-water rinses can help while you wait for your appointment.
Complications, Prevention and When to See a Dentist
Left alone, a dental abscess does not stay in one place. The infection can spread into the jaw and neck, and in rare cases into the bloodstream, where it becomes life-threatening.
Spreading infection can cause swelling that narrows the airway, which needs hospital care, and it can trigger sepsis, a whole-body reaction to infection. Dental problems send more Australians to hospital than most people realise.
How to prevent a dental abscess
- Brush twice a day with fluoride toothpaste and clean between your teeth daily
- Cut back on sugary food and drinks
- Keep up regular check-ups so decay and gum disease are caught before they reach the pulp
- Deal with a cracked tooth, a lost filling or a lingering toothache early rather than waiting
If you have a throbbing toothache, a swollen or tender patch in your gums, or a bad taste that will not shift, book in to see a dentist. A dental abscess is considered a dental emergency, so the sooner it is checked, the better. Now that you know what a dental abscess is, the takeaway is simple: it will not fix itself, and it is very treatable when caught early.
Worried you might have a dental abscess? Book online or call Currey & Jorgensen Dentistry on (07) 5479 5522 to arrange a prompt appointment at our Alexandra Headland practice.
Frequently Asked Questions
Can a dental abscess go away on its own?
No. A dental abscess will not clear up without treatment. The pus may sometimes drain and ease the pain for a while, which can feel like it has healed, but the underlying bacterial infection stays active and tends to come back. An abscess needs a dentist to drain it and remove the cause, whether that is a decayed tooth or a gum infection.
What happens if a dental abscess is left untreated?
The infection spreads. It can move from the tooth root into the jaw and neck, cause swelling that affects breathing, or enter the bloodstream and lead to sepsis. These complications are serious and occasionally life-threatening, which is why a dental abscess is treated as a dental emergency. Most cases, though, are straightforward to treat when seen early.
How do dentists treat a dental abscess?
A dentist first drains the pus to relieve the pressure and pain. Then they treat the source: root canal treatment to save the tooth, or extraction if it is too damaged. Antibiotics may be added when the infection has spread, or there is a fever. Treatment is usually completed over one or more visits, depending on the tooth.
Is a dental abscess a dental emergency?
Yes. A dental abscess is considered a dental emergency because the infection can spread quickly, so you should see a dentist as soon as possible. If you also have a fever, facial swelling, or any trouble breathing or swallowing, go straight to your nearest hospital emergency department or call 000, as these can be signs of a spreading infection.
What is the difference between a tooth abscess and a gum abscess?
A tooth abscess (periapical abscess) starts inside the tooth and forms at the tooth root, usually after decay or a crack lets bacteria reach the pulp. A gum abscess (periodontal abscess) forms in the gums beside the tooth and is linked to gum disease. Both are pockets of pus from a bacterial infection, and both need dental treatment.
What should I do if I think I have an abscess on the Sunshine Coast?
Call your dentist and describe your symptoms so they can fit you in promptly. At Currey & Jorgensen Dentistry in Alexandra Headland, you can book online or call (07) 5479 5522 during opening hours, Monday to Friday. If you have severe swelling, a high fever or any difficulty breathing outside these hours, go to your nearest hospital emergency department.
About the Author
Dr Peter Jorgensen, BDSc, Grad Dip Clin Dent (Oral Implants), Principal Dentist
Dr Peter Jorgensen is the principal dentist at Currey & Jorgensen Dentistry (CJ Dentistry) in Alexandra Headland. He earned his Bachelor of Dental Science from the University of Queensland in 1995, followed by a Graduate Diploma in Clinical Dentistry (Oral Implants) from the University of Sydney, with a focus on implant dentistry, oral surgery and complex restorative work. He handles implant cases from surgery through to the final restoration, so patients get continuity of care from start to finish.
Peter has called the Sunshine Coast home since 2000 and has a soft spot for intricate crown and bridge work that suits his perfectionist streak. He’s easy to chat with and loves building lasting relationships with patients and their families. He also gives back to the profession as a University of Sydney student mentor, a member of the Australian Osseointegration Society, a board member with the Australian Dental Association Queensland, and a fellow of the Pierre Fauchard Academy.