Symptoms

These may include:

• an intense throbbing pain in the affected tooth or gum that may come on suddenly and get gradually worse
• pain that spreads to your ear, jaw, and neck on the same side as the affected tooth or gum
• pain that is worse when lying down, which may disturb your sleep
• redness and swelling in your face
• a tender, discoloured, or loose tooth
• shiny, red, and swollen gums
• sensitivity to hot or cold food and drink
• bad breath or an unpleasant taste in your mouth
• If the infection spreads, you may also develop a high temperature (fever) and feel generally unwell

Diagnosis

In addition to examining your tooth and the surrounding area, your dentist may:

• Tap on your teeth: A tooth that has an abscess at its root is generally sensitive to touch or pressure.
• Recommend an X-ray: An X-ray of the aching tooth can help identify an abscess. Your dentist may also use X-rays to determine whether the infection has spread, causing abscesses in other areas.

Recommend a CT scan: If the infection has spread to other areas within the neck, a CT scan may be used to assess the extent of the infection.

Causes

Your mouth is full of bacteria, which form a sticky film on your teeth called plaque.

If you do not keep your teeth clean, acids produced by the bacteria in plaque can damage your teeth and gums, leading to tooth decay or gum disease.

The following can increase your chances of developing a dental abscess:

• poor oral hygiene – plaque can build up on your teeth if you do not floss and brush your teeth regularly
• consuming lots of sugary or starchy food and drink – can encourage the growth of bacteria in plaque and may lead to decay that can result in an abscess
• an injury or previous surgery to your teeth or gums – bacteria can get into any damaged part of the teeth or gums
• having a weakened immune system – this includes people with certain underlying health conditions, such as diabetes, and those having treatment, including steroid medication or chemotherapy

Prevention

To prevent dental abscess, you should:

• use floss or an interdental brush at least once a day to clean between your teeth and under the gum line
• brush your teeth with a fluoride toothpaste twice a day – spending at least 2 minutes each time
• avoid rinsing your mouth with water or mouthwash after brushing because this washes the protective toothpaste away – just spit out any excess toothpaste
• cut down on sugary and starchy food and drinks – particularly between meals or shortly before going to bed
• visit your dentist regularly – your dentist can suggest how often you should have a check-up based on your oral health

Dental abscesses are treated by removing the source of the infection and draining away the pus.

Depending on the location of the abscess and how severe the infection is, possible treatments include:

• Root canal treatment – a procedure to remove the abscess from the root of an affected tooth before filling and sealing it
• Removing the affected tooth (extraction) – this may be necessary if root canal treatment is not possible
• Incision and drainage – where a small cut (incision) is made in the gum to drain the abscess (this is usually only a temporary solution and further treatment may be needed)

Local anaesthetic will usually be used to numb your mouth for these procedures.

More extensive operations may be carried out under general anaesthetic where you are asleep.

Antibiotics are not routinely prescribed for dental abscesses, but may be used if the infection spreads or is particularly severe.

A dental abscess is a collection of pus that can form inside the teeth, in the gums or in the bone that holds the teeth in place. It is caused by a bacterial infection.

An abscess at the end of a tooth is called a periapical abscess. An abscess in the gum is called a periodontal abscess. Dental abscesses are often painful, but not always. In either case, they should be looked at by a dentist. It is important to get help as soon as possible, as abscesses do not go away on their own.