Dental Abscess

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What is a dental abscess?

A dental abscess is an infection of the head or neck that begins as a tooth infection. Dental abscesses are often painful and filled with pus. The infection can originate as a result of poor dental hygiene, injury to the mouth, or medical conditions that affect the immune system.

A dental abscess begins when bacteria invade a tooth through an area of decay in the tooth (known as dental caries) or through the gums. The bacteria can cause an infection in and around the tooth, and this infection may then spread to other parts of the mouth and, more rarely, into the face or neck.

A dental abscess can be a serious condition because the infection, particularly when left untreated, may spread and cause serious complications. Spread of the infection by local extension or through the bloodstream can lead to serious infections of the jawbone, brain, heart valves, or lungs. Therefore, a dental abscess should be immediately treated by a physician or dentist. Dental abscesses are typically treated by opening the infection, cleaning the area thoroughly to remove any bacteria, and administering antibiotics.

Seek immediate medical care (call 911) for serious symptoms such as difficulty breathing due to swelling in the mouth, vomiting, fever, nausea, or headache associated with a dental abscess.

Even if your dental abscess does not cause such serious symptoms, it should still be evaluated by a dentist or physician. Seek prompt medical care if you have a pus-filled lesion inside the mouth, or pain or tenderness in the mouth, throat or face associated with a toothache.

What are the symptoms of a dental abscess?

Symptoms of a dental abscess include pain and swelling in the mouth, face or neck. A closed or draining lesion inside the mouth or gums that is filled with pus is indicative of a dental abscess and may signal a larger area of infection deeper within the tissue. A dental abscess can cause serious symptoms, including fever, chills, nausea and vomiting. Rarely, a dental abscess can cause severe swelling in and around the mouth that may affect breathing or swallowing.

Common oral symptoms of a dental abscess

Symptoms of a dental abscess may worsen over time, may resolve on their own, or may come and go. At times, any of these dental abscess symptoms can be severe. Symptoms may be localized to the mouth or involve the entire body.

Common oral symptoms of a dental abscess include:

  • Bad breath (halitosis)

  • Bitter taste in the mouth

  • Draining pus

  • Pain

  • Swelling

  • Tenderness

  • Toothache

Other symptoms of a dental abscess

Other symptoms of a dental abscess may have widespread effects on your body. These can include:

Serious symptoms that might indicate a life-threatening condition

In rare cases, a serious dental abscess left untreated can cause life-threatening infection. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Difficulty breathing

  • Dizziness or vertigo

  • Fever and chills

  • Nausea, which may be described as feelings of wooziness, queasiness, retching, sea-sickness, car-sickness, or an upset stomach

  • Trismus (inability to open the jaw)

  • Vomiting

What causes a dental abscess?

A dental abscess is caused by bacteria that infect tissue in and around teeth. Poor dental hygiene, which results in caries (cavities) or periodontal disease (gum disease), is the most common cause of a dental abscess. The infection can progress into deeper tissues of the mouth, neck and face, especially if untreated.

A dental abscess can also result from bacteria invading tissue in the mouth after oral surgery or other causes of injury in the mouth. More rarely, immune disorders or diseases can contribute to the formation of a dental abscess.

What are the risk factors for a dental abscess?

A number of factors increase your risk of developing a dental abscess. Not all people with risk factors will get a dental abscess. Risk factors for a dental abscess include:

  • Autoimmune disorders (such as Sjögren’s syndrome, characterized by dry eyes, dry mouth, and connective tissue disorder)

  • Immunodeficiency (caused by old age, systemic conditions such as metabolic syndrome, or medical treatments such as chemotherapy)

  • Injury to the mouth or teeth, including chipped teeth

  • Poor dental and oral hygiene

  • Recent oral surgery

  • Smoking

Reducing your risk of a dental abscess

You may be able to lower your risk of a dental abscess by:

  • Brushing your teeth regularly

  • Eating less sugar

  • Flossing your teeth regularly

  • Fluoridating the community drinking water supply

  • Having regular dental examinations to monitor your oral health

  • Using antiseptic mouthwash

How is a dental abscess treated?

A dental abscess can usually be diagnosed by a simple examination by your dentist or physician. An X-ray may be helpful in identifying the extent and location of the infection, especially in more serious cases.

Medications used in the treatment of a dental abscess

An abscess is typically treated with antibiotics to fight the bacteria causing the infection. Over-the-counter pain-relieving medications may be helpful in limiting discomfort.

Examples of medical treatments for a dental abscess include:

  • Antibiotics, such as penicillin or azithromycin (Zithromax)

  • Over-the-counter medications to reduce pain and fever, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol)

In addition to medications, dental work or oral surgery may be required to repair damage done to a tooth by a dental abscess. Larger abscesses or abscesses deeper in the mouth, face or neck may require surgical drainage of the pus and irrigation of the wound.
Getting prompt treatment of a dental abscess and taking all the medication prescribed by your dentist or physician are important in preventing the spread of infection into deeper tissues and limiting additional complications or recurrence.

What you can do to improve your dental abscess

Contact a dentist or physician if you think that you might have a dental abscess. Before seeing your health care provider, you may be able to reduce the discomfort associated with your dental abscess by:

  • Rinsing your mouth with warm salt water

  • Taking over-the-counter pain relievers

What are the potential complications of a dental abscess?

Left untreated, infection from a dental abscess may spread to the jawbone, brain, heart or lungs and can lead to a life-threatening condition. It is important to seek treatment from your dentist or physician if you suspect that you have a dental abscess.

Complications of untreated dental abscesses can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan that you and your health care professional design specifically for you. Complications of a dental abscess may include:

  • Abscesses in other body parts (including the brain)

  • Cellulitis (infection of the skin)

  • Endocarditis (infection of the heart chambers or valves)

  • Infection of the face or neck

  • Meningitis (infection or inflammation of the sac around the brain and spinal cord)

  • Osteomyelitis (bone infection)

  • Pneumonia

  • Sepsis (life-threatening bacterial blood infection)

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 16
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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  3. Hull MW, Chow AW. An Approach to Oral Infections and Their Management. Curr Infect Dis Rep 2005; 7:17.