What is a dental abscess and how to treat it

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 both cases, it should be looked at by a dentist. It is important to get help as soon as possible, since abscesses do not disappear by themselves. Sometimes they can spread to other parts of the body and make you sick.

Symptoms of an abscess in the tooth or gum may include:

intense thrilling pain in the affected tooth or gum that can appear suddenly and gradually worsen;
Pain that spreads to the ear, jaw and neck on the same side as the affected tooth or gum;
Pain that worsens when you lie down, which can disrupt your sleep;
Redness and swelling in the face;
A tender, discolored or weakened tooth;
Shiny, red and swollen gums;
Sensitivity to hot or cold food and drink;
Bad breath or unpleasant taste in the mouth;
If the infection spreads, you may develop a high temperature (fever) and generally feel unwell.

In severe cases, it may be difficult for you to completely open your mouth and have difficulty swallowing or breathing.

Relieving pain from a dental abscess

While waiting to see a dentist, painkillers can help you control your pain. Ibuprofen is the favorite analgesic for dental abscesses, but if you cannot take it for medical reasons, you can take paracetamol.

Aspirin should not be given to children under 16 years of age. If an analgesic does not relieve pain, it may be useful to take both paracetamol and ibuprofen at the doses indicated in the package leaflet of the drug. This is safe for adults, but not for children under 16 years of age.

It can also help you:

avoiding hot or cold foods and drinks if it aggravates the pain;
try to eat cold and soft foods, if possible, using the opposite side of the mouth;
use a soft toothbrush and temporarily avoid performing dental floss around the affected tooth;

These measures can help you temporarily relieve your symptoms, but you should not use them to delay getting help from a dentist.

Treatments for a dental abscess

Dental abscesses are treated by removing the source of infection and draining pus. Depending on the location of the abscess and how severe the infection is, possible treatments include:

Root canal – a procedure for removing abscess from the root of an affected tooth before filling and sealing
Removal of the affected tooth (including wisdom teeth extraction) – this may be necessary if the root canal is not possible
Incision and drainage – if a small cut (incision) is made in the gum to drain the abscess (this is usually only a temporary solution and additional treatment may be required)

Local anesthetic will usually be used to numb your mouth for these procedures. More extensive operations can be performed under general anesthesia, where you sleep.

Antibiotics are not usually prescribed for dental abscesses, but they can be used if the infection spreads or is especially severe.

What causes dental abscesses?

Your mouth is full of bacteria, which form a sticky film on your teeth called plaque. If you do not keep your teeth clean, the acids produced by the bacteria in the plaque can damage your teeth and gums, leading to tooth decay or gum disease.

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

Poor oral hygiene – plaque can accumulate on the teeth if you do not floss and do not brush your teeth regularly
Consumption of foods and beverages with sugar or starch – they can encourage the growth of bacteria in the plaque and lead to an abscess
Previous injury or surgery of the teeth or gums – bacteria can penetrate into any damaged parts of the teeth or gums
A weakened immune system – this includes people with certain underlying health conditions, such as diabetes, and those who have treatment, including steroid medications or chemotherapy

Prevention of dental abscesses

You can reduce your risk of developing dental abscesses by keeping your teeth and gums as healthy as possible. To do this, you should:

use dental floss or an interdental brush at least once a day to clean between the teeth and below 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, as this washes away protective toothpaste – simply spit out any excess toothpaste
reduce foods and drinks with sugar and starch – especially between meals or shortly before bedtime
visit your dentist regularly – your dentist may suggest how often you should have a check-up, depending on your oral health