Treating a Dental Abscess

October 17, 2017

Tooth Abscess is the most common complaint from patients who seek urgent dental care in the middle of the night, according to this emergency dentist. Patients normally describe it as continuous sever toothache or a growing agonizing pain. To treat a dental abscess, you should call your dentist and make an emergency appointment ASAP.

A dental abscess is a space infection within a tooth or its surrounding tissues. It can cause excruciating pain and it is a serious condition that needs to be treated before it further affects your health and other organs in your body.

Dental abscess can form very quickly (only one or two days after an infection begins). If you have swelling on your gum, it is best to get it checked by your dentist even if it is still painless. If you are experiencing continuous toothache, it can be an abscess pain and you should make an emergency appointment and seek urgent dental treatment.

Dental Abscess Symptoms

A severe facial pain on the same side as the infected tooth is a common symptom of an abscessed tooth. The tooth itself becomes sensitive to touch and sometime painfully unbearable to touch. Dental abscess symptoms may include:

  • Possible fever
  • Continuous toothache
  • Swelling on the cheek area
  • Facial swelling
  • Swollen lower eyelid
  • Swelling in the neck
  • Red or swollen gums
  • Bad taste in your mouth

Abscess in the tooth can be caused by:

  • Tooth decay or cracked tooth (periapical abscess which is tooth-related)
  • Gum disease (periodontal abscess which is gum-related)

In Simple terms, a tooth is composed of four dental tissues. Three types of hard tissues called the enamel, the dentin and the cementum and one type of soft tissue known as the pulp. The pulp is the non-calcified and soft part if your tooth. It is in the centre of your tooth. The dental pulp contains important tissues like: tooth nerves, blood vessels and other connective tissues. Damage to the pulp or tooth decay can kill the pulp. When the pulp dies it further feeds the harmful bacteria that killed the pulp.


Bacteria activity in the pulp causes infection in the pulp that can grow and extend to the root of the tooth. Bacterial may continue to grow and spread from the root system into the tissue below the tooth and builds up to form a localized collection of pus (a thick fluid in yellow colour) at the tip of the tooth root and in the jaw bone – an abscessed tooth.


Periodontal disease is the dental term for gum disease. It also can cause tooth abscess.  Disease pulls the gum back away from the tooth and creates a pocket that collects bacteria. The bacteria grow in the pocket and spreads and form a dental abscess.


Dental abscess is typically painful; it can also be with little or even no pain. If you delay treatment, the infection may last for a long time. Dental abscess has a low PH it is acidic due to bacteria activity. The acid attacks the jaw bone and starts to dissolve the jaw bone. As the bone is dissolved away a hallow tunnel may be created in the bone. At this stage, the patient may get a false feeling of relief because with some parts of the bone dissolved, more space is created. With the additional space now available, the infection pressure against the nerves drops temporarily. But the harmful infection is still present in the jaw bone.


Jaw bone is the foundation of your tooth. Without the bone, an abscessed tooth becomes tender, mobile and eventually becomes loose because the bone no longer supports the tooth. At this point tooth extraction would be the only treatment option left. The extraction of an abscessed tooth may not be a quick extraction because with the infection present near the tooth it would be hard to numb the tooth for extraction.



Treatment of a gum abscess can be quick. Your dentist will examine the abscess and will clean the abscessed area, drain the pus and treat the infection. Treatment of an abscess inside the tooth, however, may require draining the pus, root canal therapy, restoration by filling or crown. If the abscess damages the tooth beyond repair, then extraction of the tooth would be the only option.

Due to presence of infection in the area, it is difficult to get an abscessed tooth completely numb. To extract an abscessed tooth, dentists may try to control the bacteria with antibiotics first. If numbing is not possible, with a few days of antibiotics (preferable, 4 to 7 days), the abscess should go away enough for getting your tooth completely numb for extraction.

It is recommended to have treatment done on the tooth to eliminate the cause of infection before prescribing antibiotics. When numbing of the tooth is not possible on the day, then the dentist may prescribe antibiotics first.


To treat a dental abscess dentist may:

  • Prescribe antibiotics to destroy bacteria before extraction (when complete numbing is not possible on the day)
  • Drain the infection
  • Clean the pockets between tooth and gum (abscess caused by gum disease)
  • Root canal therapy (abscess caused by trauma, cracked tooth or tooth decay)


To prevent a dental abscess, you should:

  • Maintain good oral hygiene
  • Have regular dental check-ups as recommended by your dentist
  • Have dental examination after trauma to your mouth


Before your Appointment

The best thing you can do is to get the abscess treated by a dentist. Until your appointment, you can dissolve half teaspoon of salt in 250 grams of water and rinse your mouth multiple times a day. Salt water may help draw the pus out and cause the pressure to drop and provide you with a temporary relief from pain. For a permanent treatment, you still need to go to a dental professional.


If not treated, an abscessed tooth may cause the infection to spread to other parts of the body and cause serious issues like affecting the health of your heart. Do not live with an abscessed tooth. If you have toothache you should have it treated by a dentist as soon as possible.

Author: Dr. Ellie Nadian

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