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Tooth Abscess

(Dental Abscess; Abscessed Tooth)
  • Definition

    A tooth abscess is a sac of infected material called pus in a tooth or the gums.
    Abscess Between Tooth and Gum
    Abscess tooth
    Copyright © Nucleus Medical Media, Inc.
  • Causes

    A tooth abscess is caused by bacteria. It begins when bacteria invade and infect a tooth. This results in pus build-up. When the pus is unable to drain, an abscess results.
    Conditions that allow bacteria to invade a tooth include:
    • Severe tooth decay
    • Break or crack in a tooth that lets bacteria invade the pulp
    • Failed root canal treatment
  • Risk Factors

    Factors that may increase your chance of a tooth abscess include:
    • Build up of tartar or calculus beneath the gum line
    • Poor dental hygiene leading to cavities and periodontal diseases
  • Symptoms

    A tooth abscess may cause:
    • Throbbing/lingering pain in a tooth or gum area
    • Pain when biting
    • Pain from hot or cold
    • Sudden tooth pain
    • Redness, tenderness, or swelling of the gums
    • Fever
    • Bad breath or foul taste in mouth
    • Open, draining sore on the gums
    If left untreated, complications of tooth abscess include:
    • Loss of tooth and surrounding tissues or bone
    • Spread of infection to surrounding tissue or bone
  • Diagnosis

    Your dentist will ask about your symptoms and medical history. A detailed exam of your teeth and gums will be done.
    Images may need to be taken of the tooth and surrounding bone. This can be done with x-rays.
    A sample of the abscess fluid may be taken and tested.
  • Treatment

    Removal of Abscess Via Root Canal
    • If an abscess results from tooth decay or a break or crack in the tooth:
      • The tooth and surrounding tissue is numbed and a hole is drilled through the top of the tooth.
      • Pus and dead tissue are removed from the center of the tooth.
      • The interior of the tooth and the root canals are cleaned and filled with a permanent filling.
      • A crown is placed on the tooth to protect it.
    • If an abscess results from infection between the tooth and gum:
      • The abscess is drained and thoroughly cleaned.
      • The root surface of tooth is cleaned and smoothed.
      • In some cases, surgery to reshape the gum is done to prevent a repeat infection.
    Tooth Extraction (Removal)
    • Tooth extraction may be required if:
      • Tooth decay and/or tooth infection is too extensive for filling or root canal treatment.
      • The break or crack in the tooth is too severe to be repaired.
      • The infection or loss of tissue/bone between the tooth and gum is severe.
    • If the tooth is extracted, it will be replaced with a:
      • Partial bridge
      • Denture
      • Tooth implant
    • Antibiotics to fight residual infection of the tooth or gums
    • Over-the-counter pain relief drugs, such as ibuprofen or acetaminophen
  • Prevention

    To help reduce your chance a tooth abscess:
    • Brush your teeth with fluoride toothpaste after meals or at least twice per day.
    • Floss between your teeth and gums every day.
    • Get regular dental check-ups and teeth and gum cleanings every 6 months.

    Academy of General Dentistry

    Mouth Healthy—American Dental Association


    Canadian Dental Association

    The Canadian Dental Hygienists Association


    Abscess (toothache). American Dental Association Mouth Healthy website. Available at: Accessed March 18, 2013.

    Beers MH, Fletcher AJ. The Merck Manual of Medical Information—Home Edition. New York, NY: Simon and Schuster, Inc.; 2000.

    Dental abscess. NHSinform website. Available at: Updated October 4, 2011. Accessed March 18, 2013.

    Root canals. American Dental Association Mouth Healthy website. Available at: Accessed March 18, 2013.

    Revision Information

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