What Is a Tooth Abscess?
An abscess is a limited area of pus formed as a result of a bacterial infection. The body’s immune system reacts to the infection, and sends white blood cells to the area to try to get rid of the bacteria. Pus is a mixture of live and dead white blood cells, enzymes and parts of destroyed cells and tissues. When there is no way for pus to drain, it forms an abscess.
Abscesses can form in almost every part of the body. In the mouth, abscesses form in gum tissue or in the roots of teeth and in the surrounding areas of the tooth. They can be caused by trauma (food or debris embedded deep in the gum), by bacteria that enters through a cavity and gets into the dental pulp, or from a deep periodontal pocket. People with a lowered resistance to infection are at increased risk of developing an abscess. At first, the abscess may cause a toothache, which can be severe. The tooth’s nerve can become infected and the infection can burrow through to the gum, forming a visible boil that can rupture in the mouth. Once the abscess ruptures, the pain often decreases significantly, but dental treatment is still necessary. If the abscess does not drain, the infection can spread to other areas of the head and neck and can become life threatening.
Symptoms of a Tooth Abscess
The main symptom is persistent, throbbing pain. At first, the tooth will be sensitive to heat and pressure while chewing. Later, you may develop a fever. Swollen lymph nodes under the jaw or in the neck can be tender and you may feel pain in the sinus area. If the abscess ruptures, a sudden rush of foul-smelling and foul-tasting fluid will spill into the mouth.
Diagnosis
Usually, your dentist can diagnose a tooth abscess by examining your mouth. He or she may push on the swollen area of the gum and do a pulp test on the affected tooth to see if it is still alive. A pulp test can involve:
- Gentle tapping (percussion) on the tooth
- Temperature testing
- Using an electric tester on the tooth
Your dentist also may take an X-ray to look for bone erosion around the tip of the tooth’s root.
Expected Duration
Once the abscess is drained, most symptoms go away immediately or within a few days, but the abscess will not be cured unless the cause is eliminated.
Prevention
Good oral hygiene can help prevent abscesses by keeping teeth and gums free of food and debris. Regular dental checkups are also important. If you have a weakened immune system because of medication or another condition, let your dentist know before every appointment. You may receive antibiotics before the appointment to reduce the risk of infection.
Treatment
Saving an abscessed tooth begins with draining the infection, which usually relieves pain and removes much of the infection. Root canal treatment may be necessary and should be started as soon as possible to remove diseased tissue.
If the abscess involves gum tissue, your dentist may suggest that you rinse with warm salt water (1/8 of a teaspoon of salt in 8 ounces of water) a few times a day for several days. You may be prescribed antibiotics to help make sure the infection has been eliminated. Have dental X-rays performed six months later to confirm if healthy bone and tissue are filling the area of the abscess. If the bone does not fill in after the treatment, you may need to visit a periodontist who can surgically reshape the gum so that it is easier to keep clean, or an endodontist who can surgically remove a persistent abscess.
Why You Should Never Attempt to Drain an Abscess at Home
While it may be tempting to relieve the pain by trying to drain an abscess yourself, this is never a safe option. Abscesses require professional treatment, and home remedies or do-it-yourself approaches can make matters much worse. Attempting to “pop” or cut an abscess on your own not only fails to eliminate the source of infection, but also increases the risk of spreading bacteria deeper into surrounding tissues.
Serious complications—including the rapid spread of infection to the jawbone, neck, or even the bloodstream—can arise if an abscess is not managed correctly. In rare cases, these infections can become life-threatening. Over-the-counter pain relievers or natural remedies like clove oil might temporarily dull discomfort, but they do not address the underlying infection.
For your safety, only a trained dentist or doctor should evaluate and treat a dental abscess. Professional care ensures thorough drainage and removal of infected tissue, reducing the risk of additional infection or jawbone loss. Never ignore a dental abscess—or try to treat it at home. If you suspect you have an abscess, schedule a dental appointment promptly to prevent more serious health problems.
Root canal treatment may be necessary and should be started as soon as possible to remove diseased tissue.
If the abscess involves gum tissue, your dentist may suggest that you rinse with warm salt water (1/8 of a teaspoon of salt in 8 ounces of water) a few times a day for several days. You may be prescribed antibiotics to help make sure the infection has been eliminated. Have dental X-rays performed six months later to confirm if healthy bone and tissue are filling the area of the abscess. If the bone does not fill in after the treatment, you may need to be referred to a specialized periodontist.
When To Call A Professional
If you have a toothache or notice evidence of an abscess on your gum, visit your dentist. Even if the abscess drains and the pain decreases, a visit to the dentist for complete treatment is crucial.
When Immediate Dental Care Isn’t Available
If you suspect an abscess but are unable to see a dentist right away, it’s important to closely monitor your symptoms and know when to seek urgent medical attention. While waiting for dental care, managing pain and preventing the infection from spreading are top priorities.
Signs That Require Immediate Medical Attention
Contact a medical professional or go to the nearest emergency room right away if you experience any of the following:
- Significant swelling of the face, neck, or gums—particularly if it grows rapidly or feels firm to the touch
- Difficulty breathing or swallowing, or if you have trouble taking in fluids
- High fever (above 101°F/38°C) or chills
- Swollen and tender lymph nodes in your jaw or neck
- Inability to open your mouth fully or severe jaw stiffness
- Bleeding in the mouth that doesn’t stop
These symptoms may indicate that the infection is spreading beyond your teeth and gums, which can become life threatening if not promptly treated.
What to Do at Home Until You See a Professional
If your symptoms are mild and you don’t have any of the urgent warning signs above, there are a few things you can do while waiting for dental care:
- Take over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) as directed to manage discomfort.
- Rinse your mouth gently with warm salt water several times a day to help reduce bacteria and soothe irritated tissues.
- Avoid very hot, cold, or sweet foods, which may worsen pain.
- Try to keep your head elevated, even while sleeping, to help reduce swelling.
Remember, these steps are meant to manage your symptoms temporarily. They are not a substitute for dental treatment, and the only way to stop an abscess from progressing is with professional care. If you must visit a hospital emergency department because a dentist is unavailable, physicians can provide antibiotics and manage your pain until you are able to see your dentist. However, antibiotics alone will not eliminate the source of the infection, so follow up with your dental provider as soon as possible.
Prognosis
The outlook is excellent if detected promptly and treated appropriately. Need help now? Contact our team.
Tooth Abscess Frequently Asked Questions
What Should You Do If You Suspect a Dental Abscess Without Visible Signs?
Not all dental abscesses are obvious. While some cause a visible gum-boil or swelling, others remain hidden beneath the surface and may not present any outward changes. If you’re experiencing symptoms such as persistent, throbbing tooth pain, sensitivity to hot or cold, a bad taste in your mouth, swelling, or fever—even if you can’t see anything unusual in your mouth—it’s important to contact your dentist as soon as possible.
Early evaluation is important because a dental abscess can progress rapidly and lead to serious complications if left untreated. Your dentist has several diagnostic tools, such as examining the area, performing pulp tests, or taking X-rays, to identify an abscess that might not be visible to the naked eye.
Prompt dental care can help prevent the infection from spreading, relieve pain, and protect your overall health.
Can Abscesses Form Near or Under Crowns, Dentures, Implants, or Bridges?
Yes, dental abscesses can develop in the areas around or beneath various dental restorations, although the risk varies depending on the situation.
- Crowns: While crowns are commonly used to protect teeth that have been weakened by decay or root canal treatment, they do not make a tooth immune to infection. If bacteria manage to slip underneath the edge of a crown—perhaps due to poor fit, damage, or decay in the underlying tooth—a dental abscess can form in the tissue around the root.
- Dentures: Poorly fitting dentures can cause irritation or tiny injuries to the gums, creating an opening for bacteria to enter. If an infection takes hold beneath a denture, the gum tissue can develop an abscess. Ensuring that dentures fit well and are regularly checked by a dentist helps lower this risk.
- Dental Implants: Although dental implants are made of materials that do not decay, the surrounding gum and bone tissue can still become infected. If bacteria accumulate around an implant due to poor oral hygiene or stress on the implant, an abscess may develop in the tissues that support the implant.
- Dental Bridges: The bridge itself cannot become infected, but the natural teeth supporting the bridge remain vulnerable. If these supporting teeth or the surrounding gum become compromised, an abscess can occur.
No matter the type of dental work, maintaining good oral hygiene, routine dental checkups, and prompt attention to any discomfort can help prevent complications such as abscess formation.
Can You Have Swelling Without Pain With a Dental Abscess?
It’s possible to notice swelling from a dental abscess even if you aren’t experiencing pain. This situation often arises when the nerve inside the tooth has died, and as a result, the pain subsides—even as the infection persists or worsens. Sometimes, if the abscess drains on its own, the pain may decrease, but the swelling can remain.
It’s important to know that the absence of pain doesn’t mean the infection is gone. The underlying problem may still be serious, and the infection can continue to spread, sometimes rapidly and without obvious symptoms. Even if your tooth feels better or the pain is gone, you should see a dentist as soon as possible to prevent possible complications.
Can Wisdom Teeth Be Affected by Dental Abscesses?
Yes, wisdom teeth can develop dental abscesses, just like other teeth. These third molars usually come in during the late teenage years or early twenties. In many cases, there isn’t enough space at the back of the mouth to allow the wisdom teeth to fully emerge. When this happens, the teeth may remain partially covered by gum tissue—a situation known as impaction.
An impacted wisdom tooth can trap food and bacteria beneath the gum, making it more susceptible to infection and the development of an abscess. This can also lead to pericoronitis, an inflammation of the gum tissue around a partially erupted tooth, which may progress to a localized abscess if not properly treated.
If you experience pain or swelling in the area of your wisdom teeth, it’s important to see your dentist promptly to prevent the infection from spreading.
Can Dental Abscesses Appear Under the Tongue?
While dental abscesses typically form around the roots of teeth or in the gums, sometimes an infection can spread deeper into the tissues of the mouth. In certain cases, a severe dental infection may travel to the floor of the mouth beneath the tongue. This can lead to a condition known as Ludwig’s angina—a serious, rapidly spreading infection of the soft tissues under the tongue and lower jaw.
Ludwig’s angina is rare but extremely serious. It can cause significant swelling, potentially blocking the airway and making it difficult to breathe. If you notice swelling or pain under your tongue, or if you have trouble swallowing or breathing, seek emergency medical attention immediately.
What Is Pericoronitis?
Pericoronitis is an infection that occurs in the gum tissue surrounding a tooth that has not fully erupted—most commonly around wisdom teeth. When part of the gum, called the operculum, partially covers the tooth, it can trap food particles and bacteria, which creates an ideal environment for infection. This is especially common with impacted molars, where the tooth cannot fully emerge through the gum.
In many cases, pericoronitis can cause pain in the jaw, swelling, difficulty opening the mouth, and sometimes fever. Bad breath is also a frequent companion. At times, the infection can lead to the formation of an abscess—a pocket of pus similar to those described above—that may require prompt dental care to prevent the spread of infection.
Acute pericoronitis can be quite uncomfortable, while chronic cases might cause less severe, recurring irritation and swelling. Although rinsing with warm salt water might provide mild relief, professional dental evaluation is important. Your dentist may recommend cleaning the area, prescribing antibiotics, or, in persistent cases, removing the problematic tooth.
Are Dental Abscesses Contagious?
Dental abscesses themselves are not contagious. While they result from bacterial infections, the infection is contained within your own tooth or gum tissue. You don’t need to worry about passing a tooth abscess to a friend or family member through casual contact, sharing utensils, or being in close proximity. The bacteria that cause abscesses are already present in most people’s mouths, but the abscess only forms if they invade deeper tissues due to other factors like tooth decay or gum disease. So, you can’t “catch” a dental abscess from someone else.
How a Dental Abscess Can Lead to Sepsis?
If a dental abscess is left untreated or does not respond to treatment, the infection can sometimes spread beyond the mouth. In very rare cases, the bacteria may enter the bloodstream and trigger a serious condition called sepsis. Sepsis is the body’s extreme response to infection—like the immune system going into overdrive—which can lead to widespread inflammation, tissue damage, organ failure, and can be life-threatening if not recognized and managed quickly.
Though this is uncommon, it underlines why it’s so important to address dental infections promptly. Complications such as bacterial meningitis (infection of the lining of the brain), infective endocarditis (infection of the heart’s inner lining), and, in rare instances, sepsis, can all arise if an abscess is ignored. Signs of sepsis can include fever, rapid heart rate, confusion, and difficulty breathing—a true medical emergency.
If you suspect the infection is spreading or you begin to feel generally unwell, seek medical attention immediately. Prompt dental and medical care not only alleviates pain but also protects against far more serious health risks.
Can a Dental Abscess Be Hard to the Touch?
While dental abscesses are commonly soft, warm, and may be tender, they can sometimes feel firm or even hard. This firmness often depends on how long the abscess has been present and the amount of swelling or scar tissue that has developed around the infection. If you notice a lump in your mouth—whether it feels soft or hard—accompanied by jaw swelling, pain, or other symptoms, it’s important to see your dentist promptly. Hard lumps, in particular, should not be ignored, as they can signal a spreading infection or other underlying issues that require professional evaluation.
What Foods and Drinks Are Safe After Treatment for a Dental Abscess?
After treatment for a dental abscess, your mouth may be tender for a few days. During this time, it’s best to stick with soft, mild foods that are easy to chew and unlikely to irritate the area.
Some good choices include:
- Applesauce or mashed bananas
- Scrambled eggs
- Yogurt or cottage cheese
- Oatmeal or other cooked cereals
- Mashed potatoes or well-cooked vegetables
- Blended soups and broths
- Puddings or custards
Try to avoid anything crunchy, spicy, or very hot, as these can aggravate sensitive tissues. Drinking plenty of water is important to stay hydrated and help healing. Cool or lukewarm beverages—such as milk, diluted fruit juices, or herbal tea—are usually comfortable options.
As your mouth heals, you can gradually return to your normal diet.
What Medications can Increase the Risk of Dental Abscesses Due to Dry Mouth (Xerostomia)?
Certain medications can increase your risk of developing dental abscesses by causing dry mouth (also called xerostomia). When your mouth doesn’t produce enough saliva, bacteria are more likely to thrive, making infections and tooth decay more likely.
Some common types of medications associated with dry mouth include:
- Anticholinergics (often used for allergies or overactive bladder)
- Protease inhibitors (such as those used in HIV treatment)
- Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)
If you’re taking any of these, it’s important to be vigilant about oral hygiene. Drinking water throughout the day, maintaining regular brushing and flossing habits, and discussing concerns with your healthcare provider can help minimize your risk.
