A tooth abscess, also called a dental abscess, is a pocket of pus that accumulates next to a tooth.

An abscess occurs when a bacterial infection creates a collection of pus, usually at the tip of a tooth’s root (called a periapical abscess) or on the gum adjacent to the root (known as a periodontal abscess).

Dental abscess causes include severe gum disease; tooth decay, particularly in the case of periapical abscess whereby bacteria that flourish in the soft decayed pulp (centre) of the tooth spread to the surrounding tissue; and trauma to a tooth, which may create a gateway for infection.

Complications of an untreated abscess include the infection spreading to other parts of the jaw, head and neck.

What are its symptoms?

Dental abscess symptoms include:

  • Pain: An extreme continuous throbbing toothache or sharp, shooting pains are common. Pain may get worse when pressure is applied or when chewing and teeth may be more sensitive to hot or cold.
  • Bad taste in the mouth and/or foul breath.
  • Swelling of the gums, face or cheek.
  • An open sore on the gum.
  • Swollen glands in the neck.
  • Fever and generally feeling unwell. If the infection spreads to elsewhere in the body, additional symptoms such as nausea, chills and trouble breathing or swallowing may occur.

How is it diagnosed?

A dental abscess diagnosis is usually made by a dentist based on an examination of the affected area and reports from the patient regarding the type and intensity of the pain.

In addition to tapping on the teeth to look for increased sensitivity, the dentist may order an X-ray to search for damage to the surrounding bone structure.

What are your treatment options?

Dental abscess treatment is centred not only on getting rid of the abscess, but on eliminating the infection. As such, in addition to drainage of the abscess, antibiotic treatment may be prescribed.

In cases where the tooth can be saved, root canal treatment (endodontic therapy) is used to remove the diseased pulp and decontaminate the tooth’s central cavity before it is filled and sealed.

In other cases, the affected tooth may need to be extracted. Sometimes an abscess will burst on its own – if this happens, use warm salt-water rinses to encourage cleansing and drainage but see a dentist as soon as possible as to treat the infection properly.

Can it be prevented?

Good oral hygiene is key to the prevention of abscesses. In addition to brushing your teeth twice daily and daily flossing, it’s also important you schedule regular check-ups with your dentist and professional cleaning by an oral hygienist too. 

South African tap water is not fluoridated, so a fluoride-containing toothpaste will offer your teeth protective benefits, but use with care in children under six years old, ensuring that they don’t swallow the toothpaste.

Remember too that bacteria thrive on sugar, so limiting sugary snacks is also advised to keep your teeth and gums in good health.

The accuracy of this information was checked and approved by physician Dr Thomas Blake in December 2015