Tooth abscesses are collections of pus that form in the tooth; they can be very painful and require urgent treatment. If abscesses are left untreated they can get worse and may cause damage to surrounding teeth and gum tissue.

How does an abscess form?

A tooth abscess, also known as a periapical abscess, is caused by bacterial infection. Bacteria collect in the mouth when we eat and can infect the inner portion of the tooth if the protective enamel coating is worn or damaged. The bacteria that are responsible for dental abscesses are found in plaque, a sticky film, which collects on the teeth and around the gum line. The abscess forms when the pulp portion of the tooth becomes infected and inflamed; the pulp eventually dies and the bacteria continue to infect the cavity, gradually working towards the alveolar bone, which supports the tooth. Eventually an abscess will form around the bone.

Signs to look out for

Tooth abscesses can be very painful and they can get worse very quickly if left untreated, so it is important to recognise the symptoms and get treatment as quickly as possible. Common symptoms to look out for include localised pain around the affected tooth, which may be severe and acute; most people with tooth abscesses experience throbbing pain, which tends to come on suddenly and gets worse over time. Pain can also spread to the jaw, the ear and the neck.

Other symptoms include tenderness around the affected tooth, a foul taste in the mouth, fever, increased sensitivity, especially to hot and cold foods and drinks and a general feeling of illness.

Treating a dental abscess

An abscess must be treated by a dentist; it is not something you can leave to heal and it will get worse the longer you leave it, so try to see your dentist as quickly as possible. The abscess will be treated under local anaesthetic (in most cases) by means of root canal treatment; during the procedure, the abscess will be cut away and the pus, which contains all the harmful bacteria, will be drained. Once the infected pulp has been removed and the abscess has been cut out, the empty pulp chamber and root will be filled to prevent further infection.

You can take over the counter painkillers to ease the pain while you wait to see a dentist. To prevent additional pain, try to avoid eating and drinking very hot or cold foods and drinks, steer clear of hard foods and brush your teeth using a toothbrush with soft bristles.

In some rare cases, the abscess may recur; if this is the case, you may be advised to see a specialist oral surgeon, who will remove any remaining diseases tissue from the tooth.

Once your abscess has been treated, it is important to keep an eye on your oral health and stick to a good daily oral hygiene routine; you will also be advised to attend regular dental check-ups.

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