A dental abscess is a collection of pus. It can form inside the teeth, the gums or in the bone that holds the teeth in place. It's caused by a bacterial infection.
There are 2 types of dental abscess:
- periapical abscess - an abscess at the end of a tooth
- periodontal abscess - an abscess in the gum
Dental abscesses are often painful, but not always.
Abscesses do not go away on their own. See a dentist as soon as possible.
They can sometimes spread to other parts of the body and make you ill.
Symptoms of a dental abscess
Symptoms may include:
- throbbing pain in the tooth or gum - it may happen suddenly and gets gradually worse
- pain that spreads to your ear, jaw and neck
- redness and swelling in your face
- a tender, discoloured or loose tooth
- shiny, red and swollen gums
- sensitivity to hot or cold food and drink
- bad breath or a bad taste in your mouth
You may also have a fever (a high temperature of 38 degrees Celsius or above) and feel generally unwell. The pain can get worse when you lie down. You may find it difficult to fall asleep.
In severe cases, you may find it hard to open your mouth and swallow. You may also have difficulty breathing.
When to see your dentist
See your dentist as soon as possible if you think you have a dental abscess.
Immediate action required: Go to your nearest emergency department (ED) if:
you have difficulty breathing or swallowing, or there's swelling around your eye or neck
Relieving pain from a dental abscess
While you're waiting to see a dentist, painkillers can help control your pain.
Use ibuprofen for dental abscesses. If you're unable to take it for medical reasons, you can take paracetamol.
If one painkiller does not relieve the pain, adults can take both paracetamol and ibuprofen. Always check the doses in the medicine leaflet.
[ii}Do not give both ibuprofen and paracetamol to children under 16 . Do not give aspirin to children under 16.
It may also help to relive pain if you:
- avoid hot or cold food and drink
- eat cool, soft food
- chew on the side of your mouth opposite to the affected area
- use a soft toothbrush and do not floss around the affected area
These can help relieve your symptoms for a short time. But you should see your dentist as soon as possible.
Causes of dental abscesses
The cause of most abscesses is a bacterial infection. Your mouth is full of bacteria. Bacteria form a sticky film on your teeth called plaque.
The bacteria in plaque produce acids. If you do not keep your teeth clean, these acids can damage your teeth and gums. The damage can lead to tooth decay or gum disease.
You are more at risk of developing a dental abscess if you:
- do not floss and brush your teeth regularly
- eat lots of sugary or starchy food and drink
- get an injury or surgery on your teeth or gums
- have a weakened immune system - this includes people having treatment such as steroid medication or chemotherapy
- have certain conditions, such as diabetes
Treating a dental abscess
The treatment for dental abscesses is to remove the source of the infection and drain the pus.
Treatment depends on the location of the abscess and how severe the infection is.
Treatments can include:
- root canal treatment - your dentist removes the abscess from the root of the tooth before filling and sealing it
- extraction - your dentist removes the affected tooth
- incision and drainage - your dentist makes a small cut in the gum to drain the pus
Incision and drainage is usually a temporary solution while you wait for more treatment. Extraction may be necessary if root canal treatment is not possible.
Your dentist will use a local anaesthetic to numb your mouth for these procedures. For some operations, your dentist may use a general anaesthetic, where you're asleep.
Dentists do not usually prescribe antibiotics for dental abscesses. But you may need antibiotics if the infection spreads or is severe.
Preventing dental abscesses
You can reduce your risk of developing dental abscesses by keeping your teeth and gums healthy.
To do this:
- use floss or an interdental brush (a small brush to clean between your teeth) at least once a day
- brush your teeth for 2 minutes with fluoride toothpaste twice a day
- do not rinse your mouth with water or mouthwash after brushing - this washes away the protective toothpaste
- cut down on sugary and starchy food and drinks
- visit your dentist regularly
Your dentist can suggest how often you need a check-up, based on your oral health.
Content supplied by the NHS and adapted for Ireland by the HSE