A tooth abscess is a sac of pus (infected material) in a tooth or the gums. There are two types of tooth abscesses:

• Abscess of the pulp (blood and nerve supply inside the tooth)
• Abscess between the tooth and gum

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:

• Severe tooth decay
• Break or crack in a tooth that lets bacteria invade the pulp

Food or other foreign matter that becomes trapped between the tooth and gum may lead to a bacterial infection in the area around the tooth.

These factors increase your chance of developing a tooth abscess. Tell your dentist if you have any of these risk factors:

• Build up of tartar or calculus beneath the gum line
• Poor fluoride application to teeth via fluoridated water, toothpaste, or mouthwash
• Poor dental hygiene (leading to cavities and periodontal diseases)
• Malnutrition, including severe vitamin and mineral deficiencies

If you have any of these symptoms do not assume it is due to a tooth abscess. These symptoms may be caused by other conditions. Tell your dentist if you have any of these:

• Throbbing/lingering pain in a tooth or gum area
• Pain when biting on a tooth
• Spontaneous tooth pain
• Redness, tenderness, or swelling of the gums
• Fever
• Swollen neck glands
• Tooth discoloration
• 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

Your dentist will ask about your symptoms and medical history and perform a detailed exam of your teeth and gums.

Your dentist will test the tooth for pain and sensitivity by:

• Lightly tapping on the tooth
• Stimulating the tooth nerve with heat or cold
• Stimulating the tooth nerve with a low electrical current
• Sliding a probe between the tooth and gum to measure gaps or tissue loss

Your dentist will also take an x-ray of the tooth and surrounding bone.

• 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 top of the tooth.
  • Pus and dead tissue are removed from the center of the tooth.
  • The interior of the tooth and the root (nerve) 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 recurrence of infection.

• Removal of the tooth 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
• Nonprescription pain relief drugs ( ibuprofen or acetaminophen ) and warm salt water rinses