April 10, 2017

An untreated abscessed tooth can cause serious problems. Here’s when to seek medical attention.


Most of us have had a toothache, whether it’s a wisdom tooth coming in or a cavity that needs filling. But sometimes, a toothache can be more than a toothache – especially if the pain starts getting worse. An abscessed tooth can become a life-threatening situation or lead to disfigurement. It is a very serious condition and needs to be addressed immediately by a dentist, oral surgeon or emergency room.


What is a tooth abscess?

A tooth abscess may result from tooth decay or gum disease, or occur if a tooth is chipped, broken or damaged in some way. Because there is an opening in the tooth enamel, bacteria get into the pulp, the soft tissue inside the root of the tooth. The pulp becomes infected and swollen, and pus begins to build up. This pus pocket is called an abscess.

“Many patients wait too long to seek treatment for problems like severe tooth decay, cracked or broken teeth, or periodontal issues,” said Sam McKenna, D.D.S., M.D., professor of oral and maxillofacial surgery at Vanderbilt University Medical Center. “If these conditions are not addressed, infection may spread to the bone and soft tissues adjacent to the jaw and neck. In severe cases, surgery may be required to drain the face and neck.”

You should seek prompt medical attention if you have any of these symptoms:

  • Increasing pain in the tooth and jaw;
  • Bitter taste in your mouth;
  • Foul-smelling breath;
  • Swelling of the gum over the infected tooth;
  • Swelling of the face, neck, throat;
  • Fever;
  • Difficulty opening your mouth, swallowing, breathing.

They are red flags that you may have a serious infection.


How is an abscessed tooth treated?

If you have a tooth abscess, your dentist may take X-rays or do a CT scan of your face, jaw and neck to determine the extent of infection. An abscessed tooth can be treated in several ways, depending on the severity of the infection. Some of these include:

  • Antibiotics to destroy the bacteria causing the infection until the tooth can be treated;
  • Cleaning the space between the tooth and the gum (if the cause is gum infection);
  • Root canal treatment (if the abscess is caused by an infection of the tooth pulp);
  • Tooth removal if the tooth cannot be saved.

If root canal therapy is necessary, more than likely your dentist will refer you to an endodontist, a dentist who specializes in saving teeth. The endodontist will clean the bacteria from the inside of your tooth, fill the root canals and seal the area. You will then return to your dentist, who will place a crown or other type of covering on the tooth to protect it and restore it to full function.


Getting routine dental exams and following good oral hygiene practices will significantly reduce your risk of developing a tooth abscess. If you suspect you have an abscess or your teeth become loosened, cracked or chipped, see your dentist as soon as possible.