A tooth abscess is a collection of pus caused by a bacterial infection inside or around a tooth. It can develop when bacteria enter the tooth through decay, a crack, an injury or advanced gum disease. Although a dental abscess can sometimes cause severe pain, the infection does not usually disappear without proper dental treatment.
In the UK, prompt assessment by a dentist is important because an untreated abscess can spread into surrounding tissues and, in rare cases, cause a serious infection. Knowing the symptoms, causes and treatment options can help you seek the right care at the right time.
What Is a Tooth Abscess?
A tooth abscess is a localised bacterial infection that produces pus. It can occur in different parts of the tooth or surrounding tissues.
The two main types are:
Periapical abscess: develops at the tip of the tooth root, usually because bacteria have reached the dental pulp through tooth decay, cracks or trauma.
Periodontal abscess: develops in the gum or tissues supporting the tooth and is often associated with gum disease or an infection around the tooth.
A dental abscess may cause swelling, throbbing toothache, tenderness, sensitivity to hot or cold, a bad taste in the mouth or difficulty chewing. Some people may have an abscess with relatively little pain, particularly when the infection has drained.
What Causes a Tooth Abscess?
The most common cause is a bacterial infection. Bacteria can reach the inner part of a tooth when its protective layers have been damaged.
Common causes include:
1. Untreated tooth decay
Dental decay can gradually penetrate through the enamel and dentine until it reaches the pulp, where the tooth's nerves and blood vessels are located. Once bacteria enter this area, inflammation and infection can develop.
2. Cracked or damaged teeth
A crack can provide a pathway for bacteria to enter deeper parts of the tooth. Even a small fracture can eventually lead to pulp infection and an abscess.
3. Gum disease
Periodontitis can create deep pockets between the teeth and gums. Bacteria and debris may become trapped in these pockets, increasing the risk of a periodontal abscess.
4. Dental trauma
An injury may damage the blood supply or nerve inside a tooth. The pulp can subsequently become infected, sometimes weeks or months after the original injury.
5. Previous dental treatment
A tooth that has previously received treatment can occasionally become infected again. This may happen if bacteria remain inside the root canal system or enter the tooth through leakage, decay or a new crack.
Tooth Abscess Symptoms
Symptoms vary depending on the location and severity of the infection.
Possible signs include:
Severe or persistent toothache
Throbbing pain
Pain that spreads towards the jaw, ear or neck
Swollen or tender gums
A pimple or boil on the gum
Facial or jaw swelling
Pain when biting or chewing
Sensitivity to hot or cold foods
A bad taste or foul-smelling fluid in the mouth
Loose or discoloured teeth
Fever or feeling generally unwell
Swollen glands in the neck
A particularly important sign is swelling around the face or jaw. This can indicate that the infection is spreading beyond the immediate area of the tooth.
If an abscess bursts and releases pus, the pain may temporarily improve. This does not mean the infection has been cured. The source of the infection still needs dental treatment.
Can a Tooth Abscess Go Away on Its Own?
Usually, no.
An abscess may drain naturally or temporarily become less painful, but the underlying source of infection can remain inside the tooth or surrounding tissues. Without treatment, the infection may return or spread.
Pain relief can make the symptoms more manageable, but painkillers do not remove the cause of a dental abscess.
This is why you should arrange a dental examination even if the pain suddenly improves.
How Is a Tooth Abscess Diagnosed?
A dentist will usually examine the affected tooth, gums and surrounding tissues. They may ask about your symptoms, when the pain started and whether you have experienced swelling, fever or difficulty eating.
An X-ray may be recommended to identify infection around the tooth root, bone loss or other problems that cannot be seen during a normal examination.
The dentist will then determine whether the tooth can be saved and which treatment is most appropriate.
Tooth Abscess Treatment in the UK
Treatment depends on where the infection is located, how severely the tooth is damaged and whether the tooth can be restored.
Root canal treatment
If the infection has reached the pulp but the tooth can be saved, root canal treatment may be recommended.
During root canal treatment, the dentist removes infected or damaged pulp from inside the tooth, cleans and disinfects the root canals, then seals them. A filling or crown may subsequently be required to protect the weakened tooth.
This treatment aims to remove the source of infection while preserving the natural tooth.
Tooth extraction
If a tooth is severely damaged, fractured or cannot be predictably restored, extraction may be necessary.
Removing the infected tooth eliminates the source of infection. Your dentist can discuss replacement options if the missing tooth affects function or appearance.
Drainage of the abscess
A dentist may drain pus from an abscess when appropriate. Drainage can reduce pressure and swelling, but it is generally only part of the overall treatment. The underlying dental problem still needs to be addressed.
Antibiotics
Antibiotics are not routinely required for every tooth abscess. Dental treatment to remove the source of infection is usually the priority.
A dentist or other healthcare professional may prescribe antibiotics when there are signs that the infection is spreading or when there are systemic symptoms such as fever or significant swelling. Antibiotics should only be taken when prescribed and should not be used as a substitute for dental treatment.
When Is a Tooth Abscess a Dental Emergency?
A suspected dental abscess should be assessed promptly, particularly when there is significant pain or swelling.
Seek urgent dental care if you have:
Rapidly increasing facial or jaw swelling
Severe toothache that is not settling
Fever or feeling significantly unwell
Difficulty opening your mouth
Swelling around the eye
Difficulty swallowing
Difficulty breathing
A large amount of swelling in the mouth or face
Difficulty breathing or swallowing, severe facial swelling, or swelling affecting the eye or neck can be a medical emergency. In these circumstances, seek emergency medical help immediately rather than waiting for a routine dental appointment.
In England, if you need urgent dental advice outside normal surgery hours, you can contact NHS 111. Your local urgent dental service or NHS 111 can advise you on the appropriate next step.
What Can You Do Until You See a Dentist?
While waiting for professional dental care, you can take reasonable steps to manage discomfort.
You can:
Take suitable over-the-counter pain relief according to the instructions on the packaging
Eat softer foods and avoid chewing on the affected side
Avoid very hot or very cold foods if they trigger pain
Brush your teeth gently with a fluoride toothpaste
Keep the area clean
Drink water regularly
Do not place aspirin directly against the tooth or gum, as this can irritate or burn the soft tissues.
Do not attempt to puncture, squeeze or drain an abscess yourself. This can cause additional tissue damage and does not remove the underlying infection.
How Can You Prevent a Tooth Abscess?
Good oral hygiene and regular dental care can significantly reduce the risk.
Important preventive measures include:
Brush twice a day with fluoride toothpaste.
Clean between your teeth regularly using floss or interdental brushes.
Reduce frequent consumption of sugary foods and drinks.
Attend regular dental examinations.
Treat tooth decay before it becomes advanced.
Have damaged or cracked teeth assessed promptly.
Seek advice about persistent gum bleeding, swelling or bad breath.
Wear appropriate protection during contact sports if recommended.
Preventing tooth decay and gum disease is particularly important because both conditions can provide a route for bacteria to reach deeper dental tissues.
Frequently Asked Questions About Tooth Abscesses
How long does a tooth abscess last?
A tooth abscess can persist until the source of infection is treated. Symptoms may temporarily improve if the abscess drains, but this does not necessarily mean the infection has gone.
Can a tooth abscess make you ill?
Yes. A dental infection can sometimes cause fever, swollen glands and general illness. If infection spreads into surrounding tissues, it can become serious and requires urgent professional assessment.
Can I treat a tooth abscess without a dentist?
Home measures can help control symptoms temporarily, but they cannot reliably eliminate the source of a dental abscess. Dental treatment is normally required.
Will antibiotics cure a tooth abscess?
Antibiotics can help control certain spreading dental infections, but they do not replace treatment of the infected tooth. Depending on the situation, root canal treatment, drainage or extraction may be necessary.
Can a tooth abscess burst?
Yes. An abscess can sometimes drain into the mouth, producing a sudden bad taste or release of pus. Even if this reduces the pain, you should still see a dentist because the infection may remain.
Is a tooth abscess always painful?
No. An abscess can sometimes cause little or no pain, particularly if it has drained. Swelling, a gum boil, bad taste or changes around a tooth can still indicate an infection.
Can a tooth abscess spread to the jaw?
Yes. An untreated dental infection can spread into the surrounding jaw and facial tissues. More serious infections can extend into deeper spaces of the head and neck.
Should I go to A&E for a tooth abscess?
A&E is not normally the first place for routine dental treatment. However, severe facial or neck swelling, difficulty breathing or swallowing, or other signs of a potentially life-threatening spreading infection require emergency medical attention.
Conclusion
A **tooth abscess **is a bacterial infection that requires proper dental assessment. It commonly develops from untreated tooth decay, a cracked or damaged tooth, gum disease or infection within a previously treated tooth.
Although painkillers and home care can provide temporary relief, they do not remove the underlying infection. Depending on the condition of the tooth, treatment may involve drainage, root canal treatment or extraction, while antibiotics may be appropriate when infection is spreading or causing systemic symptoms.
The most important step is not to ignore persistent tooth pain or swelling. Early dental treatment can control the infection, relieve symptoms and, where possible, help preserve the natural tooth.
