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Key takeaways
Dental abscesses can be caused by a variety of reasons.
If you feel you have a dental abscess, seek treatment from a medical or dental provider before the problem becomes serious.
Dental abscesses can usually be treated with antibiotics but surgical intervention.
Once the infection is under control, it is important to find the cause of the infection so that can be addressed so that the abscess does not reoccur.
Home remedies may be effective in minimizing the pain associated with a dental abscess but it is still important to see a medical or dental professional for a diagnosis and treatment plan.
When a tooth decides to be a problem, it can be a real pain. Coming on suddenly and with little warning, a dental abscess can seriously interfere with daily life. Pain medication and some home remedies might calm the pain, but it will take a visit to the dentist to fix the problem. Fortunately, taking care of a tooth abscess is a routine, everyday procedure for dentists and endodontists. Most people will leave their first visit well on the way to recovery.
What is a dental abscess?
A dental abscess is a swelling filled with pus in or around a tooth that is caused by a bacterial infection. There are various types of abscesses.- Tooth infection: The infection and swelling can begin inside a tooth.
- Periapical abscess: The infection spreads to the tissue below the tooth.
- Periodontal abscess: The infection builds up in a tooth's surrounding tissues.
- Pericoronal abscess: The infection builds up in the gum tissues covering a tooth that hasn't fully emerged.
- Gingival abscess (gum abscess): The infection spreads to the gums themselves.
A tooth abscess can range from a minor infection to a severe and even life-threatening infection that has spread to other parts of the face or body. While most tooth abscess treatments are outpatient, some end up in an emergency room. More than half of dental-related emergency room visits are due to dental abscesses. The most severe infections may require hospitalization.
The most common type of tooth abscess is a periapical abscess. The infection begins when a cavity or crack in the tooth reaches the pulp cavity. Bacteria on the surface of the tooth infect the soft tissue inside the tooth, called the pulp, consisting of blood vessels and nerves. The immune system kicks in, and the infected area swells up. The pressure against the inner tooth causes a toothache.
At this stage, the infection is not an abscess. The infection will gradually make its way through the root canal, eventually killing the tissue and emerging from the bottom, or apex, of the tooth. From there, it infects the bone and tissue at the apex of the root, causing a periapical abscess.
Once the infection has colonized the bone and tissues around the bottom of a tooth, it can spread to the jaw bone, the midface, the sinuses, or the neck and become a much more serious, health-threatening condition. It's crucial to stop these infections early.
How is a dental abscess diagnosed?
Most dental abscesses are due to tooth decay. Many of the risk factors for tooth decay, or dental caries, are also the risk factors for dental abscesses:- Poor oral health or hygiene
- Lack of dental care follow-up
- An unrepaired cracked tooth
- Immune suppression
- Dry mouth
- Teeth grinding
- Methamphetamine abuse
The pain—sometimes severe pain—caused by abscessed teeth motivates people to seek help. The dentist will do a physical examination of the affected tooth. The tooth or tissues will be painful and sensitive to touch. The dentist will also look for swelling, redness, fever, and other symptoms such as facial redness, lockjaw, swollen lymph nodes, and difficulty swallowing. If there is trouble breathing or any mental changes, the infection may be a medical emergency.
The initial visit will usually include a periapical X-ray of the tooth to confirm the diagnosis. In particular, an X-ray can help differentiate a tooth abscess from other conditions, such as periodontitis. Depending on the symptoms, the dentist might also X-ray the head and neck to ensure the infection has not spread. No other tests are necessary.
If the infection is more complicated or the patient has a fever and other symptoms, the abscess will require antibiotics. The dentist or healthcare professional will prescribe antibiotics. In a rare occasion that a patient does not respond to the antibiotic, the doctor may perform a blood test to determine the nature of the infection and the body's response to it. They might also order a CT or MRI scan.
RELATED: What your saliva says about your health
Dental abscess treatment options
Most dental abscesses will be treated immediately after diagnosis. An uncomplicated abscess will usually only require drainage to provide relief from the pain. Complicated abscesses may require more complex procedures and medications to control the underlying infection. If the infection spreads to the sinuses or neck, a surgeon may need to treat the condition.Incision and drainage
Except for infections within the tooth, most abscesses are treatable by incising the swollen area, draining the pus, and rinsing the area with a saline solution. This procedure will usually provide immediate symptom relief. Over-the-counter pain relievers can manage the pain while the body fights the infection. Antibiotics are often prescribed in tooth infection treatment. After the incision and drainage, the patient will need to still address the underlying cause of the infection.Root canal
For patients with an infected tooth, a dentist or endodontist will perform a root canal treatment. In this procedure, the practitioner makes an access in the crown of the tooth, removes dead tissue and bacteria from inside of the tooth, cleans and fills the root canals, and restores the tooth with a restoration. A root canal can save the tooth while eliminating the infection. There will be follow-up dental checkups where the dentist uses X-rays to ensure the infection is gone. The procedure successfully clears the tooth infection and abscess 86%–98% of the time.Medications
For more severe infections, the dentist will prescribe antibiotics to control the underlying bacterial infection in addition to drainage or a root canal. Prescription pain relievers can help manage the pain.Tooth extraction
If the tooth infection is severe or not treatable with antibiotics or a root canal or the tooth is unrestorable, the dentist may remove the affected tooth to prevent the risk of more serious infection.Dental abscess medications
Antibiotics for tooth infections
Antibiotics are used sparingly for dental abscesses because of the risk of generating drug-resistant bacteria. They will usually be used for abscesses with complications or if the patient has a fever or trouble breathing. Mostly, however, it will depend on the dentist or endodontist. The antibiotic prescribed will depend on the type of bacteria causing the infection. Amoxicillin is the most popular antibiotic for tooth infections. It's often used with clavulanic acid to increase its effectiveness against bacteria. However, patients are just as likely to be prescribed penicillin, clindamycin, or azithromycin. Relief from pain and swelling will be noticeable in a day or two, but it takes three to seven days to treat the infection completely.Pain relief medications
Over-the-counter NSAIDs, such as ibuprofen, naproxen, or aspirin, are often enough to provide substantial pain relief. Unlike opioids, NSAIDs reduce the swelling that causes the pain. Prescription NSAIDs can treat more severe pain. Opioids are only very rarely used, usually after operative procedures for dental abscesses.What is the best medication for a dental abscess?
Drug treatment for dental abscess focuses on eliminating the infection or relieving pain. Antibiotics for tooth infections are tailored to the type of bacteria causing the infection. Over-the-counter or prescription NSAIDs can adequately manage pain both before and after treatment.Best medications for dental abscess
| Drug name | Learn more | See SingleCare price |
|---|---|---|
| Amoxicillin-Pot Clavulanate | amoxicillin-pot-clavulanate details | Get free coupon |
| Augmentin | augmentin details | Get free coupon |
| Zithromax | zithromax details | Get free coupon |
| Azithromycin | azithromycin details | Get free coupon |
| Ibuprofen | ibuprofen details | Get free coupon |
| Motrin Ib | motrin-ib details | Get free coupon |
Many of the standard dosages above are from the U.S. Food and Drug Administration (FDA). Dosage is determined by your healthcare provider based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.
What are the common side effects of medicine for a dental abscess?
Different classes of medications have different side effects. However, this is not a complete list, and you should consult with a healthcare professional for possible side effects and drug interactions based on your specific situation.Oral antibiotics typically can cause upset stomach, intestinal problems, and loss of appetite. Allergic reactions are a concern. Allergies to various types of antibiotics are common and could be severe. About 1 in 15 people are allergic to antibiotics.
NSAIDs are the pain relief medication of choice for dental abscesses. They are widely available, inexpensive, and safe. The major possible issues with NSAIDs are gastrointestinal side effects including stomach problems, ulcers, gastrointestinal bleeding, and stomach pain. NSAIDs are known to cause kidney failure and can precipitate heart disease in elderly patients. All NSAIDs interfere with the blood’s ability to form blood clots, so bleeding and bruising are common problems.
What is the best tooth abscess home remedy?
When a tooth or surrounding tissue gets infected and swollen, the only sure way to fix the problem is to visit a dentist. Some home remedies can temporarily relieve the symptoms, but they can’t make the problem go away. Here are a few of the most successful ways to live with a tooth abscess until a dentist’s appointment.1. Take over-the-counter pain relievers
Most people experience dramatic and even total pain relief from toothache and dental abscesses using over-the-counter NSAIDs. These drugs not only reduce pain, they also reduce the swelling that causes the pain. Be careful, though. They only treat the symptoms. While they may make a person feel better, the infection will still rage on within the tooth or surrounding tissues.2. Apply anesthetics
Many people instinctively reach for brand-name or natural anesthetics. Benzocaine, cloves, peppermint tea, menthol—these all can numb or distract from the pain. Results can be mixed, however, as some people experience significant relief while others don’t. And remember, calming the pain does nothing to clear the infection. Topical medications, such as benzocaine, should be avoided. NSAIDs work better and benzocaine can have serious and even life-threatening side effects.3. Target the bacteria
Many substances have antibacterial properties, such as cloves, garlic, and fenugreek. Others, such as baking soda, neutralize the acids produced by bacteria on the surface of the teeth. Hydrogen peroxide in toothpaste has a limited effect on bacteria. All of these are good ideas for good oral hygiene and may provide some benefit for small abscesses on the tissue surfaces of the mouth. They will probably have no effect on a bacterial infection within a tooth or tissues below a tooth.4. Rinse with salt water
Using warm salt water as a mouthwash can both provide temporary relief from pain and rinse irritants out of the infected area.5. Use a cold compress
A cold compress applied to the face right near the abscess is an effective, natural remedy to calm the pain. The cold deadens the nerves that transmit pain signals and helps to reduce the swelling.Frequently asked questions about dental abscess and tooth infections
Can a tooth abscess go away on its own?
A tooth abscess is a specific type of dental abscess called a periapical abscess. It starts as an infection inside the tooth and moves into the area below the tooth. It will not go away on its own. If the abscess ruptures, you’ll feel immediate pain relief, but you should still seek dental treatment for the underlying infection.Can an abscess go away without draining it?
Draining an abscess will significantly reduce some of the symptoms and could bring the infection under control. If an abscess is not drained, it carries a risk of spreading to other tissues and causing a serious and even life-threatening condition. An abscess can go away without draining after a course of treatment with antibiotics.Will a tooth abscess go away with antibiotics?
Antibiotics are often used to treat dental abscesses, but they are used sparingly to avoid the risk of creating drug-resistant bacteria. An abscessed tooth will be treated with an operative procedure, and antibiotics may or may not be used. If the abscess develops into a draining fistula, antibiotics may not be necessary.How long does a tooth abscess last?
Antibiotics will often show dramatic improvement to a tooth abscess within a day, but they typically take three to seven days to clear the infection. It is important to take antibiotic medications for the full prescribed term. If you do not, the infection could return quickly.RELATED: What happens if you don’t finish antibiotics?