Abscessed Tooth: Cause, Signs and Symptoms, Complications, Treatment, and Prevention

An abscessed tooth goes by many names- tooth abscess, periapical abscess, dental abscess and tooth infection. However, the pain, danger, and expense is equivalent…no matter what you call it. An abscessed tooth is essentially just an often very painful infection that occurs at the tip of the tooth root, between the gums, and the tooth itself.


The infection is mainly caused by tooth decay, but can also occur from trauma or excessive pressure from gum disease. The tooth is made of layers. The center, or dental pulp, is the only part of the tooth that is sensitive to pain; so, it is the most well protected part of tooth. However, if a tooth cracks or develops a deep cavity, the pulp of the tooth can be exposed to bacteria. As the infection progresses, the pulp dies, pockets of pus may form, and left untreated…the infection may spread to alveolar bone, neighboring teeth, and other tissue. 


Symptoms vary per person and degree of infection. Often the tooth and surrounding gum area is very painful and swollen. At other times, the person may have a little tooth sensitivity or no pain at all.  The general symptoms are:

  • Tooth pain/ toothache
  • Pain when chewing
  • Pain when drinking hot or cold fluids
  • Bad breath odor
  • Bitter taste in the mouth
  • Fever
  • Flu like symptoms
  • Swollen glands
  • Swelling in jaw
  • An open/draining sore on the gums
  • Redness around the gums
  • Pain opening and closing the mouth

It is also important to note that if the infection goes on untreated, the root of the tooth may die, and the tooth pain may stop. This does not mean that the infection has stopped, though.

Complications and Dangers:

An untreated abscessed tooth can be very serious, dangerous, and even life threatening. Left untreated, the infection in the tooth can spread to the sinuses, jaw, throat, heart, brain, etc.. It can compromise the immune system, result in loss of tooth, disfiguring jaw bone damage, neighboring tooth damage and/or loss, heart damage (endocarditis) , brain abscess, sepsis, etc… At worst, the infection may become life -threatening, causing coma, extended hospitalization, and even death.


Mediastinitis and Ludwig’s angina are rare complications of tooth abscesses, but have very high mortality rates. Mediastinitis occurs when the inflammation from the infected tooth spreads to the mediastinum. The mediastinum area includes your heart, major blood vessels, esophagus, larynx (windpipe), etc.. Ludwig’s angina is  when the infection spreads to the soft tissues around the floor of the mouth. The cellulitis and  infection compromises the airway, and makes breathing and swallowing difficult.

Treatment of Tooth Abscess:

This is the part that no one wants to talk about, but it is so important to avoid the complications listed above with routine dental exams and early intervention at the first sign of a problem.

The primary treatment goal with an abscess is to eliminate and stop the spread of infection and preserve or repair the tooth. To remove the infection, the infected pulp tissue, bacteria, and debris are removed (root canal.) The tooth is then left open to allow pus to drain. In severe infections, the tooth may have to be removed. The pus will then drain directly from the socket or from an incision into the swollen gum tissue. Antibiotics before and after dental work are also used to fight the infection. You don’t want to wait and end up with this-


Prevention of Tooth Abscess:

Unless you are sadist, the above most likely does not sound like an appealing experience. Prevention can save you a lot of pain and money.

  • Good oral hygiene program
  • Develop a specialized dental plan with your dentist if you have certain diseases, like diabetes, that increase the risk of dental problems.
  • Brush and floss teeth regularly
  • Antiseptic mouthwash
  • Low sugar diet
  • Regular dental checkups
  • Prompt treatment tooth injury and trauma
  • Prompt treatment of dental caries 
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  1. Very useful article. In my country, dental checkup is least prioritized due to financial scarcity. It doesn’t really take much to care for one’s teeth.I’m proud to say I still have good teeth at my age.

  2. Very informative article. I was not aware of abscessed tooth. Thnx for the excellent share.

  3. wow………..great piece……….worth bookmarking……

  4. Always had trouble with my teeth. I agree regular check ups are important. Good article.

  5. omg that was almost painful to read about

  6. Excellent article. It really explained the problem. I was always under the impression that a person is born with this.

  7. Very informative article! great work

  8. Excellent article and graphic pictures which are painful to look at.

  9. dude this is happening to me right now!!! my entire face is swolllen, and its hard to breathe/ swallow, it feels like theres puss all through my jaw and it hurts HELLA bad. after reading this and seeing it could spread to my heart and brain ima go to another doctor cause the last one LITERALLY just gave me vicodin and antibiotics. He asked more about my casted arm then my now ‘life threatening’ situation. im pissed. this is why Americas’ health system needs to change

  10. I have an abscess right now. My dentist has got to remove the tooth, but can’t do it before the antibiotics have done their work, and that’s not for another 5 days! I’ve taken a dozen painkillers in 24 hours – including 2 morphine pills. And yet, the pain just gets worse and worse and worse and … I feel as though half my face has been shot off. NEVER let a cavity get away from you. If you think the dentist chair is scary, think again.

  11. i know the feeling. i work and can barely afford health insurance let alone dental, so i have no dental coverage. And with very little money i can not afford to take care of the problems i have with my teeth. whatever happened to charity care? I am in dire need of full dentures, but without 1000’s of dollars no one will help you. Go figure.

  12. I am now suffering from a second abscess – the result of a severely dry mouth. I called my dentist early to avoid complications. the last one spread into my cheek and my salivary glands-which are already non-functioning. The abscess began when bacteria entered a crack in my tooth that I didn’t know was there. I had to have it pulled.

    I just want to mention something. I’ve read on other websites where people didn’t go to the dentist because they didn’t have the money. If that’s the case, get any doctor to write a script. Penecillin is very inexpensvie, and, at some places like Walmart, it’s probably free, or may $1.00. Don’t fool around. You can die from the poison that in the abscess.

  13. An abscessed tooth is very painful as you can imagine from the photos. Proper care of your teeth and checkups with the dentist can help prevent or treat these before they become worse.

  14. I have a friend that had this. He didn’t have dental insurance or money to pay for treatment. He has been turned away from dental clinic after dental clinic. He ended up in the ER and the most they could do is give a nerve block and some pain pills, with Penicillin. The problem is that he doesn;t qualify for any aid through the State of MN and is unemployed. I feel bad for him because he has been to the so called free dental clinics in MPLS & ST. Paul and it is too extensive for the free clinics to handle. They won’t even pull the tooth because of the decay that will be left behind. It is considered a hi risk extraction. And again he can’t find help. He had to let his insurance go in order to keep the house. Hard to believe this is MN. I guess he nned to keep the insurance and not the house and let the gov. put him on welfare and pay his rent and insurance, Too bad

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