A tooth abscess is a pocket of pus that forms at the root of a tooth or between the gum and tooth, and while it can be extremely painful, what many people do not realise is that each stage of a dental abscess can be more serious than the last. Without prompt treatment, the infection can destroy the jawbone and the soft tissues that support your teeth and in more serious cases, spread to other areas of the body.
In this guide, our dentist in Kent will walk you through every stage of a dental abscess, explain what is happening inside your tooth and gums at each point, and tell you exactly what you should do before the condition progresses further.
What Is a Dental Abscess?
A dental abscess is a collection of pus that accumulates as a result of a bacterial infection. Once bacteria reach the inner pulp of the tooth, they can spread to the tooth roots, leading to painful abscesses and inflammation in the surrounding tissue.
Pus is a thick fluid composed of dead tissue, cells, and bacteria. It is the body’s natural response to fighting off infection, however, unlike many infections that the body can resolve on its own, a dental abscess requires professional treatment. Without it, the infection will continue to progress, causing further damage to the tooth.
The most common causes for dental abscesses include:
- Untreated tooth decay or cavities that allow bacteria to penetrate deeper layers of the tooth
- Cracked, chipped or broken teeth that create an entry point for bacteria
- Advanced gum disease that creates infected pockets around the roots
- Previous dental trauma that damages the inner tooth pulp over time
Types of Tooth Abscess
The dental abscess can be classified on the basis of the location they are formed, this includes:
Periapical Abscess A periapical abscess forms at the tip of the tooth’s root. It develops when decay reaches and exposes the inner tooth pulp, either through a deep cavity or a crack in the tooth, allowing bacteria to infect the pulp and spread down to the root.
Periodontal Abscess A periodontal abscess develops in the gum tissue alongside the root of the tooth. It occurs when bacteria infect the gums and the bone that supports the teeth. When a gum pocket becomes too deep, bacteria can become trapped within it, leading to the formation of an abscess.
Gingival Abscess A gingival abscess appears on the surface of the gum tissue, often resembling a small, visible pimple. Of the three types, it is generally the easiest to treat, particularly when identified and addressed in its early stages.
Stages of a Dental Abscess
Stage 1: Initial Inflammation
This is the stage at which the initial infection begins inside the tooth pulp. It can be triggered by a number of factors, including untreated cavities, dental decay, poor oral health, or trauma to the tooth. At this early stage, symptoms are relatively mild, you may notice some discomfort or increased sensitivity when consuming hot or cold food and drinks. While the signs may seem minor, this is the most important stage to act upon, as prompt treatment can prevent the infection from progressing further.
Stage 2: Pulpal Necrosis
If the initial inflammation is left untreated, the infection advances to the point where the tooth’s internal life support system begins to die. The innermost layer of the tooth containing the nerve tissue and blood vessels becomes necrotic, meaning it is no longer alive. During this stage, the pain may temporarily subside, as the nerve fibres inside the tooth have died. However, this is not a sign of recovery. The infection remains active and, if still left unaddressed, will continue to spread to the surrounding tissues.
Stage 3: Abscess Formation
As the bacteria continues to multiply, a pocket of pus forms at the root of the tooth. The pressure created by this pus buildup is responsible for the severe and often unbearable pain associated with this stage. By this point, the infection is actively affecting the surrounding bone and tissue. You may notice significant pain around the affected tooth, along with redness and swelling of the gums. Some patients also experience a fever at this stage, which is a sign that the body is working hard to fight the spreading infection.
Stage 4: Spreading Infection
This is the most serious stage of a dental abscess and, in some cases, a life-threatening one. If the abscess remains untreated, the bacterial infection can rupture and spread well beyond the tooth and jaw. Extensive decay or gum damage at this stage can result in permanent tooth loss. More critically, the infection can affect other parts of the body potentially causing osteomyelitis, a severe infection of the bone, or entering the bloodstream and leading to sepsis, a dangerous whole-body response to infection that requires immediate medical attention.
Recognising the Warning Signs of a Dental Abscess
Regardless of which stage you may be at, certain symptoms should always prompt you to pick up the phone and call your dentist without delay:
- A toothache that persists for more than 24–48 hours and does not ease with over-the-counter pain relief
- Swelling in the face, cheek, jaw, or neck
- A visible bump or blister on the gum that is painful or leaking fluid
- Persistent bad breath or a foul taste in the mouth that does not go away
- Fever accompanied by tooth or jaw pain
- Difficulty chewing, swallowing, or opening your mouth
- Swollen or tender lymph nodes beneath the jaw
What Are the Tooth Abscess Treatment Options?
Abscess Drainage
Abscess drainage often provides patients with immediate relief. Your dentist will make a small incision into the abscess, allowing the accumulated pus to drain out before thoroughly cleaning and flushing the area with saline solution to remove any remaining bacteria.
It is important to never attempt to pop an abscess at home, whether with a needle or by applying pressure with your fingers. Doing so risks pushing the infection deeper into the jawbone or bloodstream. Only a dentist can ensure the infection is fully and safely evacuated.
Root Canal Treatment
Root canal treatment is one of the most effective ways to eliminate the infection and save your natural tooth. Your dentist will remove the infected pulp from inside the tooth, thoroughly clean the space, and fill it with a specialised material to prevent reinfection. A crown is then placed over the tooth to restore its strength and function. With the right care and good oral hygiene, a tooth treated with root canal therapy can last a lifetime.
Antibiotic Therapy
Where the infection has spread beyond the tooth and into the surrounding tissue, your dentist will prescribe a course of antibiotics. These work by directly targeting the bacteria throughout the infected area, helping to reduce and manage the infection effectively. However, antibiotics are not a standalone treatment for a dental abscess. They are therefore always used alongside other treatments.
Surgical Extraction
When a tooth has been too severely damaged by infection to be saved, surgical extraction becomes necessary. This is always considered a last resort and is only recommended when root canal treatment is no longer a viable option. The procedure is carried out under sedation to ensure your comfort throughout. Your dentist will carefully loosen and remove the affected tooth, and the site will be thoroughly cleaned to ensure no infected tissue remains.
Get the Treatment You Need Today
A dental abscess will not resolve on its own. Every day without treatment is a day the infection has to spread further, cause more damage, and make eventual treatment more complex. Whether you are experiencing early sensitivity or are already in significant pain, the team at Warwick Lodge Dental is here to help.
Call us today on 01227 375 592 or contact us via our website at warwicklodgedental.co.uk to book an emergency appointment.
We are located at 44 Canterbury Road, Herne Bay, CT6 5DF, and we welcome patients from across Kent. You do not have to put up with dental pain and you do not have to face it alone.