What Does it Mean that I Have an Abscessed Tooth?

By Premier Dental of Ohio

A tooth absess can be painful

What is an Abscessed Tooth?

An abscessed tooth is a particular type of dental infection that involves the buildup of pus around a tooth. The abscess can develop around the tip of the tooth’s root or in the gums around the tooth. The pus may build up under the gums, causing a noticeable swelling.  

Sometimes, the abscess will create a small hole in the gums, called a fistula, that allows the pus to drain out.  In these cases, the area will probably not swell. There may be redness or irritation at the site of drainage.

What Causes Abscessed Teeth?

The cause of a dental abscess is always a dental infection, and there are several things that can lead to these infections.  In all cases, the infection spreads from its site of origin into the gums surrounding the teeth.  This spread is what makes abscesses so dangerous.

A Large Cavity

Cavities are bacterial infections of the hard structure of a tooth.  Bacteria begins to break through enamel and penetrate into the tooth as it eats sugar and produces enamel-softening acid.  As a cavity progresses, the bacteria and ensuing decay work toward the center of a tooth, where the hollow chamber contains nerves and blood vessels.  

If the bacteria reaches the internal chamber of the tooth, this soft tissue (called the pulp) also becomes infected.  From here, the bacteria will spread into the surrounding bone and gums through the tiny pore at the tip of each root.  

Severe Gum Disease

Unlike a cavity, which involves an infection starting inside the tooth, gum disease involves an infection starting around the tooth or teeth.  Bacteria lives in dental plaque and tartar buildup.  Plaque is the soft stuff that is simple to remove with toothbrush and floss, and tartar is the hard material that requires dental intervention for removal.  The bacteria within these types of buildup lead to a destructive inflammatory response that breaks down the bone, ligaments and gum tissue surrounding the teeth.  We call these periodontal abscesses.  

Often, in abscesses developing around the tooth, the pus can simply drain through the gum pocket, and no swelling occurs.

Trauma to a Tooth

When a tooth suffers a blunt force from an injury, the nerve and blood vessels often die.  This dead tissue, called necrotic, easily becomes infected.  Like in the case of a large cavity, the bacteria will spread from inside the tooth to outside through the opening in the tip of the root.

When our body detects this infectious material in the jawbone, it responds by sending a defensive response, which results in pus.

What are the Symptoms or an Abscessed Tooth?

The most important thing to know is that a tooth abscess does not always hurt!

When an abscess drains through a fistula, there is no buildup of pressure and often no pain at all.  This does not eliminate the danger of an abscessed tooth.  If you notice any of these symptoms, you should get in to see a dentist as soon as possible for an evaluation and x-ray of the tooth.  You can prevent any of the dangerous outcomes of an abscessed tooth by intervening early.  

Watch for these signs or symptoms in your mouth.

  • Any visible pus in your mouth, either from the area where gum meets tooth or from a “hole” in the gums
  • A swelling in the gums near the root of a tooth
  • A swelling that is visible from outside the mouth (when viewing your face in the mirror)
  • A tooth that seems to be slightly loose or moving in its socket
  • A tooth that hurts when you tap on the side of it

You may experience one or more of these symptoms.  Again, pain is not the best indicator of an abscess.  Swelling and pus drainage are much more important.

What Should I Do If I Think I Have an Abscessed Tooth?

If you believe that you or a loved one has an abscessed tooth, you should follow these guidelines to address it.

When to See Your Dentist

In most cases, as soon as you notice an abscessed, you need to see your dentist as soon as possible.  If you see your dentist regularly, he or she may be able to consult with you over the phone and call in a prescription for antibiotics.  This is only likely if you’ve had a recent evaluation of your mouth.  If this is not possible, your dentist will need to see you in person for an evaluation of the area including a dental x-ray to make an accurate diagnosis of the situation and prescribe both the proper medications and necessary treatment.

When to Go to the ER

If your tooth abscess causes visible swelling outside the mouth, either in the face or neck, you should go to the emergency room.  This enlarging swelling tells us that the infection has already spread, and we can assume it will continue to do so.  Because, in rare cases, these infections can spread into the airway, bloodstream or brain, emergency intervention is necessary.  We want you to go to the emergency room in these cases so that you can get a high dosage of intravenous (IV) antibiotics to quickly halt the infection.

What to Do At Home

While you are waiting to see your dentist, you can begin a few important do’s and don’ts to manage your situation at home.


  • Keep your mouth as clean as possible.  Do not neglect brushing and flossing your other teeth.
  • Rinse your mouth vigorously with warm salt water for one to two minutes up to five times per day.  Salt water will fight infection and reduce inflammation.
  • Maintain a balanced diet and exercise to support a healthy immune system.  Avoid sugar, alcohol and caffeine.
  • Take over-the-counter pain relievers, like Advil or Tylenol, as directed on the packaging to manage your pain.


  • Do NOT take medications prescribed to anyone else.
  • Do NOT hold an aspirin or other chemical inside your mouth against the abscess.
  • Do NOT attempt to “pop” an abscess inside your mouth.  This will introduce even more bacteria and worsen the inflammation present at the site.
  • Do NOT delay in seeing the dentist and risk further spread of the infection.

More Questions about Abscessed Teeth?

Call your nearest Premier Dental of Ohio location to schedule a visit with one of our compassionate dentists.  We offer emergency services to care for our patients experiencing dental abscesses.

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