Dental Abscess: Causes, Symptoms and Treatment Options.
A dental abscess is a localised bacterial infection that may form at the root of a tooth or within the surrounding gum tissue. Symptoms can range from mild discomfort to significant pain, and early professional assessment is important to identify the source of infection and determine the most appropriate treatment.
Professional Assessment
A thorough clinical examination can evaluate the source and extent of the infection and guide the appropriate treatment pathway.
“The infection was dealt with quickly and professionally.”
What Is a Dental Abscess?
A dental abscess is a collection of pus that forms as a result of a bacterial infection within or around a tooth. The infection develops when bacteria enter the tooth or gum tissue through damaged enamel, a crack, or a periodontal pocket. Clinical evaluation determines the type and extent of the abscess, which guides the treatment approach.
Periapical Abscess
Forms at the tip of the tooth’s root, typically as a result of untreated decay, trauma, or a failed restoration. Bacteria reach the pulp (nerve) of the tooth, causing infection that spreads to the surrounding bone. This is the most common type of dental abscess.
Periodontal Abscess
Forms in the gum tissue alongside the tooth root, usually as a result of advanced gum disease (periodontitis). Bacteria become trapped in a deep periodontal pocket, leading to a localised infection. This type may also occur when a foreign body becomes lodged between the tooth and gum.
Both types require professional assessment and treatment. A — often including X-rays — is essential to identify the source and extent of the infection and to determine the most appropriate management plan.
Common Causes of Dental Abscess
A dental abscess develops when bacteria gain access to the internal structures of a tooth or the deeper layers of gum tissue. Several common pathways can lead to this.
1Untreated Tooth Decay
Decay that progresses through the enamel and dentine can eventually reach the pulp (nerve) of the tooth. Once bacteria enter the pulp chamber, infection can develop and spread to the root tip, forming a periapical abscess.
2Cracked or Fractured Tooth
A crack in a tooth — even one that is not visible to the naked eye — can provide a pathway for bacteria to reach the inner structures. Teeth weakened by large fillings or previous trauma may be particularly vulnerable.
3Leaking or Failed Restorations
Old fillings, crowns, or other restorations may deteriorate over time, allowing bacteria to seep beneath the restoration and reach the underlying tooth structure. Regular dental examinations can help detect this before an abscess develops.
4Advanced Gum Disease
Periodontitis causes deep pockets to form between the teeth and gums. Bacteria can accumulate in these pockets, leading to a periodontal abscess. Effective periodontal treatment can help manage this risk.
5Impacted Teeth
Teeth that have not fully erupted — most commonly wisdom teeth — can create areas where bacteria become trapped beneath the gum tissue. This can lead to localised infection and abscess formation.
The progression of infection varies between individuals. Factors such as general health, immune function, and the specific bacteria involved can influence how quickly an abscess develops.
Signs and Symptoms
The symptoms of a dental abscess can vary depending on the type, location, and severity of the infection. Not all symptoms will be present in every case, and some abscesses may develop gradually while others present more acutely.
Persistent or Throbbing Pain
A continuous ache or throbbing sensation in or around a tooth is one of the most common indicators. The pain may radiate to the jaw, ear, or neck on the affected side.
Swelling
Localised swelling of the gum near the affected tooth is common. In more advanced cases, swelling may extend to the face, cheek, or jaw area.
Sensitivity to Pressure
The affected tooth may feel tender to touch or painful when biting down. You may notice increased discomfort when eating or pressing on the area.
Bad Taste in the Mouth
If the abscess drains spontaneously, you may notice a foul or salty taste. This can be accompanied by temporary relief from pain, but does not mean the infection has resolved.
Fever
In some cases, a dental abscess may cause a raised temperature, particularly if the infection is more widespread. This is less common but may indicate a more significant infection.
Important to Note
The presence of one or more of these symptoms does not automatically confirm an abscess — other dental conditions can produce similar signs. Equally, some abscesses develop with minimal initial symptoms.
A professional dental assessment — including clinical examination and appropriate imaging — is the most reliable way to determine whether an abscess is present and to identify its source.
If you are experiencing any of these symptoms, we recommend arranging a dental assessment to identify the cause and discuss appropriate management.
Risks if Untreated
While many dental abscesses present with manageable symptoms, the underlying infection will not resolve without professional treatment. If left unaddressed, there are potential risks that patients should be aware of.
Worsening Infection
Without treatment, the bacterial infection may continue to develop, potentially leading to increased pain, more significant swelling, and a larger area of affected tissue. What may begin as a localised infection can become more complex over time.
Spread to Surrounding Tissues
In uncommon but serious cases, infection from a dental abscess may spread to surrounding soft tissues, bone, or other areas. This underscores the importance of prompt professional assessment, particularly when symptoms are worsening.
Increased Treatment Complexity
Early treatment often provides a wider range of management options. When infection is allowed to progress, the treatment required may become more involved — for example, a tooth that could have been saved with root canal treatment may eventually require extraction.
Possible Tooth Loss
If infection significantly damages the tooth structure or surrounding bone, the tooth may become unrestorable. Seeking assessment early gives the best opportunity for preserving the natural tooth wherever clinically possible.
These risks are not intended to cause alarm. Many dental abscesses are straightforward to manage when assessed promptly. The key message is that professional evaluation is important so that appropriate treatment can be provided in a timely manner.
Treatment Pathway
The treatment for a dental abscess aims to control the infection, relieve symptoms, and address the underlying cause. The specific approach depends on clinical findings, including the type and severity of the abscess.
Professional Drainage
In some cases, the abscess may need to be drained to remove the accumulated pus and reduce pressure. This is carried out under local anaesthetic and aims to relieve pain and help control the infection. Drainage alone does not address the underlying cause — further treatment is typically required.
Your dentist may prescribe antibiotics alongside drainage if the infection is widespread, although antibiotics alone are not a definitive treatment for a dental abscess.
Purpose
Relieve pressure and control acute infection
Often followed by definitive treatment
Root Canal Treatment
For periapical abscesses where the tooth can be predictably saved, root canal treatment may be recommended. The procedure involves removing the infected pulp tissue, cleaning and shaping the root canals, and sealing them to prevent reinfection. A dental crown is often placed afterwards to restore the tooth’s strength.
Root canal treatment aims to eliminate the infection while preserving the natural tooth — avoiding the need for extraction.
Purpose
Eliminate infection, save the natural tooth
Often followed by a
Periodontal Treatment
For periodontal abscesses caused by gum disease, treatment focuses on cleaning the infected periodontal pocket, removing debris and bacterial deposits, and managing the underlying gum condition. This may involve deep cleaning (debridement), drainage of the abscess, and an ongoing periodontal management plan.
Purpose
Treat gum-related infection and manage gum disease
May include ongoing maintenance
Tooth Extraction
In cases where the tooth is too severely damaged or infected to be predictably restored, extraction may be the most appropriate option. This removes the source of infection and allows healing to begin. Your dentist will discuss replacement options — such as dental implants, bridges, or dentures — if extraction is recommended.
Purpose
Remove the source of infection when tooth cannot be saved
Replacement options available
When Urgent Dental Care May Be Needed
While all dental abscesses benefit from professional assessment, certain symptoms may indicate that a more prompt evaluation is advisable. If any of the following apply, we recommend contacting us to arrange an assessment as soon as possible.
Swelling That Is Increasing
Swelling that is spreading to the face, jaw, or under the eye may suggest the infection is extending beyond the immediate area of the tooth.
Severe or Worsening Pain
Pain that is intense, not responding to over-the-counter pain relief, or progressively worsening may indicate a more significant infection.
Difficulty Opening the Mouth
Restricted mouth opening (trismus) can be a sign that the infection is affecting the surrounding muscles and tissues.
Symptoms Affecting General Health
A high temperature, feeling generally unwell, difficulty swallowing, or difficulty breathing alongside dental symptoms should be assessed promptly.
Contact Information
If you are experiencing symptoms suggestive of a dental abscess, please contact our practice to arrange an assessment. We offer same-day emergency appointments for patients with acute symptoms.
Open 7 days a week, including Saturdays and Sundays
If you experience difficulty breathing, difficulty swallowing, or severe facial swelling, attend your nearest hospital A&E department or call 999.
Temporary Measures Before Assessment
The following general measures may help manage discomfort while you arrange a professional dental assessment. These do not treat the underlying infection.
General Comfort Measures
Avoid chewing on or applying pressure to the affected area.
Avoid very hot or very cold foods and drinks if sensitive.
Over-the-counter pain relief such as ibuprofen may help manage discomfort.
Rinsing gently with warm salt water may provide temporary comfort.
Maintain gentle oral hygiene — continue brushing other areas normally.
Important Reminders
Do not attempt to drain or lance the abscess yourself.
Antibiotics purchased without a prescription are not recommended.
If the abscess drains spontaneously, symptoms may ease but the infection remains.
Avoid placing aspirin directly on the gum — this can cause tissue damage.
Arrange a professional dental assessment as soon as practicable.
These measures are intended as general guidance only. They do not constitute a diagnosis or treatment plan. A dental abscess requires professional assessment and treatment to resolve the underlying infection.
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Dental Abscess Assessment
If you suspect a dental abscess, a professional dental assessment can identify the source of infection and determine appropriate treatment options. Dental abscess assessment and treatment options are available at our London clinic, where professional evaluation can determine the most appropriate course of care.
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Our South Kensington team provides thorough assessment and effective treatment for dental abscesses, from initial diagnosis through to definitive care and follow-up.
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