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Tooth Abscess Stages: Symptoms, Progression, and Treatment

A tooth abscess is a severe dental condition that can lead to significant discomfort and health complications if not treated promptly. Understanding the stages of tooth decay is crucial as it often leads to the development of a tooth abscess. Dental abscesses are pockets of pus caused by bacterial infections, which can result from tooth decay, fractures, or chips in the tooth. At Santa Ynez Valley Dental, we understand the importance of addressing this condition early. This article aims to provide a comprehensive overview of the stages of tooth abscess.

Tooth Abscess Stages

What is a Tooth Abscess?

A tooth abscess is a pocket of pus caused by a bacterial infection. A tooth abscess can result from a tooth pulp infection, where bacteria attack the inner pulp of the tooth. It can occur when a pocket of pus accumulates after a bacterial tooth infection, affecting different parts of the tooth and surrounding structures.

What are the Types of Tooth Abscesses?

Tooth Abscess Stages - Periapical Abscess
Periapical Abscess

A periapical abscess occurs at the tip of the tooth root. It is typically caused by an untreated dental cavity that allows bacteria to penetrate the tooth pulp, leading to infection. This type of abscess can also result from an injury to the tooth, such as a crack or fracture, or from previous dental work that failed to fully eliminate the bacteria. Symptoms often include severe toothache, sensitivity to hot and cold temperatures, swelling, and sometimes the formation of a visible pus pocket at the gumline near the affected tooth.

Tooth Abscess Stages - Periodontal Abscess
Periodontal Abscess

A periodontal tooth abscess forms in the gums next to a tooth root, often as a result of advanced gum disease (periodontitis). Gum disease causes the gums to pull away from the teeth, creating pockets that can become infected. Plaque and tartar build-up, poor oral hygiene, and untreated gingivitis can all contribute to the formation of a periodontal abscess. Symptoms include swollen, red, and tender gums, pain when chewing, a bad taste in the mouth, and a possible fever.

Tooth Abscess Stages - Gingival Abscess
Gingival Abscess

A gingival dental abscess affects the gums and can occur due to trauma, such as aggressive brushing or flossing, or from foreign objects like food particles lodged in the gum tissue. Removing foreign object and maintaining good oral hygiene is crucial for preventing this type of abscess.

Tooth Abscess Stages and Progression

1

Initial Infection

The first stage begins with bacteria entering the tooth through a tooth cavity, crack, or other dental issue, leading to dentin decay.

2

Pulpitis

As the tooth pulp infection progresses, bacteria attack the inner pulp of the tooth, which contains nerves and blood vessels. Symptoms include increased intense pain, persistent throbbing, and sensitivity to sweets and temperature changes.

3

Formation of an Abscess

If the infection continues to spread, the body’s immune response leads to the formation of an abscess, resulting in severe, persistent tooth abscess pain. This results in severe, persistent toothache, swelling in the face, cheek, or neck, red and swollen gums, and a bad taste in the mouth.

4

Spread of Infection

If untreated, the tooth infection can spread to other parts of the body. Symptoms include increased swelling and severe pain, difficulty swallowing or breathing, swollen lymph nodes under the jaw or in the neck, and high fever and chills.

What Are the Symptoms of Tooth Abscess?

Tooth Abscess Symptoms

Symptoms vary depending on the stage of the abscess but commonly include:

  • Severe toothache
  • Sensitivity to cold or hot foods and drinks
  • Swelling in the face or neck
  • Red, swollen gums
  • Bad breath or a foul taste in the mouth
  • Fever and general malaise

How to Relieve Abscess Pain

Relieve Tooth Abscess

Before going to your dental appointment, here are 6 simple steps you can take to relieve the pain:

Apply an Ice Pack
This can help contain the swelling. The amount of pressure and swelling around the tooth can mimic migraine-like symptoms, so decreasing the swelling will decrease the intensity of the headache.

Saltwater Mouth Rinse
Rinse the infected area with mouth rinse or saltwater at least three times a day—morning, noon, and night—and as often as you’d like. To make a saltwater rinse, mix ½ teaspoon of salt into a cup of lukewarm water. The best salt is natural sea salt. Stir until the salt is completely dissolved. Gently swish a small amount of the saltwater over the infected area before spitting it out. Repeat until the saltwater is gone.

Pain Relief Medication
Take an over-the-counter pain relief medication. Ibuprofen/ Motrin is the most common over-the-counter anti-inflammatory prescribed and works by reducing the swelling around the infected area and the amount of pain you feel. If you have an NSAID allergy, please consult your physician first.

Food and Drinks
Avoid extreme temperatures when eating food and drinking liquids.

Brush and Floss
Brush and floss the infected area gently, but thoroughly. If the pain is too severe, avoid the area until treatment is rendered – and use a mouthwash.

Elevate Head
Elevate your head and upper body during sleep. This will decrease the blood pressure to your head, as well as the pain.

What Are the Tooth Abscess Treatment Options?

Tooth Abscess Stages - Antibiotics
Antibiotics

Antibiotics are often prescribed to help control the bacterial infection that causes the abscess. While antibiotics can’t cure the abscess alone, they are crucial in preventing the infection from spreading to other parts of the body. They are particularly useful if the infection has spread or if the patient has a weakened immune system.

Tooth Abscess Stages - Drainage
Drainage

Drainage involves creating a small incision in the abscess to allow the pus to escape. This procedure helps relieve throbbing pain and reduce swelling. After drainage, the area is cleaned thoroughly to prevent further infection. In some cases, a small drain may be placed to keep the area open and allow continuous drainage until the infection is completely resolved.

Tooth Abscess Stages - Root Canal
Root Canal Therapy

During the root canal treatment, the dentist removes the infected pulp from the inside of the tooth, cleans and disinfects the root canals, and then fills and seals the space. This treatment helps save the tooth and prevents reinfection. After the root canal, a dental crown is often placed on the tooth to restore its function and appearance.

Tooth Abscess Stages - Tooth Extraction
Tooth Extraction

This involves removing the infected tooth to prevent the spread of infection. After extraction, options such as bridges, dental implants, or dentures can be considered to replace the missing tooth and restore oral function.

Complications from Dental Abscess

Tooth Abscess Complications

Spread of the Infection
An untreated tooth abscess can allow bacteria to spread from the abscessed area to other parts of the body. This can lead to infections in the jaw, face, and neck, and potentially result in serious conditions such as cellulitis or Ludwig’s angina. In severe abscess cases, the infection can enter the bloodstream, leading to more widespread health issues.

Bone Loss Around the Affected Tooth
The infection from a tooth abscess can cause bone loss around the affected tooth. This occurs because the bacteria destroy the bone tissue that supports the tooth, which can lead to the weakening of the jawbone and loss of tooth stability. Bone loss can complicate further dental treatments and may require additional procedures to address.

Sepsis
If the infection from a tooth abscess enters the bloodstream, it can trigger sepsis, which can cause widespread inflammation, and organ failure, and potentially be fatal if not treated promptly. Symptoms of sepsis include high fever, rapid heartbeat, confusion, and difficulty breathing.

Abscessed Tooth Risk Factors

Tooth Abscess Risk Factors

Poor Dental Hygiene
Inadequate oral care, such as infrequent brushing and flossing, allows plaque and bacteria to build up on the teeth and gums. This can lead to cavities, gum disease, and eventually infections that may result in an abscess.

High Sugar Diet
A diet high in sugar provides a food source for bacteria that cause tooth decay. Sugars contribute to the formation of cavities, which can lead to infections and abscesses if not treated.

Dry Mouth
Dry mouth, or xerostomia, occurs when there is insufficient saliva to keep the mouth moist. Saliva helps neutralize acids and wash away food particles and bacteria. A lack of saliva increases the risk of tooth decay and gum disease, which can lead to abscess formation.

Dental Injuries or Previous Dental Work
Trauma to the teeth, such as cracks or fractures, can create entry points for bacteria, leading to dental infections and abscesses. Additionally, previous dental work that has not been properly sealed or has become compromised can also increase the risk.

How Is an Abscessed Tooth Diagnosed?

Diagnosis

Dentists use a combination of diagnostic tools and techniques to accurately identify abscessed teeth:

Dental X-rays
Dental X-rays allow the dentist to view the internal tooth structure and surrounding bone, helping to identify the presence of an abscess, bone loss, or any damage to the tooth root. X-rays can reveal the extent of the infection and assist in planning the appropriate treatment.

Physical Examination of the Tooth and Surrounding Area
The dentist will assess the affected tooth and the surrounding gum tissue for signs of swelling, tenderness, and redness. They may gently tap the tooth and apply pressure to evaluate pain levels and check for any pus formation or abnormalities.

Pulp Vitality Tests
Pulp vitality tests are used to evaluate the health of the tooth pulp, which contains nerves and blood vessels. These tests can include thermal tests (applying heat or cold) and electric pulp testing to measure the tooth’s response. A lack of response may indicate pulp necrosis, which is often associated with an abscessed tooth.

Can an Abscessed Tooth Be Prevented?

Preventing a tooth abscess involves maintaining excellent oral hygiene and scheduling regular dental visits.

Brush Teeth
Brush Your Teeth at Least Twice a Day with Fluoride Toothpaste

Regular brushing helps remove plaque and bacteria from the teeth and gums, reducing the risk of cavities and infections. Fluoride toothpaste strengthens tooth enamel and provides additional protection against decay.

Floss
Floss Daily to Remove Plaque Between Teeth

Flossing removes plaque and food particles from between the teeth and under the gumline, areas that are difficult to reach with a toothbrush alone. This helps prevent gum disease and cavities that can lead to abscesses.

Avoid Sugar
Avoid Sugary Foods and Drinks

A diet high in sugar can contribute to tooth decay and increase the risk of developing cavities. Limiting sugary foods and beverages helps maintain healthier teeth and gums.

Regular Visit
Visit Your Dentist Regularly for Cleanings and Examinations

Regular dental check-ups and cleanings allow your dentist to detect and address dental issues before they become severe. Professional cleanings remove plaque and tartar build-up, and examinations help identify any early signs of decay or gum disease.

Understanding the stages of a tooth abscess and recognizing the symptoms early can help you seek timely treatment and prevent serious complications. If you experience any symptoms of a tooth abscess, don’t hesitate to contact Dr. James Morelli for evaluation and care.