Tooth Abscess: What if dental infection left untreated?

Update in January 11, 2024

Tooth abscess

A dental abscess is a painful swelling filled with a thick fluid that is yellow in color (pus). There are two types of dental abscess, a gum abscess (also known as a periodontal abscess) and a tooth abscess (also known as a periapical abscess). If you think you have a tooth or gum abscess you should make an appointment with a dental professional.

The goal in treating an abscess is to stop the progression of the infection, and restore your mouth to a healthy state. This may involve draining the pus from the abscess and clearing out infected gum tissue, as well as root canal, or even extraction of the tooth. In more advanced cases, treatment would depend on the exact complications presented by the infection.

Understanding How And Why Abscesses Form

Understanding How and Why Abscesses Form

The medical abscess is not restricted to the mouth. These infected swellings can develop anywhere that bacteria had been allowed to accumulate and multiply. However, dental abscesses are almost always a result of infected teeth. They can be caused by lacerations to the inside of the mouth, but this is slightly rarer. The saliva has mildly antibacterial properties, so cuts and lesions in the oral tissue tend to get conquered easily.

The problem with tooth infections (or root infections, to be accurate) is that they occur below the gum line. They do not benefit from the cleansing properties of saliva. Instead, if a cavity develops underneath a tooth, it fills up with bacteria and the root of the tooth becomes infected. While the gum tissue usually tries to drain out the infected fluid, there is nowhere for it to go but below the gum line.

There is a small difference between a root abscess and a gum abscess, but the distinction is usually more important for the dentist than the patient. It is based on the precise place from which the abscess originates; sometimes next to the tooth, sometimes directly beneath it. Root infections do start off as abscesses. And, if dealt with quickly, they do not have to progress to them either. Once you have a painful facial swelling, you know that the infection has spread.

Risk Factors

These factors may increase your risk of a tooth abscess:

  • Poor dental hygiene.Not taking proper care of your teeth and gums — such as not brushing your teeth twice a day and not flossing — can increase your risk of tooth decay, gum disease, tooth abscess, and other dental and mouth complications.
  • A diet high in sugar.Frequently eating and drinking foods rich in sugar, such as sweets and sodas, can contribute to dental cavities and turn into a tooth abscess.
  • Dry mouth.Having a dry mouth can increase your risk of tooth decay. Dry mouth is often due to the side effect of certain medications or aging issues.

Determining If You Have An Abscessed Tooth

Determining If You Have an Abscessed Tooth

Aside from the pain, there will be a number of other symptoms. If you think that you might have an abscess, keep an eye out for these. A tooth that is this infected will usually darken in colour. This is caused by necrotic (dead) pulp tissue seeping into the porous parts of the tooth. If you have a noticeably dark tooth in your mouth, consult a dentist.

You may develop a pinkish protrusion in the gum tissue, around the infected tooth. This will look like a spot or pimple. It is filled with pus and needs to be drained by a specialist. A ‘fistula’ of this kind if a sign that your body is trying to rid itself of the bacteria. It will usually be accompanied by a foul taste in the mouth and chronic bad breath.

It is possible for a tooth to be heavily infected and for there to be no pain to indicate this. What this means is that the tooth has died. It can no longer send out pain signals and will probably have to be extracted. However, if you are not in any pain, it means that the infection has not spread to your gum tissue and jawbone. You still have a chance to fight off the bacteria before the abscess gets really nasty.

This kind of infected tooth will be picked up routine exams and check-ups, so you can trust your dentist to spot the signs and respond accordingly. Once again, if you keep up with appointments, it is very unlikely that an infection will be allowed to progress very far. This is what specialists are trained to identify and treat. If your dentist suspects that there might be a problem, you will be given an x ray diagnosis.



A tooth abscess won’t go away without treatment. If the abscess ruptures, the pain may decrease significantly — but you still need dental treatment. If the abscess doesn’t drain, the infection may spread to your jaw and to other areas of your head and neck. You might even develop sepsis — a life-threatening infection that spreads throughout your body.

If you have a weakened immune system and you leave a tooth abscess untreated, your risk of a spreading infection increases even more.

The consequences of an infection are potentially more serious for patients with weaker immune systems. For example, babies, children, elderly people, and patients with underlying health conditions. If you develop a dental infection while pregnant, you must seek treatment very quickly, because the condition is dangerous for the baby.

Anybody in any one of these at risk groups should consider themselves in more danger from infection.

Soothing The Pain And Alleviating The Symptoms At Home

Soothing the Pain and Alleviating the Symptoms at home

For the most part, home remedies will do little to alleviate the pain of an abscess. They certainly cannot treat it alone. However, they may lessen the pain a little, so could be worth a try if you are waiting to receive treatment. The best advice is to gently gargle salt water solution several times a day. It is a mild disinfectant and will help to keep your mouth clean.

As odd as it sounds, placing a damp teabag over the infected area can help with pain relief. Just make sure that you are very delicate, because the last thing that you want to do is burst any swellings or fistulas. You may be able to take stronger painkillers to control the intensity of the symptoms, but you must check with your dentist first.

Usually, things like aspirin are strictly forbidden, because they thin out the blood. This then makes it harder for the dentist to perform treatments on the tooth. Usually, you will not have much time to wait before the root canal or drainage procedure is scheduled. There shouldn’t be too much in which you have to control the pain independently.

When To See A Doctor

When to see a doctor

See your dentist promptly if you have any signs or symptoms of a tooth abscess.

If you have a fever and swelling in your face and you can’t reach your dentist, go to an emergency room. Also go to the emergency room if you have trouble breathing or swallowing. These symptoms may indicate that the infection has spread deeper into your jaw and surrounding tissue or even to other areas of your body.

The Recommended Treatment For An Abscess

There is a two pronged approach to treating dental infections.


The first step is antibiotics. This makes sure that the condition is not allowed to progress and make the patient sick. The second involves dealing with the tooth itself. It has to be drained and cleaned of the nasty bacteria. The main focus at first, however, is on controlling the symptoms – antibiotics are key.

Root Canal Treatment

Root canal treatment

For adults, a root canal is the recommended treatment if there is a good chance that the tooth can be saved. The procedure will usually have to be followed up with the fitting of an artificial crown, implant, or bridge. This comes later though, because the tooth is in danger until the bacteria and infection is removed. The empty tooth (cleared of infection) is filled with a substance that acts like a barrier. It stops further infection from taking hold.

For infants, root canals are not suitable. The procedure removes the living nerve tissue inside the tooth and infant teeth need this material to continue developing. Even if the infected tooth is a baby tooth, taking out the pulp and nerves may cause damage to the developing adult teeth underneath. The good news is that baby teeth can be safely lost.

They will later be replaced with mature teeth anyway. It is very important that this not be used as a reason to avoid treatment and dental care. As abscesses are very painful, children of any age need to be examined and treated by a specialist. Once the health of the mouth has been restored, the parents must take precautions to make sure that the condition of the teeth do not deteriorate again.

Tooth Extraction

Tooth Extraction

If it turns out that you need the infected tooth pulling, your dentist will perform a routine extraction. This will be carried out under anesthetic, so you will not feel a thing. They will carefully cut away the gum tissue around the problem tooth. Then, after peeling it back and exposing the root, they will fully remove it. Sometimes this is done in one go and sometimes it is done in a few pieces.

Once extracted, the dentist will stitch the gum tissue back together. The patient is then asked to bite down on a piece of medical gauze. This starts the clotting process. It is vital that the wound clots, because a barrier is needed to prevent bleeding and stop bacteria from entering the empty socket. It is very important that you do not dislodge, disturb, or break this barrier during the healing process.

To maintain it, brush very carefully around the empty socket (do not brush the socket). Gargle twice a day with salt water solution and do not, under any circumstances, play with or poke at the wound. It can take a few weeks for the tenderness and swelling to subside, so it is a good idea to keep taking approved painkillers. If you need stronger medication, because the pain is too intense, talk to your dentist.

The average extraction takes around three to four weeks to fully heal. For the first 2-3 days, you are advised to stick to soft foods and entirely avoid cigarettes and alcohol. For at least twenty four hours after the procedure, do not get involved with any heavy lifting or manual labour. You will still be drowsy from the anesthetic and you risk delaying the healing process. In the event of any complications or problems, do not forget that your dentist is on hand.

Recovering From A Dental Abscess

Ultimately, the success of your recovery from an abscess is entirely down to you. The more closely you follow aftercare instructions and respect the fact that your mouth needs to heal, the quicker and easier things will be. In the long run, treatment will always alleviate or completely eradicate tooth pain, so the rewards are worth the temporary discomfort.

You will not get seriously sick if you seek treatment for your abscess quickly. The number of cases in which infection has led to death are minute, but the condition is not one which should be left to chance. Ordinarily, root infections are quick to solve, easy to recover from, and leave little lasting damage. In the event of an extraction, remember that an empty socket can later be filled with an implant, bridge piece, or other artificial replacement.

How Can You Prevent An Abscessed Tooth?

How can you prevent an abscessed tooth

The best way to prevent an abscessed tooth is to take good care of your teeth and gums:

  • Brush your teeth 2 times a day, in the morning and at night. Use fluoride toothpaste approved by the American Dental Association.
  • Use dental floss to clean between your teeth every day.
  • See your dentist for regular dental cleanings and checkups.
  • Eat a healthy diet, avoid sugary foods and drinks, and limit between-meal snacks.

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