Overview

A dental abscess is a collection of pus caused by bacterial infection inside a tooth, in the gum, or in surrounding bone. It is a dental emergency. Two main types: periapical abscess (at the root tip from untreated decay) and periodontal abscess (in the gum from gum disease). Without treatment, infection can spread to the jaw, neck, or brain — a life-threatening complication.

Symptoms

• Severe throbbing toothache radiating to the jaw, ear, or neck
• Sensitivity to hot and cold; pain when chewing or biting
• Swelling of the face, cheek, or neck
• Fever and feeling generally unwell
• A pimple-like swelling on the gum that may drain foul-tasting fluid
• Sudden relief of pain if abscess ruptures — this does NOT mean it has resolved

Causes & Risk Factors

• Untreated dental caries — most common cause
• Chipped, cracked, or broken teeth allowing bacteria to enter
• Severe gum disease (periodontitis)
• Previous dental trauma with a dead tooth
• Diabetes and immunosuppression increase severity risk

Complications

• Spread of infection to jaw, floor of mouth (Ludwig's angina), or neck
• Septicaemia (blood poisoning) — a life-threatening emergency
• Cavernous sinus thrombosis; permanent tooth loss

Diagnosis

Clinical examination, dental X-rays, and swelling assessment locate the abscess. Severe facial swelling or systemic symptoms require urgent hospital referral. Blood tests may assess infection severity.

Treatment

• Drainage is essential: root canal (periapical) or incision and drainage (periodontal)
• Antibiotics: prescribed alongside drainage, never instead of it
• Root canal treatment removes infected pulp and saves the tooth
• Extraction if the tooth cannot be saved
• Hospital admission for severe spreading infection

Prevention

• Treat dental decay promptly — never delay filling a cavity
• Maintain good oral hygiene: brush twice daily, floss daily
• Regular dental check-ups to catch problems early
• Wear a mouthguard during contact sports to prevent trauma

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