Dental Abscess

What is a dental abscess?

An abscess is a collection of pus. Pus is a thick fluid that usually contains white blood cells, dead tissue and bacteria (germs). The usual cause of an abscess is an infection with bacteria. A dental abscess is an infection in the centre of a tooth which spreads through the tooth to infect supporting bone and other nearby tissues. Dental abscess is common. It may develop as a complication of tooth decay (caries), or from an infection in the gums.

Symptoms of a dental abscess include one or more of the following:

• Pain (toothache) which can quickly become worse. It can be severe and throbbing.
• Swelling of the gum which can be tender.
• Swelling of the face. The skin over an abscess may become red and inflamed.
• The affected tooth may become tender to touch, and may even become loose.
• High temperature and feeling generally unwell.
• In severe cases there may be spasm of the jaw muscles with difficulty swallowing and/or breathing.

What is the treatment of a dental abscess?

See a dentist as soon as possible. A dentist will normally drain the pus and this often gives great relief of symptoms. Sometimes, if the infection is not contained, an antibiotic is prescribed for a few days after draining the pus to clear any remaining infection. However, studies have shown that an antibiotic is probably not needed once the pus is drained.

If there is a delay in seeing a dentist, a doctor or nurse may prescribe an antibiotic to help prevent the abscess from getting worse or spreading. However, an antibiotic will not clear the pus and you still need to see a dentist soon. You may also need painkillers until the abscess is drained.

Further treatment may include root canal treatment. Briefly, this treatment aims to save and restore the damaged or dead inner part of a tooth (the pulp). Sometimes the tooth needs to be removed.

What is the outlook (prognosis)?

If treated, the outlook is good. The pus can usually be drained and the tooth can be saved if it is not badly broken down. If left untreated, complications may develop which can include:

• Spread of infection
• The abscess may 'burst' onto the skin of the face, or into the mouth. This may leave a sinus tract (a channel) between a persistent focus of infection and the skin or mouth which can discharge pus from time to time.
• Osteomyelitis - an infection of the nearby bone.
• Cavernous sinus thrombosis - a serious infection and clotting of a blood vessel in the brain.
• Sinusitis - spread of infection to the nearby sinus in the face bone.
• A dental cyst (fluid filled cavity) may develop.

© EMIS and PIP 2004   Updated: November 2004   Review Date: December 2005   CHIQ Accredited   PRODIGY Validated