Abscessed Tooth Symptoms and Signs
The initial symptoms begin with localized swelling and pain that gets progressively worse over a few days. A tender and sore mass (the abscess) may be felt with a finger and gingival bleeding may occur. Periapical abscesses may be very sensitive to cold and heat.
What is an abscessed tooth?
When a tooth persistently throbs and keeps you up at night with pain, it could be something more worrisome than a simple toothache. An abscessed tooth is an infection within a tooth that has spread to the root tip or around the root. This infection originates from the tooth's inner chamber, which is called the "pulp chamber." Contained within the pulp chamber are blood vessels and nerves, collectively called the "pulp." Prior to the formation of an abscess, the tooth has essentially lost its ability to fight off infection, and bacteria are able to invade the pulp chamber and multiply. As the bacteria multiply, the infection usually spreads from the pulp chamber and exits through the bottom of the root into the bone. The abscess is a collection of pus that is made up of dead white blood cells, tissue debris, and bacteria.
A tooth abscess differs from a gum abscess by the source of the original infection. The tooth abscess (or "periapical abscess") originates from the pulp of the tooth and exits out the tooth's apex at the bottom of the root. A gum abscess (or "periodontal abscess") starts in a gum pocket outside of the tooth next to the root. Treatment will depend on where the infection originates.
What are risk factors for an abscessed tooth?
For the most part, poor oral hygiene and dental care increases the risk of infections for teeth. Grinding or clenching teeth (bruxism), high sugar diet, other tooth trauma, and even the presence of previous dental work can predispose to tooth abscess.
Reviewed on 1/31/2017
Bertossi, Dario, et al. "Odontogenic Orofacial Infections." Journal of Craniofacial Surgery 28.1 (2017): 197-202.
Burns, Richard C. and Stephen Cohen (Eds.). Pathways of the Pulp, 2nd ed. St. Louis, MO: The C.V. Mosby Company, 1980.