What to Do When You Have an Abscessed Tooth

A Painful Infected Tooth Needs Treatment

How To Relieve Tooth Pain

One cause of a painful toothache is an abscessed tooth. An abscess is an infection in or around the root of the tooth which may or may not be painful. It occurs when the pulp, the soft tissue inside the root canal, dies and becomes inflamed. Learn more about what causes a tooth abscess and why it is important to get it treated.

What Causes a Tooth Abscess?

Painful, abscessed teeth can be caused by untreated tooth decay, a cracked or broken tooth or filling, or from a gum infection, especially in advanced gum disease.

Your mouth always has bacteria, but it is kept out of the tooth by the solid tooth enamel. If tooth decay erodes that enamel or you have a cracked tooth, bacteria can get into the living pulp inside the tooth. Your immune system fights back, sending in white blood cells to kill the bacteria. Pus forms from white blood cells, dead tissue, and bacteria.

There isn't any extra room inside your hard tooth, so it tries to drain out the tip of the tooth root in the jaw. A pocket of pus can form at the root tip. The abscess can appear on a dental x-ray. The pressure and inflammation from this abscess can be very painful.

Symptoms of a Tooth Abscess

The most common symptom of an abscess is an ache in the bone around the tooth, but you may also experience pain when chewing, swelling of the gums, or other symptoms. Many people with an abscessed tooth have a difficult time identifying the  exact tooth that is causing the pain, and it doesn't always show up on x-rays.

More symptoms include:

  • A throbbing toothache that can radiate to your jaw, neck, or ear.
  • Your teeth may be sensitive to hot, cold, and the pressure of chewing.
  • You may develop a fever.
  • You might have swelling in your face, cheek, and the lymph nodes of your jaw or neck.
  • Your gums may be red and swollen.
  • If the abscess ruptures, you might get a rush of bad-tasting and smelling discharge in your mouth and have an open, draining sore.
  • If left untreated, the pain can become severe, often excruciating.

When to See Your Dentist

At the first sign of pain from a suspected abscessed tooth, call your dentist to make an urgent appointment. You need to get treatment before complications can arise. You might get some relief from the pain if the abscess ruptures, but whether it does or not, the infection can spread to your jaw.

How a Tooth Abscess Is Treated

Your dentist will examine your teeth and locate the abscess. You may need an X-ray or even a CT scan to see the exact location of the abscess and whether the infection has spread.

A dental abscess is usually treated with root canal treatment or endodontic surgery. The dentist will remove the bacteria from the empty canals within your tooth, clean, shape and fill the root canals, and seal the space. You will return to your dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function. After the new restoration, the tooth will continue to function like any other tooth.

In some cases, the tooth can't be saved and your dentist will pull out the infected tooth and drain the abscess to eliminate the infection.

You may be given antibiotics if the infection has a chance of spreading or if you have a weakened immune system.

How to Relieve Pain From an Abscessed Tooth

A toothache that is caused by an abscess may come and go, but don't be fooled if it does subside. The longer you wait to have the abscess treated, the more the chances of a serious complication rise. You may lose a tooth that could have been saved and you risk getting an advanced infection. But until you are able to get to the dentist, here are some ways to relieve the toothache caused by an abscessed tooth or dental infection:

  • Avoid foods and beverages that are very cold or very hot. Since the dentin layer of the tooth has likely been invaded by tooth decay, extremes in temperature may cause pain. Avoid foods like cold drinks, juices, ice creams, coffee, tea or hot soups as they may trigger the exposed dentin and cause extreme pain. 
  • Avoid foods and beverages that are very high in sugar, or are very acidic. Common acidic foods are soft drinks or juices. These reduce the pH in your mouth and put the tooth at risk of further pain due to demineralization. Teeth with dental abscesses are extremely sensitive so any changes in pH should be avoided. 
  • Use an over-the-counter pain relief medicine. Speak to your doctor or pharmacist about dosages, side effects, and interactions that can lead to further complications. Never exceed the recommended dose, and check to make sure you are able to take pain relief medications with any of the other medications you currently take. Most toothaches are caused by inflammation, so a pain reliever that reduces inflammation is usually the best choice. Never put pain relief medication on the tooth or gum tissue, as this could burn the tissue.
  • Floss between the teeth that are painful. Removing the food particles and plaque may help reduce the pain from the toothache. It might help reduce inflammation in the periodontal area which can transmit pain to the rest of the infected tooth. 
  • Seal a hole in the tooth temporarily. Some pharmacies have over-the-counter temporary filling material that may be used to seal the hole created by decay or a cracked tooth temporarily.
  • Sleep with your head elevated. If you elevate your head when resting, some of the pressure in the area of the toothache may diminish.
  • Rinse with warm salt water. Rinsing with warm salt water two to three times a day may help to relieve a toothache if the abscess was caused by a gum infection. Salt water works as an antiseptic to remove bacteria from the infected area.

A Word From Verywell

As soon as you develop a toothache, see your dentist immediately. An abscessed tooth isn't something that is going to go away on its own. You will save yourself days to weeks of pain by getting the problem diagnosed and treated so you can smile again painlessly.

Sources:

Abscess Tooth. American Dental Association. http://www.mouthhealthy.org/en/az-topics/a/abscess.

Abscessed Teeth. American Association of Endodontists. http://www.mouthhealthy.org/en/az-topics/a/abscess.

Tooth Abscess. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/tooth-abscess/home/ovc-20185938.

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