Tooth Abscess—Stages, Symptoms, and Treatment

What is an abscess tooth?

A tooth abscess occurs when a pocket of pus develops inside a tooth, as a result of a bacterial infection. There are two different kinds of tooth abscesses—periapical and periodontal. The type of abscess is based on its location.

  • Periapical abscess. Located on the tip of a tooth’s root.
  • Periodontal (gingival) abscess. Occurs on the gums, near the side of a tooth’s root.


  • Abscesses are commonly a result of an untreated cavity, gum disease, or an injury to the mouth.
  • Untreated cavities. Cavities left untreated result in plaque continuing to eat away at the tooth, causing decay. Overtime, the bacteria can eventually attack the tooth’s pulp (the inner part of the tooth). Once bacteria reaches the pulp, an abscess can form.
  • Gum disease. Also called periodontal disease, severe cases of gum disease cause the gums to pull away from the teeth, exposing the deep pockets between the teeth and gums. Bacteria and food can become trapped in the pockets and result in an abscess.
  • Injury to the mouth. If your teeth, gums, or mouth are damaged, bacteria can more-easily enter into your teeth or gums, which can result in an abscess.


A tooth abscess is a later stage of tooth decay, the stages include:

  • Enamel decay. Enamel is the outer layer of teeth and is the first part of a tooth to become damaged; oftentimes because of plaque build-up on the teeth.
  • Dentin decay. Dentin is the second layer of the tooth. When enamel decay is not treated properly, the bacteria continues to progress and damages the second tooth layer. Many people experience an increase of tooth sensitivity if they have dentin decay.
  • Pulp decay. Pulp is the deepest layer of a tooth. Once bacteria reaches the pulp, it can attack the tooth’s nerve. If this happens, it is likely that you’ll experience severe tooth pain.
  • Abscess formation. An abscess begins to form after bacteria has attacked the tooth’s nerve to the point where the nerve dies. Gum swelling, throbbing pain, and a small bump appearing is likely at this stage.
  • Serious complications. If you don’t treat your tooth’s abscess it can lead to tooth loss or even sepsis.

Tooth Abscess Symptoms

Symptoms of an abscess can vary, depending on how long it has been developing but common symptoms include:

  • Difficulty breathing or swallowing—if you are experiencing pain or difficulty breathing go to the emergency room or call 9-1-1 right away.
  • Severe pain or throbbing near the affected tooth or surrounding areas, including the gums or jaw
  • Sensitivity to hot and cold
  • Sensitivity when chewing or biting
  • Fever
  • Redness and swelling in your face or cheeks
  • Tender, painful, or swollen lymph nodes under your jaw or in your neck
  • Pain in the ears, neck, or jaw

Tooth Abscess Treatment

If you have a dental abscess, treatment is required. If left untreated, the infection will not go away and can spread to other areas of your body. When the infection spreads, it can result in a serious and potential life-threatening infection known as sepsis. Treatment of a tooth abscess varies, depending on the location and severity of the abscess.

  • Incision and drainage. The first stage of treatment usually involves draining the abscess to get rid of the infection.
  • Root canal treatment. A root canal may be recommended if the abscess is on the root of the tooth. This will remove the abscess from the root.
  • Tooth extraction. If the root canal is not possible or the severity of the abscess is too significant, your tooth will need to be removed.

Over-the-counter medication such as Aspirin or Tylenol can help relieve some of your pain while you wait for treatment. They should only be used to reduce pain before your dentist appointment—not used as an alternative to seeing the dentist


If you have an abscess—see your dentist immediately. Dental abscesses are a result of bacteria infecting the deep layers of your teeth or gums. You will likely experience pain in your teeth, gums, or jaw until you see your dentist for treatment. If you believe you have a dental abscess, contact us right away at (714) 996-1212 and we will see you as soon as possible.