Written by medical and health professionals
Children's teeth, if properly preserved, can be used as a source of stem cells for them later in life - Teeth are important in the development of self confidence in children and in adults - Good teeth for a good smile - Keeping your teeth into old age?  Sure can!
Written by health professionals, easy to read.

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Tooth Abscess and treatments for tooth abscess

Tooth abscess - contents this page


  • Tooth abscess Xray Photo
  • Tooth abscess Definition
  • Tooth abscesses
  • Tooth abscess Causes
  • Tooth abscess Symptoms
  • Tooth abscess Treatment
  • Tooth abscess Pictures / Diagram
  • Tooth abscess Antibiotics
  • Tooth abscess Death
  • Tooth abscess Complications
  • Tooth abscess Home Remedy

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Xray photo of a tooth abscess

X-ray of tooth abscess following root canal treatment and crown

This real x-ray picture of a tooth abscess - my tooth abscess - clearly shows the sac of pus in the area marked as ROOT ABSCESS. 

Part of one of the roots had been eaten by the infection of the tooth abscess, also marked. 

The fistulae, pus drainage line (also marked in this picture), occurred in this instance along the side of the tooth - the pus from the root abscess was being forced out into the mouth, under the physical pressure caused by the growing infection of the root abscess.

  You can also see from this x-ray picture of my tooth, that the tooth was sitting proud - forced up a fraction by the pressure of the pus sac underneath it.  The pus from the root abscess, having made it's way into the mouth, could easily cause bad breath as well, as the pus is quite stinky.  The root canals and top of the tooth appear much brighter in the x-ray picture, in comparison to the other teeth, as the tooth had root canal work - which fills in the roots with a denser substance - and the crown that is capping the tooth is again made of a much denser material than that of tooth.  With only a 25% to 80% chance of saving the tooth and then at a cost of nearly $3000 and much time and discomfort, I took the easy way out and had the tooth extracted - at this stage in the tooth abscess process, the tooth abscess is normally unbearably painful - unable to sleep, unable to find relief, with any pressure on the tooth causing horrific pain.

However, as a side note, if you had your crown put on for purely cosmetic reasons, your sucess rate for retreatment maybe around 90%, and if your crown doesn't have to be replaced, then the cost may be as low as around $1500.

It should be noted that the explanation of, and points of reference in the xray, are not definitive in a diagnosis. A dark spot on an xray could also mean cancer, an abscess, or many other things. Your dentist makes the diagnosis of tooth abscess based on your xray AND your presenting symptoms.

Tooth abscess Definition

A tooth abscess is an infection of the tooth or root of the tooth.

If the root of the tooth is dead, it is referred to as being a dead tooth and the the dentist has likely filled the tooth and root canals after drilling and cleaning the tooth and root canal out. If this the case, the likely scenario is that the tooth abscess has formed more in the root or bottom part of the tooth, with the infection in the tooth abscess generating pus. The pus from the tooth abscess causes swelling because the pus takes up space. The swelling or enlargement of the tooth abscess is causing most, if not all of the symptoms of the tooth abscess - with the pain and toothache coming from other nerves it may be stimulating below or near the tooth, but not in the tooth as such, though it may feel that way.

If the root of the tooth is still alive, then the infection in the tooth abscess is upsetting the nerve of the tooth, thus generating pain. This is the typical scenario of tooth decay, with the tooth abscess forming in the soft pulp in the center part of the tooth.

Tooth abscesses

With good oral hygiene, it is unlikely that a person will have tooth abscesses. Normally a tooth abscess occurs on it's own - that is, an infection of one tooth. However, if that tooth infection goes unchecked, other teeth may become compromised by the infection as well.

Tooth abscess causes

The cause of a tooth abscess is an infection. So the question in looking at the cause of tooth abscess, is how did the infection get there?

Common Causes of tooth abscess:

Firstly - The infection was there when the tooth had dental work performed on it; such as a crown, or root canal, or filling. Normally the tooth had been compromised by infection through a cavity in the tooth. The germ, that would later go on to form the tooth abscess, was NOT completely killed off when the tooth was repaired.

Secondly, the cause of a tooth abscess may be time delayed. If it has been a while since the tooth had work on it - then, for some reason the tooth abscess germ, which was there, is now out of control and has now formed a tooth abscess - this loss of control of the infection is put down to a degraded or weakened immune system at that time the infection took hold. For some reason the immune system just isn't up to keeping the germ in check - that's the theory of it anyway.

Thirdly, the cause of tooth abscess may be age related: A weakness in the tooth develops as it ages, such as a microscopic crack, which allows the infection to enter the tooth, or the gum withdrawing from the tooth, allowing a germ to enter more easily. Being aged also can mean a degraded immune system is more common.

Fourthly, the cause of the tooth abscess may be a cavity that has allowed a germ to enter the soft pulp part of the tooth, which is upsetting the nerve.

Tooth abscess Symptoms

There are several tooth abscess symptoms:

The tooth abscess symptoms in a dead tooth - a tooth where the nerves have been removed or died - tend to follow stages, based on the extent of the swelling of the tooth abscess.

An early tooth abscess symptom is the feeling that the tooth may be becoming loose, even though the tooth shows very little movement at all. This symptom may last about two days.

A slightly later indicating tooth abscess symptom is the feeling that the tooth is sitting a bit higher than usual - caused by the tooth abscess's infection pus build up - it's swelling or enlargement - underneath the tooth, which raises the tooth to slightly rise up. The symptom of pain caused by the tooth abscess may or may not be present at this time.

The later stage symptom of a tooth abscess is a combination of the symptoms of pain, discomfort and sometimes the feeling that the tooth is about to explode - I have a crown, so this feeling that the tooth is swelling and trapped by the crown is very real.

In the real late stages, tooth abscess symptoms include, when left untreated, the tooth abscess infection will eat away the jaw near it, cause the teeth to drop out.

In the very last stage, the tooth abscess symptoms include not only the disfigurement of the face through the compromise of the soft facial bones, but also often in death, as the tooth abscess infection can spread through out the body, causing heart attack and so on.

The tooth abscess symptoms in a live tooth is normally sharp pain on contact with fast airflow, such as breathing in and out really, really fast through the teeth. The air enters the cavity and irritates the abscess. Generally if a tooth reacts painfully to cold fluids, it is a good sign that the tooth can be repaired with the nerve kept intact. On the other-hand, if the tooth reacts badly to warm or hot fluids, it suggests the tooth nerve has been compromised by the tooth abscess, which means it will likely be more costly to repair, as it may involve the removal of the nerve - root canal treatment - leaving you with a dead tooth.

Tooth abscess Treatment

The common treatment of tooth abscess normally involves three options:

One tooth abscess treatment option, is the use of antibiotics, when the tooth is already dead and sealed by a dentist. The antibiotics kill the germ responsible for the tooth abscess and the body then repairs the bone and tooth, normally pretty good.

The second tooth abscess treatment, is root canal treatment, which is the drilling out of the root canal and infected area, cleansing out the infection, then resealing the tooth. Antibiotics appear to be rarely prescribed, as the dentist will normally paint the insides with a germ killer.

The third tooth abscess treatment involves extracting the tooth, cleansing the area, then allowing the wound to heal - antibiotics may be prescribed.

Choosing a good dentist is really important for the treatment of a tooth abscess, particularly if there is a root infection and a crown on the tooth: Many dentists may advise you to have the tooth removed and an artificial tooth inserted or refer you to a specialist to do the crown and root canal again. The bottom line is that the dentist who did the tooth for the first crown and or root canal, may not have cleaned out the root canals as well as they needed to be.

Tooth abscess Pictures

Tooth abscess and how the infection can enter and spread through the tooth and gum A tooth abscess is normally not seeable, except as a lump - sometimes - as the tooth abscess exists under the skin and can only be seen, as such, by X-rays. Sometimes you may see a picture of a face with part of it swollen, again you are seeing the swelling under the skin, not actually seeing the tooth abscess as such - some of the swellings can be through the lymph glands trying to take the infection caused by the tooth abscess. On X-ray, the tooth abscess can be seen by a trained eye. Most pictures of a tooth abscess simply show a drawing of a tooth, a cavity leading into the soft pulp, and a colored area denoting the infection.

Tooth abscess antibiotics

Tooth abscess antibiotics - typically penicillin ones - are normally prescribed by the dentist, after the dentist has taken X-rays to confirm the presence of the infection. Tooth abscess antibiotics normally control the tooth abscess extremely well, with most of the tooth abscess symptoms being alleviated within two or so days. the tooth abscess healed in about a five day course of antibiotics.

The problem in using tooth abscess antibiotics, is that they are unable to penetrate into the tooth - the blood supply is through such small blood vessels that antibiotics are too big and are unable to travel along them. So the antibiotics used for tooth abscess often only has limited success, with later episodes of tooth abscess occurring as the infection gains a foot hold again - for me this means a recurring tooth abscess roughly every year or so. In other words, the tooth abscess germ once it gets into the tooth, can live there and breed there, but antibiotics cannot touch them in there.

This later problem in using tooth abscess antibiotics, only exists if the germ has entered the tooth.

Tooth abscess and Death

Explained much already, but to recapitulate: Tooth abscess can cause the death of the tooth and it can literally be the death of you. Never leave tooth abscess to it's own end and where-ever possible, get to a dentist ASAP. Remember, infection can spread and affect the heart and it literally eats into the soft facial bones. Not something to fool around with.

Tooth abscess Complications

Avoid and or minimize tooth abscess complications by treating the tooth abscess as early and as professionally as you can.

A complication of tooth abscess, is that the tooth abscess infection, if left untreated, will likely do one of two things:

It may create an eruption (fistulae) through the skin, with the pus leaking and draining out into the mouth or through the cheek, or it may erupt into the bone area and travel along the path of least resistance, infecting the surrounding tissue and possibly damaging nerves, as it travels. Either is pretty gross.

When the eruption occurs, the tooth abscess may initially have it's symptoms greatly relieved, as the pressure caused by the pus has been relieved. It is, however, short lived, as the spreading infection can create much severer symptoms, such as pain, as more healthy tissue and bone become compromised by the germs.

Some more tooth abscess complications that have been very much explained already: Facial Disfigurement as it eats away the facial bones; teeth falling out as the tooth abscess destroys the jaw holding the tooth; the picture is pretty gruesome.

Tooth abscess Home Remedy / Home Treatment

This tooth abscess home remedy is for the root abscess of the tooth, as shown in the diagram above. This home remedy for tooth abscess may not be suitable for a pulp abscess of the tooth, as shown in the diagram above.

Okay, you may have heard about several home remedies for tooth abscess - holding salt water in your mouth for about 10 minutes at a time, packing the area of the tooth abscess with tea bags for a day - are two of the common home remedies for a tooth abscess.

Now I am going to share with you my TOOTH ABSCESS HOME REMEDY. Yes, that tooth abscess is problematic, it can take weeks to get into to see a dentist, often the dentist is very expensive. So, as I wasn't prepared to let the dentist pull my tooth out, I had to figure something else out.

My home remedy for tooth abscess are antibacterial Strepsil throat lozenges. Cheap, fast and easy to obtain.

The trick was to put the Strepsil next to the gum area of the tooth with the abscess, so that the antibacterial effect is as close to the infection as one can get it.

With this tooth abscess home remedy, it is important to keep the lozenge in position for several hours, without sucking it.

Another requirement of this home remedy for tooth abscess is to relocate the lozenge to the other side of the tooth abscess about every half hour. So, it's between the lip and gum for half the time and for the other half, the lozenge is between the tongue and the gum.

Relief with this tooth abscess home remedy should occur within about 12 to 24 hours and I normally keep replacing the strepsils as they dissolve away over this time. I then use the lozenges on and off until I feel the tooth abscess has been completely controlled.

This home remedy for tooth abscess wont likely kill an infection in the tooth, but it will likely put an end to the tooth abscess, or greatly reduce the tooth abscess, for a while, at least from what I have experienced anyway.

One problem I have encountered in using this home remedy for tooth abscess, is the skin peeling inside the mouth, where the lozenge had been allowed to dissolve. A good tip with this home remedy for tooth abscess is to use the lozenges that are just the dual acting antibacterial ones - I've found that the more complicated the lozenge, e.g. with menthol added, the harder it is on the mouth.

Another problem I found with this home remedy for tooth abscess, is that when using the complicated lozenge, it appeared to upset the tooth above it. It may have been referent pain ( pain that is caused in a healthy tooth, because it's nerves are picking up the pain from another tooth - the nerves of the various teeth are very close together as they run back to the brain, so some excitation of nerves can take place) rather than a problem caused by the lozenges, but I felt that I should mention it just in case.

Yet another problem, if the tooth abscess is left too long, the above home remedy may only partially work - the symptom of pain and swelling may be quickly relieved - but the tooth abscess has possibly gained a strong foothold that is not so easy to get rid of. A visit to the dentist may still be needed.

The longest I've let a tooth abscess go for, was to the stage where it felt like the tooth was about to explode. The home remedy worked quickly, as expected, but it took about a week for the tooth to settle to the point where I felt it was definitely not a problem. The whole tooth area remained painful and sore over those seven days, but nothing like it had been. To help the home remedy a bit, I also used Brufen (iso brufen) to relieve the pain and reduce the inflammation after I knew the infection appeared to be well controlled by the home remedy.

I estimate the success of this tooth abscess home remedy at about 67%. So if the tooth continues to generate pain or discomfort for more than a week, assume the tooth abscess is still there. After a week, it is likely that a small part of the tooth root has been eaten by the abscess. Tooth abscess antibiotics should be sought urgently. For peace of mind, always consult a dentist ASAP at first sign of a tooth abscess. This home remedy does not appear to have a high enough success rate to forgo the dental visit.

Tooth abscess Parting Comments

My parting comment on tooth abscess: Learn what the symptoms are for you personally and respond to an attack as quickly as possible. Leaving your tooth in a damaged or abscessed way, means your ability to work, to be a parent, a spouse ... may be impaired as well. Think about the consequences of tooth abscess, before you put material possessions first.

Top tooth x-ray picture and the drawing are copyright Donald Urquhart of www.hemorrhoidshemroids.com 2007

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