A dental abscess is an infection with pus localized around the tip of the tooth root (apex) due to bacteria that killed the dental pulp and try to spread outside the tooth canal. There are two most common abscess types: periapical abscess which affects the end of a tooth and the periodontal abscess that forms in the gingival tissue.
Statistics reveal that caries, broken teeth (trauma), severe gum disease (periodontitis) or a failed root canal treatment are the most frequent dental abscess causes.
Pain, redness, swelling and bad breath are the most common dental abscess symptoms usually treated with antibiotics like: amoxicillin, augmentin, keflex. Antibiotics are also useful to avoid the tooth infection spreads to the neck, maxillary sinus, jaw joint or ear.
Natural home remedies and over the counter medication are useful as pain relief or mouth disinfection (hydrogen peroxide). To lower the pressure inside the bump, your dentist may decide to drain the tooth abscess making the pus coming out. It can be a painful procedure but once done you will feel much more better.
In some cases there are risk factors that can worse the disease (diabetes, HIV).
The tooth abscess during pregnancy or breastfeeding has to be treated by a doctor instead of using home remedies.
Abscessed tooth symptoms
Cheek redness and swelling
The most characteristic dental abscess symptom is the swollen cheek. That is caused either by the pus accumulation and the increased blood quantity. In fact, the immune defenses (white blood cells) are transported by the bloodstream, which is why the infected area swells up and turns red or purple.
Gum boil with yellow or white head
A small to medium bump with a gum boil inside the mouth close to the tip of the dental element root. Usually referred as “yellow or white head”.
Bitter taste in your mouth
When the pus comes out from the abscess that drains on its own or because of the dentist treatment, you may feel a bitter unpleasant taste in your mouth. It is temporary and to get rid of that you just need to rinse your mouth with water or using an antibacterial mouthwash with chlorhexidine.
Ear, jaw and neck pain
some patients reported a mild to acute pain that affected their ear, jaw and neck on the same side as the affected tooth or gum.
Pain gets worse at night
This happens because of the position of your body. When you lay in the bed, the blood pressure in your infected tooth increase pressing against the nerve located in the tissue pulp within the dental root canal. To relieve the pain caused by the periodontal abscess you should put a couple of pillows behind your head.
Bad breath caused by pus
You may feel bad breath in the mouth (halitosis) coming from the infection area due to the pus and necrotic tissue smell.
Increased sensitivity to hot or cold drink and food
If your abscess is caused by a broken tooth or a deep caries, the toothache can suddenly come on or get worse if you drink or eat too hot or cold food that’s because the dental nerve is leaved uncovered.
Difficulty to chew and swallow
The abscess symptoms listed above are the most common but there are additional signs to be taken into account.
If leaved untreated, the infection spreads causing you:
- Difficulty to wide open the mouth or swallow
That happens because the tooth infection affects the jaw joint ;
- Swollen neck lymph nodes.
- jaw numbness;
- generally unwell feeling.
How dentists treat a tooth infection ?
The tooth abscess diagnosis is done by the dentist proceeding by steps;
- The doctor will first collect the signs and symptoms reported by the patient;
- The second step of the diagnosis involves the sensitive test. The endodontist will tab vertically on the painful tooth using the handle of the dental mirror. An abscessed tooth, in fact, is usually very sensitive to touches or pressure;
- At this point the X-Ray exam can show the dentist how far the infection spread and whether a fistula or a cyst formed or not.
- If the infection has already spread to other zones like neck or jaw joint, the X-Ray is not enough and the doctor usually prefers to rely on the CT scan.
Once the diagnosis is complete and the dentist has the whole clinical picture, it’s time to proceed with the most appropriate tooth abscess treatment or therapy.
Pus drainage procedure
The first goal of the dental abscess treatment is to reduce the pressure inside the swelling.
In order to drain the abscess a little cut of the tissue or boil is required. The dentist will then gently squeeze the bump to make the pus coming out. As soon as the pus starts to exit the pressure decrease and the pain calms down but it doesn’t mean that the problem is solved. The infected and necrotic tissue is still there and it is necessary to remove it to avoid the infection restarts again.
Root canal treatment or re-treatment
Since a deep caries is the most common cause of the infection of the pulp within a dental element, the root canal is the conventional dental abscesses treatment.
After providing you with the local anesthesia, the endodontist opens a little hole in the crown enamel to access the pulp chamber.
With the help of manual tools the specialist will remove nerves, blood vessels, died cells and the infected necrotic material from the inside the affected tooth.
In order to disinfect the root canal and to kill bacteria, usually sodium hypochlorite is injected in the tooth and immediately reabsorbed.
At the end of the canal therapy the dentist closes the canal using a temporary filling and a prosthetic crown. To complete the procedure a few medication are required.
When the infection is completely removed it is possible to close the hole using a special filling called gutta-percha.
In case the doctor doesn’t totally remove bacteria from the abscessed tooth, after some time the infection restarts again that’s why a second canal therapy is needed. This second procedure is called “root canal re-treatment”.
When the abscess affects posterior teeth like molar or premolar, it is more difficult to remove all the infected material accessing the area from the tooth enamel.
In this particular case some dentists prefer the apicoectomy approach instead of the root canal. In other words, instead to drill the crown, the endodontist cuts the gum and makes a small hole in the bone to reach the infected area by accessing the opposite side.
In case of the tooth is completely damaged by the caries and the dental abscess spread all around, the last chance is the tooth extraction and the disinfection of the hole leaved by the removed dental element (“alveolar socket” is the correct medical term).
Antibiotic and antibacterial mouthwash
This is a controversial topic in the dentistry field because some doctors believe that antibiotics are necessary to fight the tooth infection caused by an abscess while others consider them useless and harmful.
It is not this article goal to tell you who is right. In order to provide you with the most complete information about antibiotic for tooth abscess treatment, you’ll find an exhaustive list of common antibiotics the dentist may prescribe you. Please, in case you are pregnant and suffer because a dental abscess, let your doctor know about your condition before to take any drugs.
- Amoxicillin (Augmentin);
- Ampicillin and sulbactam (Unasyn);
- Clindamycin (Cleocin);
- Erythromycin (EES, E-Mycin, Ery-Tab)
- Metronidazole (Flagyl);
- Penicillin VK (Veetids)
- Ticarcillin and clavulanate (Timentin)
Over-the-counter pain killers and medication
- Ibuprofen (Advil or Motrin);
- Chlorhexidine gluconate mouthwash (0.2%).
7 tooth abscess treatment and home remedies
1) Salt water oral rinse
Salt water is the most old and used abscess home remedy simply because it works especially at the early dental infection stage. So as soon as you recognize the firsts abscess symptoms you can put a tablespoon of salt in half glass of warm water and mix until the salt is completely melted. Rinse your mouth for 2 minutes paying attention to focus on the infected area. The salt properties are helpful to kill the bacteria and to promote the healing.
2) Hydrogen Peroxide-containing homemade mouthwash
Hydrogen peroxide is an affordable natural tooth abscess home remedy. It contains hydrogen and oxygen mixed in different diluted percentages (the most common is 3%). Hydrogen peroxide is well known for its antiseptic and antibacterial properties that are ideal for treating an abscess.
How to use it ?
Just fill half of a coffee cup with 50% of hydrogen peroxide and 50% of plain water and mix the two ingredients. After brushing and flossing use the prepared solution to rinse your mouth as you usually do with your daily mouthwash.
Pay attention to not swallow hydrogen peroxide because it may cause you side effects like diarrhea and stomach pain. To see the first results, you should repeat the procedure three times a day for 1 week and then just twice a day.
3) Oil pulling as treatment for abscessed tooth
Oil pulling is an additional effective home remedy to get rid of tooth abscess pain and infection. The procedure is very easy and it should be repeated several times along the day for 2 weeks.
You just need to put a half teaspoon of a good essential oil in your mouth and swish it around teeth and gums. There is a chemical attraction between the essential oil and the bacteria membrane so they remain trapped in the oil and removed from your oral cavity as soon as you spit it.
Which essential oil should you buy ? there are several types of oil you can use but the most used for pulling are: olive oil, sesame or coconut oil.
In order to calm down the sore spot. coconut oil can also be used to gently massage the painful gum tissue with your finger.
4) Whiskey, vodka or pure alcohol rinse
Rinse your mouth with whiskey or pure alcohol. This is a granny’s abscess remedy indicated to relieve the pain caused by tooth infection. Alcohol acts its anesthetic and antibacterial effect, relieves pain and partly removes bacteria. Alcohol should not be swallowed, rather hold it in the mouth for 30 seconds, then spit it out. Many doctors are against this remedy for the irritating effect of alcohol on the oral mucosa.
5) Colloidal silver (CS) for a proven tooth abscess treatment
Colloidal silver is an effective tooth abscess home remedy. It can be used either locally or internally.
For the topical use you can choose from:
- Rinse the mouth with a tablespoon of this type of silver for 4 to 6 min every 5 hours or more frequently in case of severe pain.
- Spray: you should apply it directly to the painful zone;
- Abscess plug: put a small amount of CS on a gauze and apply it to the tooth or swelling that causes pain.
6) Black Tea Bag
Why black tea can be a proved abscess home remedy ? The point is that black tea contains polyphenols and tannins that have anti-inflammatory and antibacterial effects. so applying a tea bag on the dental abscess you can get a double result. First, tannins reduce the dental infection so your pain will decrease. Second, the black tea ingredients will kill the oral bacteria that cause tooth decay and bad breath.
How does it works ?
- First you need to put a black tea bag in a cup with warm water for 5 min;
- When the content of the bag is completely wet, put it on the area of the abscess and gently press the bag itself.
The tea and its curative ingredients can reach the infected tissue and start to relieve the pain as well as to kill the bacteria.
7) Apple Cider Vinegar
Apple cider vinegar is well known as home remedy for an abscessed tooth. Its anti-inflammatory and disinfectant properties help to keep under control pain and inflammation.
Laser therapy for abscessed tooth infection
As mentioned above, the most important goal treating an abscessed tooth is the infection removal. This means that the dentist had to be sure that no bacteria or infected tissue has been left in the tooth canal.
It is very hard to reach that goal using manual or mechanical dental instruments due to the root shapes that often are irregular (“S” shape).
Here is where the laser makes the difference and can be the definitive method to treat the tooth abscess. Unlike conventional dental instruments, the laser has two main feature:
- can target both aerobic and anaerobic bacteria that caused the tooth infection and decontaminate the surrounding area;
- has a biostimulatory effects: it accelerates the healing response with minimal pain and swelling following the procedure
The laser therapy in tooth abscess treatment, represents a complementary procedure that complete the conventional protocol and it is not an alternative to the standard one.
How long does it take for an infected tooth to heal ?
This is a very hard question to answer because it depends on the infection severity, how badly damaged the tooth is and the dental abscess treatment your dentist thinks is required.
After the draining procedure that lets the pus coming out, the cheek swelling starts to decrease as well as the pain. If you follow the doctor instructions, after two or three days, the drainage from the abscess should be minimal to none. All sores should heal in 10-14 days.
Even if the bump, the swelling and the sore disappear it doesn’t mean that the periapical pathology is solved. You still need medication or surgery treatment to save your tooth or to get it removed.
How much is abscess removal cost (no insurance) ?
The price for dentistry procedures can easily scare patients because we all know that dentists are expensive especially for people without insurance.
So what is the dental abscess removal cost in the US ? A quick answer is: $700 to $5,500 !
I think you are asking yourself why so much difference. The point is that, as seen above in this article, abscess treatments are different and it depends on which one is the best to solve your case.
The most affordable price is related to the initial visit, x-ray exam to get the clinical picture and the cure of the cavity that caused the infection.
If that is not enough the doctor has to go with the root canal treatment to get rid the bacteria from the dental root and preserve the tooth. This is the case where the abscess removal cost will be the most expensive because you also need a prosthetic crown in place of the natural one.
Does the insurance cover the cost of dental abscess treatment ?
The dental infection therapy is usually included in the basic health insurance and the dental infection treatment cost depends on your personal insurance coverage plan.
So to know what is the amount of money you have to pay out-of-your-pocket to get the dental infection removed, you should talk to the dentist that accepts the type of dental insurance you subscribed.
Can an abscess in the mouth kill you ?
The percentage of people who died due to a dental abscess is really low; at the same time, an explanation is required.
The tooth abscess is not the direct cause of death but the infection at the base of the dental pathology could.
In 2007 a 12 y. o. guy from Maryland died because bacteria from an abscess infected his brain.
So yes, if you feel tooth pain caused by infection, the infection itself can be deadly if leaved untreated.
Practices to prevent dental and gum abscess
Preventing a dental abscess as well as caries and gum disease is directly connected with adequate oral hygiene practices.
Best oral hygiene practices
- brushing twice a day (not to hard);
- flossing once daily especially before to go to sleep;
- consider the possibility to use fluoride toothpaste that gives your teeth additional protection against tooth decay;
- rinsing with an antibacterial mouthwash (chlorhexidine gluconate is excellent to keep bacteria under control);
Bad habits better to avoid
- Quit to smoke;
- Limit alcohol consumption;
- Do not drink or eat junky or sticky foot (soda, sports drinks high in sugar, potato chips, dried fruits, high calories snacks).
Routine check-ups and professional cleaning at the dentist
We all know that all health problems caught in time can be easier to solve. That’s true for dental infection too.
So we strongly recommend you to visit your dentist office at least twice a year to get your full mouth examination, x-ray exam to discover hidden cavities and your teeth professionally cleaned.
If you still have your wisdom teeth, you should pay more attention on them because they can causes gum infection that may lead to abscess.