Symptoms & diagnosis
Tooth abscess and root infection treatment in Nuneaton
A dental abscess is a collection of pus caused by bacteria that have spread from inside a dead tooth into the bone around its root. It can be excruciating or completely painless. Either way, the infection has a source — the inside of the tooth — and treating that source is what cures it.
How an abscess forms
When the pulp inside a tooth dies — after deep decay, a crack, a large filling or an injury — the empty canal space becomes a reservoir for bacteria that the body's defences cannot reach. They multiply and their by-products leak out of the tip of the root, provoking inflammation in the bone. Over time this becomes a pocket of infection, which can drain through a small boil on the gum, swell the face, or sit quietly and enlarge without any symptoms at all.
Signs of a root infection
- a tooth that is tender to bite on or to tap, or feels slightly raised;
- a dull, throbbing ache that may come and go;
- a swelling of the gum, cheek or face, sometimes with a bad taste or smell;
- a pimple-like spot on the gum that discharges and then returns;
- a darkened tooth, or an old filling or crown that has become uncomfortable;
- a shadow at the root tip on an X-ray taken for another reason.
Why antibiotics are not the answer on their own
Antibiotics travel in the bloodstream, and a dead tooth has no blood supply. They can reduce a spreading swelling and are sometimes prescribed when you are unwell or treatment must be delayed, but they cannot reach the bacteria inside the canals. The infection therefore returns, often within weeks, each time a course finishes. Repeated courses also contribute to antibiotic resistance. The cure is to remove the source. See antibiotics for toothache: what they can and cannot do.
How the infection is treated
For a tooth that has not been root-treated before, root canal treatment removes the dead tissue, disinfects the canals and seals them. For a tooth that already has a root filling, retreatment or an apicectomy does the same job by a different route. Once the source is gone, the body clears the remaining infection and the bone regrows around the root — a process followed on an X-ray some months later. Where a swelling is draining into the mouth, the first visit may include releasing it to make you comfortable while treatment is planned.
When it is an emergency
A swelling that is spreading quickly, especially one that affects the floor of the mouth, the eye or the neck; difficulty swallowing or breathing; or a high temperature with feeling generally unwell — these need medical attention straight away through NHS 111 or A&E, not a dental appointment. Severe pain or a localised swelling without those features should be seen promptly; say your symptoms are urgent when you book. See urgent endodontic care.
Can an abscessed tooth be saved?
Very often, yes. The size of the lesion on the X-ray is not, by itself, a reason to extract the tooth; even large areas of infection usually heal once the canals have been properly cleaned and sealed. The exceptions are a cracked root and a tooth with too little sound structure left to restore. See can my tooth be saved?