A tooth abscess occurs when there is a bacterial infection in the nerve or pulp of the tooth. This infection can spread from the tooth root into the surrounding bone and tissues. Knowing the signs and symptoms of a spreading tooth abscess is important to get prompt treatment and prevent serious complications.
What are the symptoms of a tooth abscess?
Some common signs and symptoms of a tooth abscess include:
- Throbbing, severe toothache that can radiate to the jaw, neck or ear
- Sensitivity to hot and cold temperatures
- Fever and chills
- Swollen lymph nodes under the jaw or in the neck
- Swelling around the cheek, jaw or neck on the affected side
- Redness or swelling of the gums around the infected tooth
- Bad breath or foul taste in the mouth
- Gum that bleeds easily around the infected tooth
- Pimple or blister on the gums near the infected tooth
- Loosening of the infected tooth
The severity of symptoms depends on the extent of the infection and how much it has spread beyond the tooth. Mild cases may have minimal swelling and pain that comes and goes. More advanced abscesses typically cause severe, constant pain and other symptoms.
How do you know if the infection is spreading?
There are several signs that indicate a tooth abscess is advancing and spreading to surrounding tissues:
- Increasing pain: As the infection spreads, you may experience more intense, constant throbbing pain that is not relieved by over-the-counter pain medications.
- Swelling: Swelling that starts in the gum around an infected tooth may spread to the cheek, jaw and neck on the same side.
- Difficulty opening mouth: It may become hard to open your mouth fully as swelling increases.
- Difficulty swallowing or breathing: Severe swelling and infection spreading down the throat can make swallowing and breathing more difficult.
- Tooth feels loose: Increased infection in the bone around the tooth can lead to loosening of the tooth.
- Gum blister/pimple: A pimple-like bump on the gum near the infected tooth indicates pus building up under the gum.
- Bad taste/smell: A persistent bad taste or foul odor in the mouth may indicate advancing infection.
- Fever, chills, swollen lymph nodes: These systemic signs mean the infection is spreading beyond the tooth and surrounding tissues.
The more of these symptoms you have, the more likely it is that the tooth abscess is spreading. Spreading abscesses require prompt medical treatment before the infection progresses too far.
What problems can a spreading tooth abscess cause?
If left untreated, a spreading tooth abscess can lead to serious health risks, including:
- Cellulitis: This is a potentially serious bacterial skin infection that can develop from a spreading facial abscess.
- Osteomyelitis: An infection of the jaw bone that can be challenging to treat with antibiotics.
- Sinus infection: The infection may spread upward into the maxillary sinus in the case of upper tooth abscesses.
- Ludwig’s angina: A rapidly spreading infection under the jaw that causes severe neck swelling and can block airways.
- Sepsis: A life-threatening, whole-body inflammation caused by the spread of infection into the bloodstream.
- Brain abscess: Rarely, the infection may spread from upper teeth or sinuses to the brain.
In addition to health risks, a spreading infection can destroy the jaw bone around the tooth leading to tooth loss. Seeking emergency dental care is critical at the first signs of a spreading abscess.
How is a spreading tooth abscess diagnosed?
A dentist can diagnose a tooth abscess and determine if it is spreading based on:
- Dental exam: Checking for loose teeth, gum swelling, bleeding, blisters, bad odor and sensitivity to percussion.
- X-rays: Dental X-rays can show infection in the root and bone destruction around the affected tooth.
- Testing: Gently pressing on swollen areas to assess the extent and checking lymph nodes for swelling.
- Medical history: Asking about the onset and severity of symptoms and how they have progressed.
- Risk factors: Poor oral hygiene, chipped/broken teeth and previous dental issues increase risk.
The dentist will determine whether the abscess can be treated with just a root canal or extraction, or if hospitalization for intravenous antibiotics and surgical drainage of the infection is needed in cases of extensive spreading.
What is the treatment for a spreading tooth abscess?
Treatment options include:
- Antibiotics: Powerful prescription antibiotics are used to control the infection’s spread and provide pain relief until definitive treatment.
- Root canal therapy: This can eliminate the infected pulp tissue and save the tooth if swelling is minimal.
- Tooth extraction: Removal of the tooth is required if it cannot be saved by root canal treatment.
- Surgery: Incision and drainage of the abscess may be needed to prevent further spread of infection.
- Hospitalization: Severe, rapidly progressing abscesses require hospitalization for IV antibiotics and close monitoring.
In addition to antibiotics and dental treatment, your dentist may prescribe medication for pain and swelling. Prompt treatment within 24 hours is needed to address a spreading infection before serious complications develop.
How can I prevent a tooth abscess from spreading?
You can lower your risk of developing a spreading tooth abscess by:
- Brushing and flossing your teeth thoroughly each day.
- Using antimicrobial mouthwash to reduce bacteria in the mouth.
- Seeing your dentist regularly for cleanings and checkups.
- Getting cavities filled quickly before decay progresses.
- Treating gum disease to prevent damage to tooth roots.
- Wearing a mouthguard if you play contact sports.
- Avoiding trauma to the teeth from chewing hard items.
- Seeking prompt care for any signs of an abscess before it worsens.
Good oral hygiene and dental care can prevent abscesses. But if you do develop a tooth abscess, seek emergency dental care right away if you notice signs it is spreading to prevent serious and even life-threatening complications.
When should I see a doctor?
You should seek emergency dental care right away if you have symptoms of a spreading tooth abscess. This includes:
- Severe, throbbing toothache and swelling that keeps increasing.
- Difficulty opening your mouth and swallowing.
- Fever higher than 101°F.
- Significant swelling extending into the neck or face.
- Sudden loss of feeling or numbness in the face, mouth or neck.
- Rapidly progressing gum blister, redness and swelling.
These signs indicate the infection requires urgent dental intervention. The abscess can spread quickly from the tooth to surrounding tissues in just hours or days. Prompt treatment is vital.
When to seek emergency care
Seeking emergency medical care is crucial if you develop any of the following along with a worsening tooth abscess:
- Difficulty breathing or swallowing
- Fever over 103°F
- Extreme weakness, fatigue or confusion
- Swelling spreading down into the chest or up into the eye region
- Severe infection of the gum, jaw or neck
- Skin redness and warmth over swelling
- Pus draining from the gums
- Neck stiffness and severe sore throat
- Racing heart, rapid breathing or fainting
These emergency symptoms can arise if the infection spreads into deeper facial planes, sinuses or down the throat. You may need hospital admission for IV antibiotics and drainage of the abscess to prevent life-threatening complications like airway obstruction, sepsis or meningitis.
FAQ
How long does it take for a tooth abscess to spread?
A tooth abscess can spread from the tooth’s root up into the bone and surrounding tissues in anywhere from a few days to a couple weeks. The rate of progression depends on the type of bacteria involved and how quickly you seek treatment.
Can a tooth abscess spread to the brain?
It is very rare, but a tooth abscess, especially in the upper jaw, can potentially spread from the tooth to the sinus and into the bones of the skull, leading to a brain abscess. This is a medical emergency requiring hospitalization.
Can a tooth abscess spread to the eye?
A severe tooth abscess in the upper jaw can cause infection to spread up through the cheek and into the soft tissues around the eye. This requires emergency medical care to prevent vision loss or permanent eye damage.
Can tooth abscesses go away without treatment?
A tooth abscess will not go away on its own without treatment. The infection will continue to destroy tooth and bone tissue until it drains out through the gum, spreads deeper into the face and neck, or enters the bloodstream.
How do you know if tooth abscess is healing?
Signs a tooth abscess is healing after treatment include: decrease in pain and swelling, improved ability to open the mouth, lack of fever, no more pus drainage, and no foul taste or odor.
The takeaway
A spreading tooth abscess is a severe dental infection that can quickly escalate and cause major health complications. Seek emergency dental care immediately if you notice increasing swelling, pain, difficulty swallowing or breathing, fever, or other signs the infection is worsening.
Getting prompt antibiotic treatment and drainage of the abscess is crucial to stop the infection before it spreads through large facial planes, the sinuses or down the throat. Good oral hygiene and regular dental care can help prevent painful tooth abscesses from developing in the first place.
