Signs You Might Have A Tooth Abscess And Its Stages

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Dental care is an important part of life, taught to people from the time they are children. Without it, people are at risk for cavities, inflamed gums, and toothaches. Poor dental hygiene can even put people at risk for more serious conditions, like a tooth abscess. This condition can be painful, and it can progress to multiple tooth abscess stages. 

In advanced stages of a tooth abscess, a patient’s health can be at risk due to complications, so prompt treatment is important. Fortunately, if caught early, a tooth abscess can be treated with little risk of complications.

What Is a Tooth Abscess?

A tooth abscess is a pocket of pus that forms in the tissues surrounding a tooth. This is the result of a bacterial infection from a pus-forming or purulent bacteria. This can form anywhere around or inside a tooth, but the most common location is at the tip of the root. 

The infection can also spread out to and past the gums and create bone loss in the jaw. Unfortunately, a tooth abscess will not simply recover on its own. Dental care is required for complete healing.

Is a Tooth Abscess Serious?

Yes. Although rare, a tooth abscess can result in death. If the infection spreads to the entire body, it can result in sepsis: an infection in the blood. Sepsis has symptoms such as breathing difficulties, increased heart rate, and a fever over 101 degrees Fahrenheit. A patient with sepsis should be taken immediately to the emergency room because it can be fatal. 

What Causes a Tooth Abscess?

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Many dental problems stem from bacterial infections. Bacteria can damage and decay teeth, creating cavities. It can also infect the inside of a tooth, extending to the roots. This is when root canals are performed. The infection can even extend out of the tooth and into the tissue or bone in the jaw. When this happens, it can form a tooth abscess.

Human mouths are full of bacteria under normal circumstances. Tooth abscesses are often due to multiple types of bacteria, such as streptococci and prevotella, getting from the main areas of the mouth into places they shouldn’t be. 

If there are pockets of space between the gum and a tooth, bacteria can invade that area, causing an infection and creating an abscess around this space. The risk for this increases if food particles and plaque fill these pockets. If an infection develops here, it could grow into one of the early tooth abscess stages.

What Are the Symptoms of a Tooth Abscess?

While some medical conditions are silent for some time, with only mild or inconclusive symptoms, the symptoms of a tooth abscess are immediate and intense. Patients usually experience continuous, severe pain around a tooth and the surrounding gum areas. There will also be swelling and redness around the infected area. This creates sensitivity to hot and cold foods as well as pain with chewing. Sometimes, the tooth will feel loose.

Because an abscess is a pocket of pus, there may be a discharge of pus from the infected area. Patients may notice a bad taste in their mouths. Finally, an abscess is a bacterial infection, so a fever is a common symptom for this and any bacterial infection; and it can run quite high as well.

If you are experiencing these symptoms, contact a medical professional because you could have one of the early tooth abscess stages. If a tooth abscess is present, immediate dental treatment is required.

What Increases the Risk of a Tooth Abscess?

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Poor Hygiene

One of main preventable risks of a tooth abscess is poor dental hygiene. If plaque builds up on teeth and under the gumline, it can cause inflammation and eventually create a pocket. Bacteria can infect that pocket and create an abscess. 

Poor dental health can also result in tooth decay and infection inside the tooth. This too can extend past the tooth, creating an abscess that could be both inside and outside the tooth. Regular brushing and flossing can decrease plague and remove bacteria. Dental cleanings can further remove plaque and bacteria, especially under the gumline.


Another preventable risk is a diet high in sugar. Sweet foods increase the risk for tooth decay, thus increasing the risk of infections. 


Another factor that can increase the risk for tooth decay is a dry mouth. This can be a result of medications or aging issues.

Weak System

Aside from dental hygiene, a weakened immune system increases the risks of any infection, including around the teeth. While a normal immune system may be able to keep a moderate level of bacteria around the teeth from creating an infection, a weakened system leaves you prone for infections to form and enter the early tooth abscess stages. Stress, exhaustion, and chronic illnesses are possible causes of a weakened immune system.

4 Tooth Abscess Stages

Based on location and size, one can identify 4 tooth abscess stages.

Abscess Only in the Tooth

This is an early stage of a tooth abscess where the infection is limited to the tooth. If the infection is the result of a decayed or a damaged tooth, this will be the first stage. Dental treatment can resolve an abscess at this stage.

Abscess in the Gum

This is another early stage of a tooth abscess where the infection has grown past the tooth and is now in the gums. It may have exited the tooth along the root, creating an abscess at the tip of the root: a common location. At this stage, treatment is still relatively uncomplicated.

Although this is the second stage, it is also possible for a tooth abscess to begin at this stage if the infection comes from pocket around the tooth. It is then possible for the infection to penetrate and grow inside the tooth.

Abscess in the Bone Around the Tooth

At this third stage, the abscess is becoming more serious. Bone loss commonly occurs at this point. Treatment becomes more extensive at this point and the patient is at risk of more severe complications if the infection grows.

Bodily Infection

This is the final stage where the infection has extended past the mouth and jaw and has entered the body. Sometimes the abscess can rupture, leaking pus into the mouth, creating a foul, salty taste. This can indicate that the infection has entered the body even though it can also reduce the pain. Sepsis occurs if the bloodstream becomes infected and can be life-threatening.

Some symptoms of bodily infection are the following:

  • Fatigue and malaise
  • Fever and chills
  • Dizziness
  • Increased heart rate
  • Dehydration with stomach pain

When patients are at this stage, they should seek emergency medical care immediately.

Does Treatment Change for Different Tooth Abscess Stages?

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Treatment will vary depending on the severity of the tooth abscess. The goal is to remove all of the pus, so the extent of the treatment will depend on the amount of pus. If the abscess is confined to the tooth, or only slightly extending into the gum, a root canal may be sufficient. For larger abscesses extending into the gum, a tooth extraction may be required. In more severe cases in the third stage, where there is bone infection or bone loss, further surgery and bone grafts may be required for recovery.

Aside from the teeth, a serious bacterial infection like a tooth abscess can affect the entire body. Antibiotic medication can prevent the infection from spreading beyond the tooth and could also reduce the inflammation. It can also prevent the infection from reoccurring during the recovery period. Pain medication can help with tooth pain as well as any body aches or fever that occurs as a result of the infection.

How Can One Prevent a Tooth Abscess?

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Dental hygiene is the best way to prevent a tooth abscess. Daily flossing and brushing two or three times a day will reduce plaque. Dental examinations and cleanings every six months further reduce plague and discover problems before they progress. A tooth abscess in one of the early stages will be detected during a dental examination and treated before it can grow to cause serious complications.

Finally, even if a patient has a weakened immune system or other medical condition, proper dental hygiene will help prevent any infection from forming in the mouth. In fact, these patients should carefully practice dental hygiene due to their increased risk of infection.


A tooth abscess is a painful and potentially serious dental condition. It is a pocket of pus from a bacterial infection that can be in or around the tooth, creating swelling and pain, especially with eating. At early stages, the abscess is confined to the tooth and nearby gums. This can easily be treated by a dentist. However, at later stages, the infection can spread to the body, creating a life-threatening condition called sepsis. For this reason, it is imperative that people with a tooth abscess seek dental or medical care immediately.