When the inside of your mouth gets hurt or irritated, bacteria may enter and cause an infection. Sometimes you will see a painful swelling filled with pus (a thick, yellowish fluid). If the pus can’t drain out, the area will get more swollen and painful. This is known as an abscess. The abscess forms a barrier around the infection. This is one way that your body tries to keep a bacterial infection from spreading.
Abscesses can form very quickly. Sometimes they form only one or two days after the infection starts. A tooth-related abscess (also called a periapical abscess) occurs inside the tooth. This happens when the tooth’s nerve is dead or dying. This type of abscess shows up at the tip of the tooth’s root. Then it spreads to the surrounding bone.
Most abscesses are painful, so people usually seek treatment right away. Sometimes the infection causes little or no pain. If an abscess is not treated, the infection can last for months or even years. It will not go away on its own, so it’s important not to ignore the symptoms.
If the infection is not treated, it can damage the surrounding bone and teeth. A hollow tunnel sometimes forms through the bone and skin to allow pus to drain. This tunnel is called a fistula or “sinus tract.” You might see or feel this opening inside your mouth. It looks like a pimple. If you have pus draining through a fistula, you might notice a strange taste in your mouth.
The buildup of pressure causes the pain of an abscess. Draining the abscess through a fistula reduces the pressure. The pain will disappear. However, the infection still needs to be treated.
Sometimes, an abscess that isn’t treated can form a fluid-filled bubble (cyst) in the jaw bone. If the tooth is severely broken down and can’t be saved, the cyst may come out when the tooth is extracted. If the tooth can be saved, you will need a root canal to remove the infected nerve. If this treatment does not heal the cyst, you may need surgery to remove it.
In rare cases, the infection that causes an abscess may spread and lead to serious health problems.
What You Can Do
Abscesses are always serious because the infection may spread to other parts of the body. Call your dentist for an appointment.
If you can see or feel a pimple-like swelling on your gum, rinse your mouth several times a day with a mild salt-water solution. Use 1/2 teaspoon of salt in 8 ounces of water. This may help draw the pus out and relieve pressure. Even if the rinse seems to help, you still need to see your dentist as soon as possible.
What Your Dentist/Endodontist Will Do
An endodontist will typically treat your abscess with a root canal procedure or endodontic surgery. This involves removing the bacteria from the empty canals within your tooth, cleaning, shaping and filing the root canals, and sealing the empty space. Then, after some time to be certain the treatment was successful, you’ll visit your dentist who will put a crown or other restoration on the tooth to protect and restore it to full function. After the dentist restores it the tooth will continue to function like your natural teeth.