Symptoms & diagnosis
Abscessed tooth treatment in Burton upon Trent
A dental abscess is a pocket of pus produced by bacteria that have escaped from inside a dead tooth into the bone around the root. It may be excruciating, or it may be entirely painless. Either way it has a single source — the inside of the tooth — and treating that source is what cures it.
How an abscess develops
When the pulp dies after deep decay, a crack, a large filling or an injury, the hollow canals become a refuge for bacteria. With no blood supply left inside the tooth, the immune system cannot reach them, and their by-products trickle out through the root tip into the bone. The bone becomes inflamed, and over time a pocket of infection forms that may drain through a boil on the gum, swell the cheek or simply grow in silence.
The signs
- tenderness when biting or when the tooth is tapped, or a tooth that feels taller than its neighbours;
- a dull, throbbing ache that waxes and wanes;
- swelling of the gum, cheek or face, sometimes with a foul taste or smell;
- a pimple on the gum that discharges and returns;
- a tooth that has darkened, or an old crown or filling that has started to ache;
- a shadow at the root tip on an X-ray taken for some other reason.
Why antibiotics are not the cure
Antibiotics travel in the blood, and a dead tooth has none. They can shrink a spreading swelling and are occasionally prescribed when you are unwell or treatment has to wait, but they never reach the bacteria inside the canals, so the infection returns when the course is finished. Repeated courses also contribute to resistance. The cure is to remove the source.
Removing the source
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 with an existing root filling, retreatment or endodontic surgery achieves the same by another route. Once the source is gone the body clears the remaining infection and the bone regrows, which is confirmed on an X-ray a few months later. Where a swelling is draining into the mouth, the first visit may include releasing it so that you are comfortable while treatment is planned.
When it is an emergency
A swelling spreading rapidly — particularly towards the eye, beneath the tongue or down the neck — difficulty swallowing or breathing, or a high temperature with feeling generally unwell need medical help at once 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 emergency root canal treatment.
Will the tooth have to come out?
Usually not. The size of the shadow on the X-ray is not by itself a reason for extraction; even large areas of infection 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 alternatives to extraction.