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Six Stages Of Dental Abscesses – Symptoms & Treatments

Excerpt: Also known as a “tooth abscess”, or “oral abscess”, a dental abscess occurs from a localized infection within the tooth that results in a collection of pus.
Table of Contents

What is a dental abscess?

Tooth abscess (oral abscess), are when a dental abscess occurs from a localized infection within the tooth that results in a collection of pus. The pus will cause an abscess to form as a result of infection by bacteria. This infection will eventually spread to other oral structures which will cause discomfort and pain as well.

Are There Different Types Of Abscesses?

There are three main types of dental abscesses, they include:

Gingival Abscess (Gum Abscess)

This abscess is a rapidly expanding painful lesion that grows between the gums and the teeth. The gingival abscess is generally caused by the presence of a foreign object like a toothpick splinter or a small piece of food. You most likely see a red swelling abscess with a shiny smooth surface in the first 48 hours. Later on, the abscess will appear to be pointed and will have a greater chance of erupting.

Periodontal Abscess

The periodontal abscess is a pocket of pus that occurs in the gum tissue. The appearance of this abscess will be a shiny smooth swollen bump that protrudes out from the gums. This abscess will be sensitive to touch, and the teeth near the abscess may become sensitive, or start to loosen. As the name suggests, this abscess occurs in patients with periodontal disease.

Periapical Abscess

This abscess forms at the root of your teeth. A pocket of pus will form as a result of local bacterial infection. If a crack, chip, or opening appears in your teeth, bacteria can enter it. Once the bacteria get inside, if it is not treated in time, the bacteria will proceed down to the root and cause an abscess to form. Inflammation, swelling, and varying degrees of pain will typically occur.

Are there different stages of a dental abscess?

An abscess usually occurs as a result of severe decay, there are 5 distinct stages of the abscess:

Enamel Decay

In the first stage of decay, the enamel will be targeted. Enamel decay is usually caused by a build-up of plaque. The decay can also appear in the form of cavities which will look like little black or brownish spots on your teeth. If left untreated, these cavities can grow and will eventually cause bigger issues.

Dentin Decay

At this stage, the decay has reached the next layer of your teeth. The layer after the enamel is called “dentin”, it will look slightly yellowish. You will probably notice increased sensitivity when consuming hot or cold food or beverages. If you notice a hole in your tooth, you have probably reached this stage.

Pulp Decay

This is when more serious, impactful issues can occur. Once you reach this stage, the bacteria will begin to attack the inner pulp, and will eventually attack the nerve of the tooth. The nerve will eventually die, however, it will cause severe tooth pain.

Abscess Formation

In the final stages of decay, the bacteria will spread into the gums and jawbone which will cause a dental abscess to form as a result of the infection. Depending on where and when the abscess forms, you may see or feel a varying array of symptoms.

Man lying on side with toothache

Dental abscess symptoms

Dental abscesses will have many symptoms depending on the type of abscess, and severity of the infection.


  • Severe toothache
  • Painful, swollen lymph nodes in the neck area.
  • Redness of your gums
  • Swelling
  • Sensitivity to temperature
  • Constant unexplained bad breath (halitosis)
  • Neck or jaw pain
  • Pain when eating
  • Trouble when you eat or swallow
  • Fever
If your abscess ruptures, you will experience a foul tasting, salty fluid, and your mouth will smell. Because of the rupture, you will also notice some relief. However, you should immediately call your dentist if this happens to occur.

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How Is A Dental Abscess Treated?

Depending on the abscess, you will have multiple options for treatment:

Abscess Draining

In the early stages, an abscess can be drained. The dentist will accomplish this by making a small incision to the abscess to drain the pus. The area will be cleaned, and antibiotics will be administered. 

Root Canal Therapy (RTC)

This is a fairly common dental treatment, it involves taking a small specialized tool that will clear out the infected inner pulp of the tooth, which will prevent the infection from spreading. Once the inner part of the tooth has been cleared out, the dentist will generally recommend the procedure be completed with a crown. RTC can compromise the integrity of the tooth.

Dental Extraction

The tooth will be extracted before the infection can spread to the gum tissue and jaw bone. This is one of the most inexpensive ways to deal with an infected tooth, but it is generally the last resort. If the patient has insufficient coverage or budget, it may be the only option.

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