Tooth Abscess Stages: Symptoms and Treatment Options

A tooth abscess is a painful and potentially serious oral health condition. This condition occurs when pus collects in a pocket of tissue around a tooth, usually due to a bacterial infection. If left untreated, a tooth abscess can lead to severe complications, spreading the infection to other parts of the body. In this article, we will explore the stages of a tooth abscess, its symptoms, various types, causes, and treatment options. Additionally, we will discuss the risks of leaving dental abscesses untreated, and provide tips for preventing them.

What is a Tooth Abscess?

A tooth abscess is a pocket of pus caused by an infection. The abscess is often accompanied by throbbing pain, sensitivity to hot or cold temperatures, biting pain, and swelling of the face or gums.

When a tooth becomes abscessed, it is usually due to untreated dental decay or a cracked tooth. The bacteria from the decay or crack can penetrate the inner layers of the tooth, reaching the pulp chamber, where the nerves and blood vessels are located. This invasion triggers an immune response, leading to the formation of pus as the body tries to fight off the infection.

A periapical abscess is the most common type of tooth abscess. It occurs when the infection spreads from the pulp chamber to the surrounding tissues at the tip of the tooth’s root. This type of abscess can cause severe pain and can even lead to the formation of a fistula, which is a small channel that allows the pus to drain out of the abscess.

On the other hand, a periodontal abscess originates in the gum tissue alongside the tooth. It is usually caused by gum disease or an injury that allows bacteria to enter the gum pocket. This type of abscess can cause localized swelling, tenderness, and a bad taste in the mouth.

It is important to seek prompt dental treatment for a tooth abscess as it can lead to serious complications if left untreated. The infection can spread to the surrounding tissues, causing cellulitis or even a life-threatening condition called Ludwig’s angina. In some cases, the infection can also spread to other parts of the body through the bloodstream, leading to systemic complications.

When you visit a dentist for a tooth abscess, they will typically perform a thorough examination, and may take dental X-rays to determine the extent of the infection. Treatment options may include draining the abscess, prescribing antibiotics to eliminate the infection, and performing root canal therapy or tooth extraction, depending on the severity of the abscess, and the condition of the tooth.

Prevention is key when it comes to tooth abscesses. Maintaining good oral hygiene practices, such as brushing twice a day, flossing daily, and visiting the dentist regularly for check-ups and cleanings, can help prevent dental decay and gum disease, which are the main causes of tooth abscesses. Additionally, avoiding habits such as consuming excessive sugary foods, and drinks can also contribute to reducing the risk of developing a tooth abscess.

What does a tooth abscess look like in my mouth and on an X-ray 

A tooth abscess can be invisible to the naked eye if it is small enough, or deep enough in the oral tissues. If the dental pus drains to the outside of the oral cavity, it can appear like a red swollen pimple. Despite looking like a pimple, do not try to “pop” the abscess, it can severely harm the tissues if not handled correctly. When a dentist sees an abscess on a dental X-ray, it can look like a radioleucent(black) circle surrounding the root tip. 

Symptoms of a Tooth Abscess

The symptoms of a tooth abscess vary depending on the stage of the infection. Initially, you may notice persistent toothache that becomes increasingly severe. The pain may radiate to your jaw, ear, or neck. This throbbing pain can be debilitating, making it difficult to focus on daily tasks or get a good night’s sleep.

As the infection progresses, you may experience additional symptoms that indicate a more severe abscess. Swelling and redness in the face or gums can occur, making it uncomfortable to eat or speak. The affected area may feel warm to the touch, indicating inflammation, and the body’s immune response.

Tender or swollen lymph nodes in the neck or jaw area can also be a sign of a tooth abscess. These small, oval-shaped glands play a crucial role in the body’s immune system, and when they become enlarged and tender, it indicates an ongoing infection.

Pain when biting or chewing is another common symptom of a tooth abscess. The pressure exerted on the tooth can worsen the pain, making it difficult to chew, or even take a sip of a hot or cold beverage.

In some cases, a tooth abscess can cause a low-grade fever. This is the body’s natural response to an infection, as it tries to fight off the bacteria. If you notice a persistent fever alongside other symptoms, it is important to seek dental care immediately.

Another unpleasant symptom of a tooth abscess, is foul-smelling breath, or a bitter taste in the mouth. The infection can produce an odor that is difficult to ignore, and the taste can linger even after brushing your teeth or using mouthwash.

If you experience any of these symptoms, it is crucial to seek dental care immediately to prevent complications and relieve the pain. Ignoring a tooth abscess can lead to further infection, damage to surrounding teeth and tissues, and potentially even systemic infections that can affect your overall health.

Types of Dental Abscess

As mentioned earlier, there are two main types of dental abscesses: periapical and periodontal abscesses. A periapical abscess occurs when the bacteria invade the dental pulp, which is the soft tissue inside the tooth that contains nerves and blood vessels. On the other hand, a periodontal abscess develops when the infection affects the gums and surrounding tissues, usually as a result of gum disease or a foreign object lodged between the tooth and gums.

What Causes Dental Abscess

A dental abscess is primarily caused by bacteria entering the tooth or gum tissue. The most common bacteria associated with abscessed teeth are Streptococcus and Staphylococcus species. Poor oral hygiene, tooth decay, cracked teeth, and gum disease can all contribute to the development of an abscess. In some cases, dental procedures or trauma to the tooth can also lead to an abscess.

Tooth Abscess Stages

A tooth abscess typically progresses through several stages. Understanding these stages can help you identify the severity of your condition and seek appropriate treatment. The stages of a tooth abscess are as follows:

Stage 1: Early Infection

In the early stage of a tooth abscess, bacteria enter the tooth or gum tissue, causing infection. At this point, you may experience mild discomfort, sensitivity, or occasional toothaches. It is crucial to address the infection promptly to prevent it from progressing to a more advanced stage.

Stage 2: Abscess Formation

As the infection progresses, a pocket of pus starts to form in the affected area. You may notice increased pain, swelling, and tenderness. The abscess may appear as a small bump on the gum or a pimple-like lesion on the gum surface. If left untreated, the abscess can enlarge and cause more severe symptoms.

Stage 3: Spreading Infection

In the advanced stage of a tooth abscess, the infection can spread into the surrounding tissues and bones. You may experience severe pain, swelling that extends to the face or neck, difficulty opening your mouth, and pus drainage. In some cases, the infection can enter the bloodstream and lead to systemic complications.

Treatment for Tooth Abscess

The treatment for a tooth abscess depends on the severity of the infection and the individual’s overall health. In most cases, the abscess needs to be drained and the source of the infection eliminated. Treatment options include:

  1. Root Canal Therapy: This procedure involves removing the infected pulp from the tooth’s root canal system, cleaning the area, and sealing it to prevent further infection.
  2. Tooth Extraction: If the tooth is severely damaged or the infection is extensive, removing the tooth may be necessary. This is usually followed by replacing the missing tooth with a dental implant, or a bridge.
  3. Draining the Abscess: In some cases, your dentist may need to make an incision to drain the abscess and flush out the infected material. Antibiotics may also be prescribed to help clear the infection.

Your dentist will determine the most appropriate treatment plan based on your specific situation.

Risks of Leaving Dental Abscesses Untreated

Leaving a dental abscess untreated can have serious consequences. Here are some risks associated with untreated dental abscesses:

  • Spread of Infection: The infection can spread to the jawbone, sinuses, throat, or other parts of the body.
  • Oral Health Complications: Untreated dental abscesses can lead to bone loss, tooth loss, or the need for more extensive dental treatments.
  • Sepsis: Rarely, the infection can enter the bloodstream and cause a life-threatening condition called sepsis.

To prevent these complications, it is essential to seek prompt dental care if you suspect a tooth abscess.

Preventing Dental Abscesses

While dental abscesses can be challenging to prevent entirely, practicing good oral hygiene can significantly reduce the risk. Here are some preventive measures to consider:

  • Brush your teeth twice a day with fluoride toothpaste.
  • Floss daily to remove plaque and food particles from between your teeth.
  • Limit sugary and acidic foods and beverages, as they can contribute to tooth decay.
  • See your dentist regularly for check-ups and professional cleanings.
  • Address dental issues promptly, such as tooth decay or cracked teeth.

By following these preventive measures and maintaining good oral hygiene habits, you can minimize the chances of developing a dental abscess.


Understanding the stages, symptoms, and treatment options for tooth abscesses is crucial for maintaining optimal oral health. If you experience any symptoms of a tooth abscess, seek dental care promptly to prevent complications and alleviate pain. Remember, preventing dental abscesses starts with proper oral hygiene and regular dental check-ups. Take care of your teeth and gums to ensure a healthy and pain-free smile.


All Second Opinion Dentist content is medically reviewed and fact-checked by a licensed dentist to ensure the information is factual, current, and relevant.

  1. Tooth abscess – Symptoms and causes. (2019). Mayo Clinic.
  2. Abscessed Teeth. (n.d.). American Association of Endodontists.
  3. Tooth abscess: MedlinePlus Medical Encyclopedia. (n.d.).

About the author

Dr. Latecia Miller is a board-certified dentist and graduate of The University of Utah School of Dentistry. She has several years of clinical practice experience across a wide variety of cases, treatment, and research. Dr. Miller's primary goal is to spread her love of dental health to her patients and the public.