Tooth infections are a form of dental abscess caused by oral bacteria (usually various strains of Streptococcus mutans). This condition is often very painful and can cause serious complications including tooth loss if left untreated. Fortunately, it is possible to prevent most cases of tooth infection with proper oral hygiene, healthy lifestyle habits and regular prophylactic cleanings. If a tooth abscess does develop, prompt treatment usually makes it possible to save most of the tooth structure.

How Do Tooth Infections Develop?

Infections in the pulp of a tooth almost always develop as a result of dental caries (cavities). Bacteria in the mouth release acids as they feed and multiply. These waste products dissolve healthy enamel and allow the bacteria to penetrate further and further into the tooth. Once the cavity has penetrated to the living tissue in the center of the tooth, the bacteria can enter and infect the pulp. It is also possible for bacteria to gain access to the pulp through a chip or crack in a damaged tooth.

What Happens Inside the Infected Tooth?

When a tooth becomes infected, the body sends white blood cells to attack the bacteria. The interior of the tooth becomes filled with dead pulp tissue, bacteria (both living germs and those that have been killed by the immune system) and white blood cells. This material is called pus. It is an off-white color and has a foul smell. Inflammation is a side effect of the body’s immune response to the tooth abscess. Damage to the nerve in the tooth root causes ongoing pain. If the nerve is completely destroyed, the pain may stop. However, the bacteria may migrate through the root of the tooth into surrounding tissue, creating an even larger abscess and causing more swelling and pain. The bacteria can even infect the jaw bone or sinus cavities.

What Symptoms Do Tooth Infections Cause?

Toothache is the most common sign of an infection. This can be a persistent throbbing or shooting pain that ranges from painful to unbearable. Your mouth may have a bitter taste and your breath is likely to smell bad. There may be pus draining from your gum line near the infected tooth. The lymph nodes in your neck can swell up as part of your body’s immune response. You may find chewing uncomfortable or painful as your tooth becomes sensitive to pressure. Drinking hot or cold beverages may also trigger sensitivity in the infected tooth.

A fever and swelling in your face, mouth or jaw can be signs that the infection is getting rapidly worse. In that case, you need to seek immediate dental care. If it is after regular office hours and you can’t find a dentist who will see you, go to the emergency room. The longer you wait, the more severe the infection will become. In cases of severe tooth abscess, the infection may travel to the brain, causing swelling of the brain tissue and resulting in death.

How Are Tooth Infections Treated?

The immediate treatment for an infected tooth is usually a root canal. This procedure involves drilling into the tooth and removing the dead tissue and pus. The root canal (where the nerve and blood supply enter the tooth through its root) is thoroughly cleaned out. The empty space inside the tooth is filled and sealed. The hole created at the beginning of the procedure is filled with a metal amalgam or composite dental filling. Depending on the amount of decay present, the tooth may need to be restored with a crown instead of just a filling.

If the infection is not localized inside the pulp of the tooth, the dentist will prescribe an antibiotic to help get the infection under control and keep it from spreading. If infection returns or persists after a root canal, a more extensive procedure called an apicoectomy is performed. In this procedure, the tip of the tooth root is cut out and the opening is sealed. If this still doesn’t resolve the problem, or if the damage to the tooth is too extensive to restore, the tooth may be extracted.

Can You Prevent Tooth Infections?

Tooth infections are usually preventable. Children can have their molars protected from dental decay that leads to abscessed teeth with a dental sealant. Eating a nutritious diet and practicing proper brushing and flossing to remove plaque reduce the chances of getting a tooth infection. Regular dental visits are also important. Your dental hygienist can clean tartar and plaque from areas you missed. In addition, cavities can be identified via x-ray and treated before they penetrate to the center of the tooth.