How to tell if you have a tooth abscess? 12 symptoms explained

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Have you been having a strange and unpleasant feeling around one of your teeth and you suspect a dental abscess? So how to tell if you have a tooth abscess? In this article, we will tell you how to understand this dental issue, what to do about it, and discuss the treatment a bit. Are you ready to find out if you have an abscessed tooth?

We’ll teach you how to tell if you have a tooth abscess, let’s get into it.

What are the symptoms of a tooth abscess?

If we want to teach you how to tell if you have a dental abscess we need to talk symptoms. A dental abscess is the pus formation around a tooth root and in the innermost layer of the tooth, the pulp, caused by a bacterial infection. This tooth infection also affects adjacent structures like gums and bones as the dental pulp is in direct contact with bones and gums. Knowing the symptoms of a dental abscess results in a faster diagnosis and thus a quick treatment. A tooth abscess has different manifestations, here’s how to tell if you have a tooth abscess:

  • Symptom 1: pulsating pain in different positions
  • Symptom 2: swallowing or chewing difficulties
  • Symptom 3: extreme sensitivity to hot and cold food and drinks
  • Symptom 4: facial swelling
  • Symptom 5: swelling and redness on the gums
  • Symptom 6: generalized symptoms
  • Symptom 7: bad breath or absurd taste
  • Symptom 8: difficulty opening the mouth  
  • Symptom 9: a dark tooth
  • Symptom 10: a tender and a loose tooth
  • Symptom 11: you actually have none

Symptom 1: pulsating pain in different positions

Toothache is the main symptom of dental abscess. The pus accumulation and pressure on the tooth root cause pain. it is a throbbing and intense pain that usually starts suddenly and gets worse as time goes by. In some cases, especially in more advanced stages, the pain can radiate to the cheeks, throat, neck, or ear. The patient can suffer from this severe pain while eating or even while sleeping.

Pain while chewing or biting

When the tooth or the gums are infected, you feel pain whenever you apply pressure on them. That’s why people feel pain around an abscessed tooth while chewing or biting.

Pain while lying down

Patients can feel this pain in different positions. The pain persists and even gets worse while lying down. When we lie down, blood circulation towards the head increases. This puts more pressure on the oral structures such as teeth. People with an abscessed tooth experience sleep disturbance due to throbbing pain.

Symptom 2: swallowing or chewing difficulties

In severe cases when the abscess had spread to the neck and throat, it can cause a sore throat and swell there. So in addition to hardships associated with chewing, swallowing can be difficult as well due to extreme pain.

Symptom 3: extreme sensitivity to hot and cold foods and drinks

The dental pulp is where the nerves and blood vessels are located. When the pulp is infected the nerves are also affected. So when the person consumes cold or hot foods or drinks, the tooth becomes sensitive to these stimuli due to nerve damage. The patient feels irritating pain and discomfort.

Symptom 4: facial swelling

If the infection starts to spread to the face, it can affect the skin and its underlying soft tissue which results in infection and inflammation. This causes facial swelling, redness on the affected area, and tenderness.

This is a serious sign and the patient should immediately seek treatment.

Symptom 5: swelling and redness of the gums

The infection can spread through the tooth root to the gums and create pus. Their infection and inflammation lead to gum swelling and redness. The inflamed gum tissue which is filled with pus may look like a bulge that can rupture and drain to the mouth causing a foul taste.

Symptom 6: generalized symptoms

In cases of an untreated dental abscess, the infection can enter the bloodstream and cause general symptoms. This can be a life-threatening condition and immediate medical intervention is required. Common Generalized symptoms include:

  • Fever
  • Swollen lymph nodes on the neck
  • General unwellness


In higher tooth abscess stages, where the infection is spread to different parts of the body, the general immune response of the body against bacteria is fever. When the infection travels to other body parts than the oral cavity high temperature is among the symptoms.

Swollen lymph nodes on the neck

Swollen lymph nodes are a sign that the body is fighting against the growing infection. Usually, they return to their normal size after treatment and recovery. However, this is a serious sign that the patient should get treatment as soon as possible.

General unwellness

When the infection spreads through the body, one common symptom is the general feeling of illness. Other symptoms associated with this unwellness can be nausea and vomiting. If a patient shows these symptoms they should immediately start the treatment as if this situation is left untreated it can lead to septicemia. This is a condition in which the infection can get into the blood vessels and cause a dangerous bloodstream infection.

Symptom 7: bad breath or absurd taste

The foul smell the person might feel is because of infectious and sticky liquid produced by the infection. The bumps on gums people see are pus accumulation, The terrible taste is due to the pus and infectious discharges emptying into the mouth following the abscess rupture.

Symptom 8: difficulty opening the mouth

in severe cases, the person can face hardships in opening their mouth due to excruciating pain. The infection has spread to the jaw bones and causes pain and discomfort. Also due to the spreading of the infection to the jaw bones and the muscles in this area, spasms can occur. This causes a restriction in the motion range of the mouth, also referred to as lockjaw. In this situation, the mouth can not be opened more than 35 mm on average.

Symptom 9: a dark tooth

When an abscess occurs, the infected pulp will eventually die and will secrete some byproducts of the dead tissue. These byproducts will get into the outer surface of the tooth through very tiny pours and will change its color. The tooth becomes darker and it is a sign of a tooth abscess.

Symptom 10: a tender and a loose tooth

The infected tooth becomes painful and spreads the infection to the near tissues. As a result, the gum and bone tissues that hold the tooth in its position can lose strength and the tooth becomes loose. Without medical care and treatment, the permanent natural tooth might fall off.

Symptom 11: you actually have none

Due to the damage to the living part of the tooth, the tooth pulp, symptoms such as tooth pain might not be seen. As the tooth root loses the ability to sense pain or discomfort, the abscess might go unnoticed until it reaches higher tooth abscess stages with general signs and symptoms.

But how to tell if you have a tooth abscess if there are no symptoms? An abscessed tooth can be diagnosed via an X-Ray. That’s why regular dentist visits are recommended. If you are someone who regularly visits your dentist, out of like, you’ll know you have a tooth abscess even though you have no symptoms.

What to do if you have a tooth abscess?

So far we have explained how to tell if you have a tooth abscess. If you notice any of the mentioned symptoms, call your dentist immediately. The dentist will examine and evaluate your condition thoroughly and will start the appropriate dental treatment accordingly. Your dentist will also ask for an X-Ray of the affected tooth and oral cavity to evaluate the size of the abscess.

If your dentist is not available, you should go to an emergency department to seek professional medical treatment, especially if you are feeling ill and unwell.

How are tooth abscesses treated?

Many people ask if a tooth abscess goes away on its own. The answer is absolutely no.

Even though there are some home remedies to relieve the pain temporarily, for a complete and full cure you should get professional help and medication.

To relieve the pain you can get over-the-counter pain relief medications such as NSAIDs, use cold to increase the swelling and pain, rinse with salt water, avoid having cold or hot meals and brush regularly. In cases of an abscess rupture rinsing with warm water can be helpful to reduce the pain and drain the pus. However, this does not prevent the patient from visiting a specialist for proper treatment.

Severity level 1: Drain the puss

Usually, the first step to treating an abscess is draining the pus through surgery. The dental surgeon does this dental procedure either by making a hole in the infected tooth or by making an incision in the gum tissue to let out the pus.

Severity level 2: Root canal treatment 

After the drainage, the whole area should be cleaned and rinsed off the infection and the dead tissues. Mostly, pus drainage is followed by a root canal treatment. This dental procedure is done to remove the infected tooth pulp. Once the pulp is removed, the area is filled with another material as a mature tooth can survive without its pulp. This is done to prevent recurrent infection and to save the tooth.

Severity level 3: Tooth extraction

In case of severe damage when the dentist is unable to save the tooth, tooth extraction is necessary. This will help the pus to drain through the empty tooth socket.

If the abscess is present in the bone and/or the jaw, surgery is required.

After the procedure is done, the dentist prescribes antibiotics for better medical care and to prevent further recurrent infections.

We hope this article has answered all your questions regarding how to tell if you have a tooth abscess, what to do if you have one, and how it is treated. If you have any further questions or concerns about dental abscess symptoms and how to diagnose them, feel free to contact us at Dentfix. We assure you a professional medical consultant will reach back to you in no time to help you with any piece of information you need.

We are here to save your magnificent smile!


Santiago-Rosado LM, Lewison CS. Trismus. [Updated 2021 Nov 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.

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