Tooth Abscess Stages: How It Starts and How To Prevent & Treat It 

A problem with your oral health may appear to develop overnight, but the chances are that you’ve had it for quite some time without realising it. A dental abscess is something that develops over time. 

Tooth abscess can even be life-threatening if it isn’t taken care of early on, That is why it’s important to be aware of the tooth abscess stages, how you reach them in the first place, and what you can do afterwards. The earlier the treatment, the better it is. 

What Is Tooth Abscess?

A tooth abscess is defined as a painful, localised collection of pus that develops due to a bacterial infection. It can affect the tooth, gums, jawbone and surrounding tissues. The abscess itself prevents the infection from spreading, but it doesn’t mean that you should leave it untreated. Mainly, there are two types of abscess: 

  • Periodontal Abscess: When the pus collects in the pockets between the gum and teeth. It affects the gum tissue and can be seen as a small swelling. It can develop in patients who have severe gum disease. 
  • Periapical Abscess: When the pus collects at the root of the tooth, it is known as a periapical abscess. The bacterial invasion takes place through an opening in the tooth, where it affects the pulp (the area containing nerves, blood vessels, and connective tissue) before reaching the root to create an abscess.  

There are different reasons why a person may end up with this condition, but it always involves the invasion of bacteria. Other than adults, it is also possible for children to develop a tooth abscess. And if it’s too severe, it can even damage the permanent teeth, according to the British Dental Association. 

While it is possible to treat a tooth abscess now, it was once among the leading causes of mortality. According to the London (England) Bills of Mortality, tooth infections were the 5th or 6th most common cause of death. 

What Are the Tooth Abscess Stages? 

The following are the tooth abscess stages. The problem worsens and progresses from one stage to another if it’s not treated. 

Stage 1: Enamel Decay 

This is one of the first tooth abscess stages. Protecting the dentin and pulp is the hard outer shell of the tooth, known as enamel. It’s the first line of defence, so it’s the first one to get damaged. Normally, our teeth have a “dental biofilm” on them. This is what accumulates to form plaque if the teeth are not taken care of due to one reason or another. 

The bacteria in plaque produce acids and lower the pH, which is what causes the enamel decay. At this tooth abscess stage, you may experience increased sensitivity than what’s considered normal. In addition, a demineralized enamel can leave white spots on the tooth.

Stage 2: Dentin Decay 

Surrounding the pulp of the teeth, this calcified tissue is one of the 4 that makes up the tooth. Compared to the enamel, it’s yellowish in colour. Once the enamel is decayed, the dentin is next. At this tooth abscess stage, the tooth sensitivity will increase. In addition, you may end up developing a small cavity. 

Stage 3: Pulp Decay 

The dental pulp is the innermost part of the tooth. As mentioned above, it contains nerves, tissues, and blood vessels. Once the infection reaches this tooth abscess stage, it can damage the nerves. This can result in pain. However, here, it should also be noted that because of nerve damage, some people don’t experience symptoms of tooth abscess. 

Stage 4: Formation of Abscess 

After the infection has spread deep into the tooth, it can spread to the bone and the surrounding tissue. In order to fight off the bacteria, the body’s immune system sends white blood cells. This process results in the death of some tissues, resulting in the pocket where the pus is collected.  

Stage 5: Loss of Tooth 

This is when the bacterial infection has severely damaged the tooth. At this tooth abscess stage, the tooth structure may be frail enough to collapse and break. You’ll end up losing your tooth. However, this does not mean that the abscess will resolve on its own. 

What Are the Symptoms of Different Tooth Abscess Stages? 

Your symptoms may vary depending on where you’re at in the different tooth abscess stages. Depending on that, you may experience the following: 

  • Throbbing pain in the affected area, which can radiate to the ear, jaw, and neck 
  • Pain in the tooth 
  • Redness and swelling 
  • Swollen lymph nodes around the face or neck 
  • Sensitivity to hot, cold and sweet foods
  • Bad breath 
  • Loose teeth near the affected area
  • Difficulty biting, chewing and swallowing
  • Fever 

A “draining fistula” is when the abscess starts to release the pus into the mouth. It can happen when the abscess has ruptured. You can end up with a foul, salty taste in your mouth. It’s a clear sign of infection, and you need to get in touch with your dentist as soon as possible.  

How Is A Tooth Abscess Diagnosed? 

If you notice anything unusual with your teeth, you should not wait for the problem to worsen to the other tooth abscess stages. Your dentist will perform an oral examination to determine whether or not you have an abscess. An x-ray may also be required. 

You might feel pain in some of your teeth when you bite or when the dentist taps on that particular tooth. Among swelling, warmth and redness, oozing pus is another sign of infection. 

What Are the Causes of Tooth Abscess? 

You may have developed a tooth abscess because of one or more of the following reasons: 

Poor Oral Hygiene 

The dental biofilm on your teeth is normal and natural. However, it becomes problematic when it’s not cleaned away and left to accumulate. As the bacteria eat away at the different layers of the tooth, the risk of an abscess increases. 

When you don’t have good dental hygiene, you can also end up with gum disease, which makes it even more difficult to keep the teeth clean. The pockets trap bacteria and food particles in them, worsening the problem. 


An opening is all the bacteria needs to enter the tooth. If your tooth has cracked or chipped due to physical trauma following an injury or accident, you might end up with an abscess. 

This also becomes possible because the blood supply to the tooth is cut off, which means it isn’t getting any nutrients needed to grow and stay alive. You can also slowly injure your own teeth if you have bruxism. 

Eating Sugary Foods 

Just like you like to eat sugar, so do the bacteria in your mouth. If you feed more of it to them, they’ll form plaque and lower the pH. This is more worrisome if you also don’t have good oral hygiene. 

Weak Immunity 

Since it’s an infection, your body’s immune response is important. If it’s too weak because of certain health conditions or their treatments, you are at a greater risk of developing a tooth abscess. This can happen if you have HIV/AIDS, cancer, diabetes or are undergoing chemotherapy/radiation therapy. 

What Is the Treatment for A Tooth Abscess? 

The treatment for this problem may vary depending on the tooth abscess stage and why you have developed it in the first place. While you’re waiting to get an appointment, though, you may need to take painkillers for pain management. 

Scaling & Root Planing 

If the reason why you have developed a tooth abscess is gum disease, your doctor may recommend scaling and root planing to remove the hardened plaques. The treatment will involve cleaning the pockets and the area below the gumline. 

Surgical Incision & Drainage 

The pus in the abscess needs to be drained. It can be painful as the surgeon makes an incision into the abscess. A rubber drain may also be inserted in the area. After the pus has been drained, your dentist may prescribe antibiotics. 

Root Canal Treatment

If you’re at the pulp decay tooth abscess stage, you might end up needing a root canal. In this, the pulp is removed, and the interior of the tooth is cleaned. Afterwards, it is filled with gutta-percha and topped off with a dental crown. You may need to visit the dentist multiple times for this. 

Tooth Extraction 

If the tooth is severely damaged and there’s no way to save it or reconstruct it, then it becomes necessary to extract it. Afterwards, the pus is drained, and you may be prescribed antibiotics. You may need dental implants following this treatment. 

What If You Leave the Tooth Abscess Untreated? 

One of the biggest risks of leaving an abscessed tooth untreated is that it can be fatal. It can also cause serious health complications by spreading to other areas of the body, such as the brain, heart, and bone. The infection can end up “poisoning the blood.” This condition is known as septicemia or sepsis, and it can progress to a septic shock, which has a very high mortality rate.  

How Can You Prevent Tooth Abscess? 

You can prevent a tooth abscess from developing by doing the following: 

  • Maintain good oral hygiene, which means brushing twice a day with fluoride toothpaste and flossing.
  • Get a new toothbrush once the bristles of the old one have frayed. 
  • Make sure to use an antiseptic mouthwash. 
  • Eat a healthy, well-balanced diet. 
  • Make sure to get regular dental check-ups to prevent the progress of tooth abscess stages. 

All these can help prevent your problems from worsening. 

Can You Treat A Tooth Abscess At Home? 

You should not try treating your dental abscess at home by yourself. That means you should not pop it, prick it, or squeeze it. This can worsen the infection. You need to wait for your dentist’s appointment. Meanwhile, you can do the following at home to better manage the symptoms of tooth abscess:

  • Use warm compress
  • Do salt water rinse
  • Eating from the opposite side of the mouth 
  • Avoiding too hot or cold foods 
  • Be very gentle when brushing your teeth

Concluding Remarks 

A dental abscess can be a very dangerous oral health problem if it is not treated. There are different reasons why it develops, and it progresses through different tooth abscess stages. It’s important to know about them so that you can get help early on. Also, there are a few ways to prevent the problem entirely. However, if you have developed it, make sure to wait for your dentist’s appointment.

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