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An endodontic abscess

Shows up on an x-ray

Endodontic Abscess

What is an endodontic abscess?

An endodontic abscess is a pocket of pus that forms in the jawbone at the tip of a tooth root.

You may realize you have an abscess because the tooth hurts when you tap or bite on it, you have a bad taste in your mouth, or you experience pain and swelling. On the other hand, you may be unaware of an abscess because you have none of these symptoms at all.

What causes an endodontic abscess?

An endodontic abscess begins when bacteria, which are always present in your mouth, infect the inner pulp layer of the tooth and kill the pulp.

The infection can then spread from the pulp chamber, down the root canals, through the tip of the root, and into the jawbone. There the pus builds up and creates a hole in the bone. This hole in the bone is the abscess. Sometimes, the body attempts to rid itself of the infection by draining the abscess near the infected tooth, forming a gumboil. Two common causes of infection in the pulp are deep cavities and fractured or broken teeth. Both allow the bacteria to get through the enamel and dentin layers of the tooth and into the pulp. Sometimes a blow to the tooth allows bacteria to enter the pulp. In some cases, though, there is no apparent cause.

Treating an endodontic abscess

It's important to treat an endodontic abscess because it creates pressure inside the bone and ligaments surrounding the tooth. It can also cause excruciating pain. An infected tooth will never heal on its own. Left untreated, an endodontic abscess can damage the adjacent soft tissue, lead to bone loss, be a continuing source of infection that drags down your immune system, and may even be life threatening.

To find an endodontic abscess, we perform a thorough examination, including x-rays. On an x-ray, a dark area at the root tip indicates an endodontic abscess. We may also use an electric pulp tester to determine whether the pulp is inflamed or infected. Root canal therapy is often the first treatment because it removes the infection and usually heals the abscess, too. Sometimes however, even after root canal therapy, the infection continues to grow. In that case, retreating the tooth with root canal therapy or a further surgical procedure, called an apicoectomy, will stop the infection and restore the health of your tooth.

An endodontic abscess is painful and can lead to much more serious conditions. It should be treated right away to maintain a healthy mouth and body.