Why Does a Tooth Die: Understanding a Tooth Abscess


First of all, what the heck is a tooth abscess?  Generally a tooth abscess occurs when a tooth dies (rest in peace little buddy).  When the tooth dies, an infection forms at the root tip.  This infection, if left untreated, eats away at the bone in the jaw and can cause you to lose the tooth.

Abscesses usually follow a toothache that is sharp or the kind that wakes you up at night.  You may feel cold sensitivity that lingers after let’s say, eating ice cream.  This will eventually stop, and the tooth will feel better.  Usually this means that the tooth was in the process of dying and is now dead.  That is when the abscess starts to form.  The dead tissue that is left in the canals of your tooth ends up feeding the infection.  You may think that when the pain stops, that the infection will go away, but unfortunately, it won’t and you will then need to make the decision in how to treat it.

There are two ways to treat an infected tooth.  One is to have it extracted.  This will obviously leave a space and you may want to have this space replaced depending on where it is located in your mouth.  Your options are a dental implant (which is becoming a very popular option), a bridge or a partial denture.  The other way to treat an infected tooth is to have endodontic treatment, otherwise known as a root canal.  Ah yes, the dreaded two words of the dental industry, root canal.  Root canals are very common and have become a fairly routine procedure.  The dentists at Szmanda Dental do them often and are quite good at them.  If the dentist feels that there might be a complication, you will be referred to a specialist who has lots of little gadgets to deal with an atypical case.


Why does a tooth die?  There are numerous reasons why including decay, a deep filling, defects in a tooth and trauma.  A tooth could have a large filling in it that was placed and then will decide to die several years later.  Sometimes a tooth can experience trauma, such as hitting the handlebars of a bike with your mouth or a soccer ball to the face as we are kids and not much will happen.  But, there is always a chance that the injured tooth or teeth will eventually become abscessed as we get older.  And, there are times when there just isn’t a reason for the tooth to die, which is always perplexing.

What are the signs of an abscessed tooth?  As mentioned before, a toothache that throbs, lingering cold sensitivity, heat sensitivity, darkness is color, swelling or drainage, which can cause a bitter taste.  There may be a pimple that forms on the gum tissue.  Another sign is pressure to chewing.

Sometimes patients aren’t sure which tooth is causing the problem as pain can radiate. One of the easiest ways to detect an abscess at our dental office is a simple tapping of a dental instrument on the infected tooth.  This usually causes pain or irritation and makes it easier to pinpoint which tooth is having the problem.  An x-ray also can let us know where the problem is coming from.  We may also check with ice or have you bite on something that will cause pressure.

One of the crazy things about a tooth abscess is that the patient may not feel pain at all.  They may have had it for years and not even know it.  This type is called a chronic periapical abscess.  In this case, we tend to find out about those by taking a panoramic (entire jaw) x-ray or a full-mouth series of x-rays, which will show all of the root tips of the teeth.  At Szmanda Dental, we like to take these particular x-rays every 3-5 years and this type of abscess is one of the reasons we do it.

There have been numerous times at our office when a full-mouth set of x-rays is taken and an abscess shows up on the film.  Even though the patient may not have experienced any pain, it is still an infection that is running through the body and needs to be taken care of.  A course of antibiotics may be given to curb the infection, but it will not go away until the dead tissue from the tooth or the tooth itself is removed.

The best way to avoid getting an abscess is by practicing great dental hygiene, and having regular dental cleanings and check-ups.  But even though you may have the most awesome, dental hygiene, things happen and there just may be no way to avoid it.  All the candy and soda one had as a teen may have given us some larger fillings and even the best care can still leave us with a dying tooth as an adult.

As far as trauma goes, we obviously do not live in bubbles.  Go out and enjoy life, but a great way to protect your teeth is to wear a mouth guard when participating in sporting activities.  It’s really important to do this, especially kids.  But, even adults can get a little crazy playing racquetball, basketball or any contact sport.  Believe me, as my husband can attest, a racquetball racquet is not the most enjoyable when it comes in contact with your mouth.

Just remember, if you are having a toothache, please don’t hesitate to call us at Szmanda Dental Center.  Even if the toothache has gone away, that doesn’t necessarily mean that you are out of the woods.  We would love to help you and if you are in pain, you will be seen the day that you call thanks to our Urgent Care program.