Tooth Infection: Signs, Symptoms & When to See a Dentist

The pain usually starts small. A twinge when you drink something cold, a dull ache that shows up at night, a tender spot on your gum you keep touching with your toothbrush. Then it stops being small. Within a few days you are chewing on one side of your mouth and wondering whether this is a wait-and-see problem or a call-the-dentist-today concern.

If you're dealing with an infection, it is almost always the latter. A tooth infection will not clear up without treatment from a dental provider, and the longer it sits, the further it can travel beyond the tooth¹.

Here is how to recognize an infected tooth, what causes one, and when the situation calls for same-day care instead of a scheduled appointment.

What Is a Tooth Infection?

A tooth infection happens when bacteria get past a tooth's protective outer layers and reach the soft inner tissue called the pulp, which holds blood vessels, nerves, and connective tissue². Once the irritation becomes irreversible, the pulp dies, and a pocket of pus develops³. That pocket is a tooth abscess.

Abscesses fall into three types, based on where they form:

• Gingival: Develops in the gums and usually spares the tooth and its supporting structures.
• Periapical: Forms at the tip of the tooth root, often after decay or a fracture lets bacteria reach the pulp.
• Periodontal: Starts in the bone and tissue that support the teeth and is more common in adults.

Tooth Infection Symptoms

Tooth infection symptoms usually start with pain; additional signs could include:

• A severe or persistent toothache that may radiate to the jaw, neck, or ear
• Increased sensitivity or discomfort when eating or drinking something hot or cold
• Pain when chewing or putting pressure on the affected tooth
• Fever
• Swelling around the face, cheek, or neck, which can sometimes cause issues breathing and swallowing
• Swollen or tender lymph nodes beneath the jaw or along the neck
• An unpleasant or foul smell coming from the mouth
• A sudden release of foul-tasting, salty fluid followed by relief from pain, which may occur if an abscess bursts

Fading pain can be misleading. When an infection kills the pulp, the nerves inside stop working and the pain stops with them, while the bacteria keep spreading into surrounding tissue. You might not notice an infection at first, which is why routine dental exams are vital. A professional will catch problems that self-monitoring misses⁴.

What Causes a Tooth Infection?

Anything that creates an opening for bacteria to enter a tooth or the surrounding tissue can cause an infection that can lead to an abscess. The most common routes include:

• Severe cavities: Decay destroys the tooth's hard outer surface, giving bacteria a path to the pulp.
• Broken, cracked, or chipped teeth: Bacteria seep into any opening and travel inward.
• Gum disease: As periodontal disease progresses, bacteria reach the deeper tissues around the tooth.
• Tooth injury: Trauma can damage the inner pulp even when there is no visible crack.

A wisdom tooth infection follows a slightly different path. When a wisdom tooth breaks through the gum only partially, the tissue flap left behind traps food and bacteria, a condition called pericoronitis that a dental provider can treat⁴.

Certain factors raise the odds. People who smoke are about twice as likely to get tooth abscesses as people who do not, and dry mouth, poor oral hygiene, and a weakened immune system all make infection easier to develop¹.

Frequently eating and drinking sugary foods contributes to the cavities that start the process. Cavities are also easy to miss in their earliest stages, which is one reason dentists take X-rays at regular intervals⁵.

Can a Tooth Infection Spread? Why You Shouldn't Wait

Untreated infections spread, and the timeline is unpredictable. Left alone, a tooth abscess eventually reaches the surrounding tissue, and that can take days, weeks, or months. Spread to other parts of the body is rare, though the consequences are severe when it happens⁶.

Signs that an infection has moved beyond the tooth include⁷:

• Headache, fatigue, and dizziness
• Fever, chills, sweating, or skin flushing
• Swelling that makes it hard to open the mouth, swallow, or breathe
• Reduced urination, darker urine, and confusion
• Rapid pulse and lightheadedness
• Breathing faster than 25 breaths per minute
• Stomach pain with diarrhea or vomiting

Documented complications of an untreated infection include osteomyelitis, cavernous sinus thrombosis, cellulitis, parapharyngeal abscess, and sepsis⁶. Head to the nearest emergency room if a tooth abscess comes with a fever of 100.4 degrees Fahrenheit or higher, confusion, difficulty swallowing, an elevated heart rate, or facial swelling¹.

How Dentists Treat a Tooth Infection

Treatment targets the bacteria trapped inside the tooth, and the approach depends on how much damage the tooth has already sustained.

• Incision and drainage: The dentist makes a small cut in the abscess to drain the pus and may place a small rubber drain to keep the area draining.
• Root canal: The dentist removes the infected pulp and fills and seals the space, which usually saves the tooth. Most root canals are finished in one or two visits, and a single appointment lasts an hour and a half to a few hours.
• Extraction: When an abscessed tooth is damaged beyond repair, removal becomes the remaining option.
• Antibiotics: Medication helps fight off remaining bacteria, though it does nothing about the affected tooth itself.

Once bacteria settle inside a tooth, they destroy the surrounding tissue, including the blood vessels antibiotics travel through to reach the bacteria⁸.

Note: Not every dental infection calls for antibiotics. A professional can often treat an infection at the site during an appointment⁹. While waiting for an appointment, over-the-counter pain relievers, a cold compress on the jaw, and chewing on the opposite side of the mouth can take the edge off¹⁰.

How to Prevent Tooth Infections

Adopt these habits to prevent tooth decay and reduce the risk of infection:

• Drink water that contains fluoride
• Brush your teeth for two minutes twice a day using fluoride toothpaste
• Clean between your teeth each day with traditional floss or a water flosser
• Swap out your toothbrush every three to four months, or earlier if the bristles become worn
• Cut back on sugary foods and frequent snacking between meals
• Schedule routine dental exams and professional cleanings
• Use an antiseptic or fluoride mouthwash for additional protection

If you think you're experiencing a tooth infection and are based in New York or New Jersey, book an appointment with Beam Dental for emergency dentistry before it gets worse.

Frequently Asked Questions

What does a tooth infection feel like?

Most people describe severe tooth pain that shoots, throbs, or radiates toward the ear, jaw, or neck, hurting either constantly or only while chewing. Sensitivity to hot and cold temperatures and pain under biting pressure are also common.

Can a tooth infection go away on its own?

No. The pain can stop if the infection kills the pulp inside the tooth (since the nerves no longer work), but the bacteria keep spreading and destroying surrounding tissue. Seek care even after the pain fades.

How do I know if my tooth infection is spreading?

Watch for fever, swelling of the face or neck, difficulty swallowing or opening the mouth, a rapid heart rate, and confusion. Contact a dentist immediately if any of these appear, and go to the emergency department of the nearest hospital if no dentist is available.

Do I need antibiotics for a tooth infection?

Not always. Draining the abscess, deep cleaning, performing a root canal, and pulling a tooth that cannot be saved are the primary treatments for a tooth infection, and these procedures often clear the infection without antibiotics.

Dental providers typically prescribe antibiotics to treat severe infections, to treat infections that are spreading, and to prevent infection after a dental procedure. When they are prescribed, the infection generally begins to clear two to three days after the first dose¹¹, though a course usually takes at least a full week to finish.⁸

How dangerous is an untreated tooth infection?

Anyone searching how long until a tooth infection kills you is asking about a real risk that has become extremely rare thanks to advances in medicine and dental hygiene. Untreated, an infection can spread to other tissues over weeks or months and lead to life-threatening complications¹².

Sources

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