By dentist Dr. Richard Mitchell
Tooth abscess symptoms can vary a LOT, depending on how advanced the infection is.
At the very start, the symptoms of your tooth infection can be quite mild. It may be as simple as a tooth that's just a little tender to bite on. You notice it when you're eating, and you try to avoid that tooth when chewing something hard. At other times the tooth is OK to bite on, BUT sore if you tap it from the side with your fingernail.
Either way, that tooth feels different to your other teeth. This MIGHT also be due to having bitten on something hard, jarring the tooth.
You'll know within a few days, as a "bruised" tooth generally settles down fairly quickly, whereas symptoms of tooth infection tend to gradually get worse.
As the days go by, the tooth becomes more uncomfortable to pressure. You might even feel as if the tooth is being "pushed out of it's socket" a tiny bit. It seems like you can't avoid the tooth, constantly knocking it with the opposite teeth.
This is because the infection under the tooth creates a bit of pressure inside the tooth socket, which forces the tooth out of the socket slightly. This is what causes that sensation of constantly hitting the tooth with your opposite teeth, even though you are trying to avoid it!
What you might notice is that the tooth is NOT sensitive to temperature extremes at all. You can drink scalding hot coffee or ice-cold soda, and the tooth doesn't hurt. Weird, huh?
Not really. There's no pain on hot or cold because the nerve has died. There is no nerve inside the tooth anymore. It's the nerve inside the tooth that feels temperature.
Sure, you can tell if something is hot or cold from the gum sensation around the tooth, but it is the nerve deep inside the tooth that is most sensitive to fine differences in temperature. SO, it the nerve has died, the tooth cannot feel temperature anymore.
So where's the pain coming from?
The pain is coming from the infection in the jawbone socket where the tooth sits.
When the nerve inside a tooth dies, it shrivels up and then starts to decay. It becomes infected with bacteria. As the bacteria breed, they release toxins that gradually seep out of the tip of the root.
These toxins cause your immune system to set up a reaction, resulting in inflammation. So your dead tooth is sitting in an inflamed socket. No wonder it's sore to touch!
It's like having a big splinter in your finger. The skin is all red and swollen, and touching it is painful. Imagine that redness and swelling around a tooth. This should give you a good idea of tooth abscess symptoms!
As the infection gets worse, the gum next to the tooth may start to feel puffy, or even start to swell up. You could get a lump on the gum, which is quite tender to touch.
Generally the first thing a dentist will do is prescribe some antibiotics, to combat the infection and prevent things getting worse. You can read more about this at Tooth Abscess Antibiotics. Antibiotics will take down the worst of the pain and infection, but the dead, infected tooth will flare up again without further treatment. You can read about the options at tooth abscess treatment.
If can stick out the pain for long enough, without antibiotics, the abscess may work it's way out to the gum surface, causing a swelling.
Strangely, the tooth itself may become less tender when the gum swells up. This is because the swelling is a result of the infection on the root escaping out through the bone socket, releasing the pressure on the tooth. So now the tooth feels better, but the gum is sore!
Sometimes the gum swelling will pop, letting the infection drain out. You will have a bad taste in your mouth, and feel the swelling going down a bit.
But the infection isn't completely gone.
It's still around the tooth, being fed by the bacteria inside the tooth. You've only got a temporary break from the pain. The infection will build again, and the gum will continue to weep, until you get tooth abscess treatment.
On upper teeth, it's possible for your face to swell up, sometimes enough to close the eye on that side. You'll look like you've done 5 rounds with Mike Tyson! As before, the tooth responsible may be only slightly tender, whereas your cheek is very sore.
On lower back teeth (the molars), a swelling like this tends to come up under your jawline, and can spread into your neck.
This is when things get serious. These infections do not drain on their own. They are too deep. You will need to see a dentist, or go to your local ER.
As you can see, tooth abscess symptoms depend on how advanced the infection is.
At one extreme it's just a slightly uncomfortable tooth, while at the other extreme the symptoms of tooth infection can be very uncomfortable. As always, if you think something's not right, get a dentist to check it as soon as possible.