Know if You Have an Infected Tooth

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Do you have tooth or jaw pain? Is it a nagging, sharp, throbbing pain? Does it hurt more when you chew or eat? You might have a tooth infection, or what’s called an abscess. This is when — whether by bad dental hygiene, trauma, or other injury — bacteria enter your tooth’s inner pulp and infect the root or the gums and bone near the root (called periapical and periodontal abscesses).[1] An abscess is not just painful — it can kill your tooth or even spread infection to nearby areas of your body, even reaching your brain in severe cases. If you think that you have one, you should see a dentist or doctor right away.

Steps

Monitoring Tooth Pain

  1. Monitor any toothache that you feel. An infected tooth can cause mild to severe pain in that area, depending on how infected the tooth is. The pain is generally continuous and sharp.[2] Some dentists describe it as a shooting, throbbing, or gnawing type of pain. This pain will radiate upwards and downwards along the side of your face to places like your ear, jaw or head.[3]
    • Your dentist will tap your teeth with a dental probe. If you have an abscess, you will feel pain when the infected tooth is tapped — what the Merck Manual describes as “exquisite” sensitivity.[4] — or when you bite down.
    • Keep in mind that if your infection is severe, you will most likely be unable to pinpoint the exact tooth causing the pain because the whole area around the tooth will also feel painful. Your dentist will need to take x-rays to identify which tooth is infected.
    • If the infection destroys the pulp at the root of the tooth — the "heart" of the tooth — the pain may stop because your tooth has died; however, this does not mean that the infection will stop. It will continue to spread and destroy other tissue and bone.[5]
  2. Pay attention to dental sensitivity. Some amount of sensitivity to hot and cold is normal in teeth. This is caused by small holes in the enamel called “caries” and often doesn’t require special treatment;[6] however, an infected tooth becomes very sensitive to hot and cold substances. For instance, you will most likely experience severe pain if you eat a hot bowl of soup — a shooting pain that lingers after you have stopped eating.[7]
    • Aside from hot and cold, you might also experience pain when you eat sweet products, as the sugar can irritate the infected tooth and create pain.[8]
    • All of these repeated sensations may affect the pulp and inflame the entire system of vessels and nerves. In most cases this damage is irreversible and you will need to have a root canal.
  3. Watch for pain while eating. Chewing may also be painful when you have an abscessed tooth, particularly with solid foods. Biting or chewing applies pressure to your tooth and jaw and can cause pain. This pain may linger even after you stop eating.[9]
    • Keep in mind that there can be other causes of pain in the teeth or jaw while chewing. It does not always mean that you have a tooth infection. For example, sometimes people internalize stress and clench their jaw muscles, which can lead to very similar kinds of pain. This is a “Temporomandibular joint and muscle disorder.”[10]
    • Some people also grind or clench their teeth when they sleep, which is known as bruxism.
    • Sinus or ear infections may also cause discomfort like a toothache, but these usually feature a headache. One symptom of heart disease, as well, is tooth and jaw pain. No matter what it turns out to be, you should take the pain seriously and see a dentist.[11]

Recognizing Other Symptoms

  1. Look for swelling or discharge of pus. Check to see if the gums around your tooth have become red, swollen, and sensitive. You may notice a gum boil, a pimple-like formation on the gum near the infected tooth and up to the root. You may also be able to see white pus in the sore or around the tooth — the pus is actually what causes the pain because it puts pressure on your tooth and gums. When the pus begins to drain, your pain will subside some.[12]
    • Bad breath or a foul taste in your mouth is another give away. This is directly related to the build-up of pus. If your tooth is severely infected, pus may begin to drain from the tooth or from a gum-boil into your mouth. It may happen suddenly, in a rupture of the abscess, and it will taste metallic or sour. It will also smell bad. Avoid swallowing the pus.[13]
  2. Note any tooth discoloration. An infected tooth can change in color from a yellow to a dark brown or grey color. This change is caused by the death of the pulp inside of your tooth, namely a “bruising” from dying blood cells.[14] The dead pulp will emit toxic products, like anything that decays, that will reach up to the surface of your tooth through the porous passageways in your tooth.[15]
  3. Check for swollen neck glands. A tooth infection may well spread to adjoining areas of the body, especially if you have let it go untreated. For example, the infection can affect your jaw, sinuses, or the lymph glands under your jaw or in your neck. These latter may swell, feel tender, or be too painful to touch.[16]
    • While any tooth abscess is serious and needs treatment, please seek medical attention immediately if you have an infection that spreads. Because it is close to vital organs — notably your brain — such an infection can easily become life-threatening.[17]
  4. Beware of fever. Your body can react to an infection by raising your internal body temperature, causing you to run a fever. Normal body temperature can range from 97 to 99°F (36.1 to 37.2°C). A fever is usually a reading over 100.4°F (38°C).[18]
    • Along with fever, you may also develop chills, headache, or a feeling of nausea. You may feel weak and become dehydrated, so be sure to drink water.
    • Seek medical attention if your fever continues to rise or does not respond to medication, or if you run a temperature of over 103°F (39.4°C) for several days.[19]

Tips

  • See your dentist regularly to prevent the development of infected teeth.
  • If you have any tooth fractures, cavities, or broken fillings, getting them filled and fixed right away to prevent tooth infection.

Warnings

  • If you have these symptoms, see your dentist immediately. If you do not take care of your infected tooth right away, you may end up losing the tooth.

Sources and Citations