Dental abscess

Last revised by Dr Yuranga Weerakkody on 18 Apr 2022

Dental (periapical) abscesses are an acute infection of the periapical tissue around the root of the tooth.

Patients may present with pain, edema, and purulent discharge localized to the site of pathology with or without fever and tender cervical lymphadenopathy 1.

Dental caries result in damage to the tooth enamel, which allows bacteria access to the dental pulp. From here the infection spreads down the root canal and out of the apical foramen where abscess formation occurs 2,4.

Early dental abscesses, within the first ten days, may not have any radiographic features 3,4.

  • well-defined lucency at or distal to the root apex, usually <10 mm with or without surrounding (<22 mm) sclerosis 2-4
  • the tooth or teeth involved often show signs of caries
  • an empty socket may indicate recent extraction for infection

Some dental abscesses will spontaneously resolve but dental surgery and antibiotics are generally required 1,4. Most (~90%) will show some evidence of healing (bone filling the lucency) one-year post-treatment 4.

Dental abscesses can exert pressure on the root of the tooth, which contains the neurovascular bundle, and can lead to devitalisation of the tooth 5

Complications range from contiguous or hematogenous spread of infection and include potentially fatal conditions 1-4:

Possible differential considerations include:

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Case 1
    Drag here to reorder.
  • Case 2: OPG
    Drag here to reorder.
  • Case 2: with masticator space abscess
    Drag here to reorder.
  • Case 3
    Drag here to reorder.
  • Case 4
    Drag here to reorder.
  • Case 5: with parapharnygeal abscess
    Drag here to reorder.
  • Case 6: with maxillary sinusitis
    Drag here to reorder.
  • Case 7: submandibular odontogenic abscess
    Drag here to reorder.
  • Case 8: OPG
    Drag here to reorder.
  • Case 9
    Drag here to reorder.
  • Case 10: OPG
    Drag here to reorder.
  • Case 8: odontogenic abscess
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.