Dental abscess

Dr Henry Knipe et al.

Dental (periapical) abscess is an acute infection of the periapical tissue around the root of the tooth.

Patients may present with pain, oedema and purulent discharged localised to the site of pathology with or without fever and tender cervical lymphadenopathy 1.

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 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

Plain radiograph / OPG and CT
  • well-defined lucency at or distal to the root apex, usually less than 1 cm 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

Complications

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 haematogenous spread of infection and include potentially fatal conditions 1-4:

Possible differential considerations include


Share article

Article Information

rID: 26220
System: Head & Neck
Section: Gamuts
Synonyms or Alternate Spellings:
  • Periapical abscess
  • Periapical dental abscess
  • Dental abscesses
  • Periapical abscesses

Support Radiopaedia and see fewer ads

Cases and Figures

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

    Alert accept

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

    Alert accept Thank you for updating your details.