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Apical Abscess: Symptoms, Diagnosis And Treatment

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An apical abscess is one of the most common types of dental abscesses, which are serious dental issues that require treatment. When you have an abscess, it's important to visit your dentist promptly for diagnosis and treatment. Arriving at your appointment armed with a basic knowledge of what the abscess is can also help.

What Is an Apical Abscess?

A dental abscess is your body's inflammatory reaction to infection in the nerve of the tooth, as a study in the International Journal of Applied Dental Sciences explains. The abscess itself is a collection of pus arising from a source of infection in the root of the tooth, according to Merck Manuals. The collection of pus formed in response to infection can break through the tissues and discharge into the mouth.

As a study in BMC Oral Health notes, the estimated prevalence of apical abscesses in mature teeth is between 9.7% and 18.1%.


An article in Decisions in Dentistry outlines the two types of apical abscesses: chronic and acute. The symptoms of an abscess depend on the type.

A chronic abscess occurs gradually with little or no discomfort and occasional discharge of pus. On an X-ray, a chronic abscess will display bone destruction as dark regions in the bone, also known as radiolucencies.

An acute abscess occurs quickly and involves pain without stimulation, such as pain waking you up at night or when not even chewing, and extreme tenderness to pressure on the tooth. Pus may form with swelling of surrounding tissues. X-rays may appear normal. Often, an acute abscess comes with malaise, fever or swollen lymph nodes.

As the Mayo Clinic explains, severe dental abscesses can even lead to sepsis, which is a life-threatening infection in the blood stream. These severe manifestations can require hospitalization.


Your dentist will tap your teeth to assess sensitivity, take X-rays and possibly recommend a CT scan for further evaluation, according to the Mayo Clinic. Your history of symptoms will also aid the diagnosis.

Sometimes, it can be unclear which tooth is causing the abscess. As a study in the Journal of International Dental and Medical Research notes, if this is the case, your dentist may insert a gutta percha point — a flexible material — into the draining opening of the abscess. An X-ray will then trace the opening of the abscess straight to the primary source of infection.


Treatment for an apical abscess starts at the source of infection, as the Mayo Clinic explains. For large swellings, your dentist may need to drain the infection and deliver antibiotics if the infection has spread. For dental abscesses contained in the mouth, your dentist may recommend root canal therapy or an extraction of the infected tooth.

If you have any signs of an abscess, it's important to visit your dental professional. An infection can cause severe problems and spread to other regions of the body, making it a higher risk to your health. Arming yourself with this information can help you keep an eye on your dental health and make appointments with your dentist as necessary if an urgent concern arises, such as an apical abscess.

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This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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