Dra. Cléo Salustiano In this article
SummaryWhere does a tooth infection come from, and what are the signs?How is a tooth infection treated, and what should you do until your visit?FAQRead nextTooth infection: signs, risks and what to do
Quick summary of this article+
A tooth infection comes from inside the tooth, the gums or a wisdom tooth and may cause pain, swelling, pus, bad taste and fever, or be silent. Treatment removes the source: root canal, gum drainage and cleaning or extraction. Antibiotics are a complement, not a solution, and only with a prescription. Facial swelling, fever or trouble swallowing need same-day care.
A tooth infection happens when bacteria reach the inside of the tooth or the surrounding tissues and the body responds with inflammation, pain and often pus. Common sources are deep decay reaching the nerve, a crack, a tooth that died after trauma, gum disease and inflammation around a partly erupted wisdom tooth. Signs range from throbbing pain and tenderness when biting to swelling, a pimple with pus on the gum, bad taste and fever.
In clinical practice, it is common to see patients who took antibiotics on their own, improved for a few days and returned with the same problem, sometimes worse. Antibiotics may temporarily control spreading infection, but they do not remove the source inside the tooth or gum pocket. Some infections are painless and found on a routine X-ray.
In this article, Dr. Cléo Salustiano (CRO-SP 170844), who handles dental emergencies in Mooca, East Zone of São Paulo, explains where tooth infections come from, how to recognize them, when they are urgent and how they are treated.
This article comes from Dr. Cléo Salustiano's dental office in Mooca, São Paulo (care in English, Portuguese and Spanish). See the root canal treatment page to learn how the treatment is done here and book your assessment.
Where does a tooth infection come from, and what are the signs?
Tooth infections come mainly from three sources: inside the tooth, when decay, a crack or trauma brings bacteria to the pulp; the gums, when periodontitis forms deep pockets; and a partly erupted wisdom tooth whose gum flap traps food. Signs may include pain, swelling, pus, bad taste and tenderness when biting.
From inside the tooth, the usual path is pulpitis, with lingering pain to hot and cold, then nerve death and an abscess at the root tip, with pain on biting, a tooth that feels high and gum or facial swelling. Sometimes a fistula forms, a small bump through which pus drains, and pain eases even though infection continues. Some infections are silent, revealed by a darkened tooth or a dark area at the root tip on an X-ray.
Signs of spreading infection need same-day care: increasing swelling of the face, under the chin or neck, difficulty opening the mouth, swallowing or breathing, fever, chills and malaise. Swelling moving toward the eye or neck, or difficulty breathing, requires a hospital emergency room.
How is a tooth infection treated, and what should you do until your visit?
Treatment removes the source: a root canal when it comes from inside the tooth, drainage and cleaning of the pocket when it comes from the gums, cleaning and sometimes extraction for a wisdom tooth, and extraction when the tooth cannot be kept. Antibiotics may complement treatment when there are signs of spread, but do not replace it.
Until your visit, keep the area clean, rinse with warm salt water if the gums are inflamed, use cold compresses on the outside of the face, avoid chewing on that side and use only pain relievers a professional has recommended. Do not apply heat, put tablets on the gum or pop the bump. Avoid self-medicating with antibiotics; delaying treatment can destroy bone, cost the tooth and, rarely, lead to serious spread.
In Mooca, Dr. Cléo Salustiano handles dental emergencies every day from 8 a.m. to 10 p.m., including Sundays and holidays, near Bresser-Mooca subway station, in Portuguese, English and Spanish. The visit includes an exam and X-ray to find the source and start treating the cause.
What are the signs of a tooth infection?
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Throbbing pain, tenderness when biting, lingering pain to hot or cold, swelling of the gum or face, a pimple with pus on the gum, bad taste or breath, a darkened tooth and, in more serious cases, fever and malaise. Some infections are silent and only show up on an X-ray.
Will a tooth infection go away on its own?
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No. Pain may ease when pus drains through a fistula or the nerve dies, but the infection continues and can flare at any time, destroying surrounding bone. Only treating the source, such as a root canal, gum cleaning or extraction, resolves it definitively.
Do antibiotics cure a tooth infection?
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Not on their own. Antibiotics may temporarily control spreading infection but do not remove the source inside the tooth or gum pocket. They are a complement when there are signs of spread, always with a prescription. Treating the cause is essential.
Can a tooth infection spread?
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Yes. Rarely, infection spreads to facial tissues, under the chin and into the neck, causing swelling, difficulty swallowing or breathing and fever, which require hospital care. Rapidly increasing swelling or difficulty breathing are emergency signs.
What should I do about a tooth infection at night or on the weekend?
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Keep the area clean, use cold compresses on the outside of the face, avoid chewing on that side and use only previously recommended pain relievers. Seek dental care as soon as possible. If facial swelling is increasing, you have trouble swallowing or breathing, or high fever, go to an emergency room.
Does an infected tooth have to be pulled?
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Not always. Many infected teeth can be saved with a root canal and a filling or crown. Extraction is indicated when the tooth is badly destroyed, has a root fracture or lacks bone support. The decision is made with a clinical exam and X-ray.
Where can I get a tooth infection treated in Mooca, São Paulo?
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In Mooca, Dr. Cléo Salustiano (CRO-SP 170844) handles emergencies at Rua Hipódromo, 1141, every day from 8 a.m. to 10 p.m., including Sundays and holidays. The visit includes an exam and X-ray to identify the source and start treating the cause.
