What Is a Gum Abscess
A gum abscess, also called a periodontal abscess, is a pocket of pus that forms in the gum tissue. It develops when bacteria become trapped in the space between the gum and the tooth, known as the periodontal pocket. This pocket deepens when gum disease progresses, creating a space that is difficult to clean with brushing and flossing alone.
Gum abscesses are most common in people who have existing periodontal disease. They can also occur when food or a foreign object, such as a popcorn hull or a broken piece of dental floss, becomes lodged under the gumline. The trapped material creates a closed-off area where bacteria multiply rapidly.
Symptoms of a Gum Abscess
- A swollen, shiny bump on the gum near the affected tooth
- Pain or tenderness in the gum tissue, especially when pressing on it
- Bleeding from the gum around the affected area
- A bad taste in the mouth if the abscess drains on its own
- The affected tooth may feel slightly loose
- Sensitivity to hot foods or liquids
What Is a Tooth Abscess
A tooth abscess, also called a periapical abscess, forms at the tip of the tooth root. It starts when bacteria enter the inner chamber of the tooth (the pulp) through a cavity, crack, or traumatic injury. Once inside, the bacteria infect the nerve and blood vessels, and the infection spreads down through the root canal to the bone at the root tip.
A tooth abscess can develop in a tooth that has never had dental work or in a tooth with a large filling or crown that has broken down over time. Unlike a gum abscess, a tooth abscess does not require existing gum disease. The infection pathway is through the tooth itself, not through the gum tissue.
Symptoms of a Tooth Abscess
- Throbbing pain that may radiate to the jaw, ear, or neck
- Pain that worsens when lying down or at night
- Sensitivity to hot and cold that lingers after the stimulus is removed
- Swelling in the face, cheek, or under the jaw
- A pimple-like bump on the gum near the root tip (a draining fistula)
- Fever in more severe cases
How to Tell a Gum Abscess From a Tooth Abscess
While both types of abscess cause pain and swelling, several features help distinguish them. Your dentist or specialist will use clinical examination and X-rays to confirm the diagnosis, but these differences can help you understand what you may be dealing with.
Location
A gum abscess typically appears along the gumline, at the margin where the gum meets the tooth, or in the space between two teeth. A tooth abscess tends to produce swelling or a draining bump lower on the gum, closer to the root tip of the tooth. If you can see swelling right at the gumline, it is more likely gum-related. If the swelling is higher up on the gum (closer to the lip or cheek), it is more likely coming from the root.
Underlying Cause
A gum abscess is caused by bacteria in the periodontal pocket, often in the context of existing gum disease. A tooth abscess is caused by bacteria inside the tooth, entering through a cavity, crack, or previous dental work that has broken down. If you have a history of gum disease, a gum abscess is more likely. If the affected tooth has a large cavity or old restoration, a tooth abscess is more likely.
Pain Patterns
Gum abscess pain is typically localized to the gum tissue. It hurts when you press on the swollen area and may cause the tooth to feel sore when chewing. Tooth abscess pain tends to be deeper, more throbbing, and can radiate to the jaw or ear. Tooth abscesses often cause spontaneous pain that occurs without any trigger and may wake you at night.
Can a Gum Abscess Cause a Tooth Abscess, or Vice Versa
Yes. The two types of abscess can be connected. A severe gum infection that reaches the bottom of a deep periodontal pocket can spread to the root tip and infect the tooth nerve from the outside. This is called a retrograde pulpitis. When this happens, the tooth may need both periodontal treatment and a root canal.
In the other direction, a tooth abscess can drain through the gum tissue and mimic the appearance of a gum abscess. The draining fistula, a small pimple-like bump on the gum, may look like it is coming from the gum, but the actual source is inside the tooth. This is why professional diagnosis with X-rays is important. Treating only the gum when the tooth is the source will not resolve the infection.
Treatment for Gum Abscesses and Tooth Abscesses
Both types of dental abscess require professional treatment. Antibiotics can help control the spread of infection, but they cannot eliminate the source. The abscess will return if the underlying cause is not addressed.
Gum Abscess Treatment
Treatment starts with draining the abscess and cleaning the infected periodontal pocket. Your dentist or periodontist will numb the area, open the abscess to release the pus, and irrigate the pocket to remove bacteria and debris. This is called incision and drainage.
After the acute infection is controlled, the underlying gum disease needs to be treated. This typically involves scaling and root planing (a deep cleaning procedure) and may include periodontal surgery if the pockets are deep. A periodontist is the specialist trained to manage advanced gum disease and prevent recurrence.
Tooth Abscess Treatment
Treatment requires removing the infected tissue from inside the tooth. This is done through root canal treatment. An endodontist removes the infected pulp, cleans and shapes the root canals, and seals the tooth to prevent reinfection. The tooth is then restored with a crown or filling.
If the tooth cannot be saved, extraction is the alternative. After extraction, the missing tooth can be replaced with a dental implant, bridge, or partial denture. Your dentist or prosthodontist can discuss replacement options.
Cost Comparison
Treatment costs vary by location, provider, and case complexity. The following ranges provide a general idea of what to expect.
Incision and drainage of a gum abscess typically costs $150 to $400. Scaling and root planing to treat the underlying gum disease ranges from $200 to $400 per quadrant. Periodontal surgery, if needed, ranges from $500 to $3,000 depending on the procedure.
Root canal treatment for a tooth abscess ranges from $700 to $1,500 depending on the tooth. A crown to restore the tooth afterward costs $800 to $3,000. Extraction, if the tooth cannot be saved, typically costs $150 to $650. Most dental insurance plans cover a portion of these treatments, though annual maximums and waiting periods may apply.
Which Specialist Should You See
If you suspect a gum abscess, especially if you have a history of gum disease, a periodontist is the specialist best equipped to treat the abscess and the underlying periodontal condition. Periodontists complete 3 years of additional training beyond dental school focused on the gums, bone, and supporting structures of the teeth.
If you suspect a tooth abscess, an endodontist is the specialist trained to diagnose and treat infections inside the tooth. Endodontists complete 2 to 3 years of additional training focused on root canal treatment and related procedures.
If you are not sure which type of abscess you have, start with your general dentist. They can diagnose the source and refer you to the appropriate specialist.
Find a Periodontist or Endodontist Near You
If you have a dental abscess that needs specialist care, search the My Specialty Dentist directory to find a periodontist or endodontist in your area. Every specialist listed has verified credentials. Schedule a consultation to get the right diagnosis and treatment plan.
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