What does a spreading tooth infection feel like?

A spreading tooth infection, also known as a dental abscess, can cause severe pain and discomfort. The infection occurs when bacteria invade the tooth’s inner chamber (pulp) and spreads through the root canal system and into the bone surrounding the tooth.

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Symptoms of a Spreading Tooth Infection

Here are some of the common symptoms of a spreading tooth infection:

Throbbing, persistent toothache that can radiate to other areas like the jaw, ear, head, and neck
Sensitivity to hot and cold temperatures
Pain when chewing or biting down

Foul taste in the mouth
Swelling of gums, face, and neck
Tender, swollen lymph nodes under the jaw or in the neck

Fever and chills
Fatigue and generally feeling unwell
Loosening of the infected tooth

Bad breath

The pain is often described as a severe, throbbing ache that gets worse as the infection spreads deeper into the tooth and jawbone. Pain levels can rapidly escalate over a few days, often disrupting sleep.

What Causes a Spreading Tooth Infection?

There are several ways tooth infections start:

Untreated cavities: Cavities that penetrate the enamel and reach the inner pulp allow bacteria to infect the root canal system.
Cracks or fractures: Cracks that expose the inner pulp also provide an entryway for bacteria.
Trauma: Injuries that damage the tooth or dislodge fillings can enable bacteria to get inside the tooth.

Leaky dental work: Poor quality fillings, veneers, crowns or other dental work that doesn’t properly seal the tooth can lead to infection.
Gum disease: Advanced gum disease damages tissue around the tooth root, creating pockets where bacteria can grow.

Once inside the tooth’s pulp chamber, bacteria multiply quickly and release acids that cause inflammation. The inflamed pulp tissue dies, allowing the infection to spread through tiny canals at the end of the tooth roots.

How Does the Infection Spread?

A tooth infection usually starts as a localized abscess at the root tip. However, if left untreated, the infection can burrow deeper into the bone and spread:

Periapical abscess: This abscess forms at the tooth’s root tip and can destroy surrounding jawbone.
Periodontal abscess: This abscess extends into the periodontal tissue around the tooth root and can spread via the gums.

Gingival abscess: This abscess originates in the gum tissue and can spread to the tooth roots.

As the infection advances, it can spread along facial planes and spaces between muscles. Potential dangerous spread to deeper facial areas and the neck can develop rapidly over 2-3 days.

Why is Prompt Treatment Important?

It’s crucial to get prompt treatment for a tooth infection before it spreads deeper. An uncontrolled infection can lead to some serious risks and complications:

Bone loss – The infection can destroy jawbone and damage tooth sockets.
Facial cellulitis – Swelling can spread down through cheek tissues or below the jawline.
Dental cysts – Infection can pocket in the jawbone and form a cyst.

Sinus infection – Bacteria can spread to the maxillary sinuses.
Brain abscess – In rare cases, infection can spread to the brain from upper teeth.
Sepsis – A widespread blood infection.

Seeking emergency dental care is vital at the first sign of a spreading infection before the risks above develop. Quick treatment can help save the tooth too.

What Does the Pain Feel Like as the Infection Spreads?

Patients often describe the pain as becoming excruciating as the infection progresses. Here’s an overview of how the pain may change:

Early stage: Mild, sporadic pain localized to the infected tooth which worsens with chewing or temperature changes.

Moderate stage: Throbbing, constant ache radiating along the jawline, ear, and head on the infected side. Pain may wake you from sleep.
Advanced stage: Severe, stabbing pain that can be nearly unbearable. Pain described as “bolts of lightning” or “electric shocks” pulsating through the tooth, jaw, and head. Agonizing sensitivity to hot or cold.
Spreading infection: As the infection tracks along fascial spaces, pain becomes more widespread in the face, jaw, neck and lymph nodes. Any movement of facial muscles, talking, swallowing or chewing aggravates pain.

Without antibiotics, the severity of the throbbing pain continues to escalate until the infected tooth is treated or the infection drains itself.

Treatment for a Spreading Tooth Infection

Treating a spreading tooth infection requires a combination of antibiotics, dental procedures, and sometimes hospitalization for IV antibiotics. Here are some common treatment approaches:

Antibiotics: Antibiotics like penicillin or clindamycin fight the bacterial infection. Antibiotics are continued until tests show the infection has resolved.

Draining the infection: The dentist may need to lance and drain the abscess by creating a small opening in the gum.
Root canal treatment: If the tooth can be saved, the infected pulp is removed and the root canal system cleaned and disinfected.
Tooth extraction: Non-restorable infected teeth require extraction to fully remove the source of infection.

IV antibiotics: Hospitalization for intravenous antibiotics is needed for severe spreading infections.
Surgery: Surgical incision and drainage or tooth extraction may be done while hospitalized to control the infection.

Catching the infection early and taking a full prescription antibiotic course is key to preventing the infection from worsening and spreading.

When to Seek Emergency Dental Care

Seek emergency care if you have symptoms of a spreading tooth infection like:

Facial swelling that progresses quickly, especially if swelling spreads into the neck area.
Difficulty swallowing or opening your mouth due to swelling and pain.

Fever higher than 100°F along with chills and fatigue.
Severe pain, especially pain that radiates down the neck or to the ear.
Difficulty breathing, swallowing, or speaking.

Prolonged bleeding from your gums.

Some people describe a spreading tooth infection pain as the worst pain they have ever felt. Don’t delay getting treatment from an emergency dentist if you have the above symptoms that indicate an infection may be spreading deeper or involving fascial spaces. This can develop into a dental emergency requiring hospitalization if not managed promptly.

Home Remedies for Temporary Pain Relief

While you wait to see a dentist, you can try some temporary pain relief measures at home:

Over-the-counter pain medication like ibuprofen (Advil) or acetaminophen (Tylenol) for mild-moderate pain symptoms.
Cold compresses on your cheek or jaw to reduce swelling.
Salt water rinses can help keep the area clean.

Dental anesthetic gels like Orajel applied to the gums near the infected tooth.
Clove oil applied topically for its mild numbing effect.
Avoid very hot or cold foods and drinks which can aggravate pain.

These remedies only provide temporary relief until you can get professional dental treatment. The infection must be treated with antibiotics and drainage.

When Does the Pain Go Away?

Once you start taking antibiotics and receive dental treatment to address the infected tooth, you should start to get relief within a few days. Here’s a general timeline:

24 hours after starting antibiotics: Pain may start improving.

2-3 days: Swelling and pain steadily decrease.
5-7 days: Pain, swelling, and other symptoms largely resolve.
7-14 days: Infection is eliminated (some cases may take several weeks). Finish your full antibiotic prescription.

After the infection clears, you may still have some lingering soreness or tenderness in the area that continues improving over the following weeks. A follow-up appointment will help confirm the tooth infection has resolved.

Complications from a Spreading Tooth Infection

Potential complications from an uncontrolled spreading tooth infection include:

Osteomyelitis: The infection spreads to the jawbone (osteomyelitis) causing tissue death, chronic swelling, drainage, and cellulitis.

Facial abscess: A collection of pus forms in the facial tissues, often requiring surgical incision to drain.
Ludwig’s angina: A rare, serious infection which causes severe swelling and cellulitis under the jaw and floor of the mouth, making breathing difficult.
Sinusitis: The maxillary sinuses become infected leading to nasal congestion, facial pain and pressure, and foul-smelling mucus drainage.

Sepsis: A systemic blood infection that can be life-threatening.

Even with successful treatment, permanent complications like loss of tooth vitality or bone loss around the tooth root can result from the damage caused by the infection.

When to Follow Up with Your Dentist

Schedule a follow-up appointment with your dentist to evaluate healing and ensure the tooth infection has fully cleared approximately:

1 week after starting antibiotics
2-3 weeks after having an infected tooth treated or extracted
1 month later to assess gum and bone healing

Regular dental cleanings and checkups can help detect potential problems early before they turn into infections requiring more extensive treatment.

Can a Tooth Infection Return?

In some cases, a tooth infection can return after antibiotic treatment if the source of infection isn’t fully eliminated. Reasons an infection might recur include:

Not completing the full antibiotic course, which allows remaining bacteria to multiply again.

An undrained tooth abscess that reaccumulates pus and bacteria.
An unaddressed problem like a cracked tooth or failing root canal that persists as a source of infection.
Development of antibiotic resistance from repeated infections.

An undiagnosed source of infection, like an extracted tooth fragment left behind.

To prevent recurrence, your dentist will want to identify and definitively treat whatever allowed bacteria to infect the tooth initially. This may require a procedure like root canal, tooth extraction, or re-extracting a previously extracted infected tooth.

When to See an Endodontist

For teeth with deep infections or complications, your dentist may refer you to an endodontist, a specialist in root canal treatment. Reasons you may need to see an endodontist include:

The tooth has a complex root canal system that is difficult to fully clean out.
Infection has caused complications like a fractured root.
Previous root canal treatment failed.

Re-infection of a tooth after root canal therapy.
Persistent symptoms that haven’t resolved with your dentist’s treatment.

Endodontists have specialized equipment, techniques and expertise to treat challenging tooth infections, perform microscopic root canal procedures, and save infected teeth that might otherwise require extraction.

Preventing Tooth Infections

You can help prevent tooth infections by:

Brushing and flossing twice daily.
Seeing your dentist every 6 months for exams and cleanings.

Treating cavities early before they reach the inner pulp.
Promptly treating any tooth injury like cracks or fractures.
Having loose fillings or defective dental work replaced.

Stopping habits like chewing on ice or fingernails that can crack teeth.
Giving up tobacco, which increases gum recession.

Catching small problems early before they progress to infections requiring root canals or tooth extractions is the key. Don’t delay dental care.

Conclusion

A spreading tooth infection can rapidly escalate from slight sensitivity to agonizing, throbbing pain radiating along the head and neck. Severe infections require emergency dental treatment to remove the source of infection and begin antibiotics to control the spread. While waiting for professional care, temporary relief measures include pain medication, cold compresses, dental gels, and saltwater rinses. Prompt treatment is vital to avoid complications like facial swelling, jawbone damage, and systemic illness. With aggressive antibiotic therapy and addressing the infected tooth, most cases resolve without lasting effects. Good dental hygiene and regular dental visits can help reduce your risk of developing tooth infections in the first place.