Young girl with tooth pain

If your child is experiencing a severe toothache, a dental abscess might be the cause. Read on to find out more about the following topics, as well as why you should contact your child’s pediatric dentist right away:

What Is A Tooth Abscess?

An abscess is a pocket of pus. Abscesses can form in many areas of the body, including around the teeth and gums. Perhaps the most common type of abscess that pediatric dentists see are periapical abscesses, which are abscesses that form around the apex of a tooth – that is, the tip of the tooth’s roots. In this article, when we refer to a “tooth abscess,” we will be referring to a periapical abscess. We will save discussions of other types of dental abscesses for another day.

A periapical abscess is an abscess that forms around the tip of a tooth’s roots.
A periapical abscess is an abscess that forms around the tip of a tooth’s roots.

What Causes Tooth Abscesses in Children?

Periapical abscesses are caused by bacterial infections in the dental pulp. A tooth is composed of three layers – a hard outer layer, a porous second layer, and a soft, nerve-filled center known as dental pulp. When a bacterial infection causes a child’s dental pulp to become severely inflamed, the child may develop an abscess around the infected tooth’s apex.

How does dental pulp become infected? These infections are often the result of untreated cavities in children. If left untreated, a cavity will eventually become so deep that it reaches the dental pulp. When this happens, bacteria can invade the dental pulp, leading to inflammation or pulpal necrosis (death of the dental pulp), and often a subsequent tooth abscess.  

In some cases, dental injuries can also lead to tooth abscesses. For example, if a child’s tooth has a deep crack, bacteria may be able to enter the tooth’s dental pulp through that crack. In addition, when a tooth is “pushed” during an accident, the nerve and blood vessels inside the tooth can be severed or damaged, which may lead to future infection.

Is A Tooth Abscess A Dental Emergency?

Yes. If you suspect your child may have a tooth abscess, it is important to seek care as soon as possible. Call your child’s dentist right away and inform the dentist of your child’s symptoms. If left untreated, a tooth abscess can spread to other parts of the body, potentially leading to serious medical complications. In rare cases, tooth abscesses can even lead to life-threatening conditions such as brain abscesses and Ludwig’s angina.

If your child is experiencing difficulty breathing, difficulty swallowing, swelling in the neck, severe facial swelling or other potentially life-threatening conditions, you should first seek immediate treatment from a hospital’s emergency department. Note that many hospitals do not have dentists on staff. If this is the case at the hospital you visit, your child will need a dentist to treat the abscess after your child leaves the hospital, but the emergency room doctors will be able to help control the infection and stabilize your child until dental treatment is available.

How Do I Know if My Child Has An Abscessed Tooth?

The symptoms that a child with a periapical abscess will experience depend on a number of factors, including how far the bacterial infection has spread. Symptoms could include

  • Severe pain in the affected tooth (and possibly in other teeth, the child’s ear, the neck, the temple and/or the eyes)
  • Temperature sensitivity
  • Sensitivity to pressure placed on the affected tooth
  • Tooth mobility
  • Color change in the affected tooth (e.g., the tooth turning black)
  • Swelling and/or redness in the gums near the affected tooth
  • Facial swelling
  • Swollen lymph nodes under the child’s jaw or in the neck
  • Fever

If you suspect your child may have a tooth abscess, you should contact your child’s dentist right away. A pediatric dentist can use dental X-rays to confirm the presence of the abscess and determine its exact location.

Swelling in the gums near a tooth can be a sign of a periapical abscess.

Will My Child’s Tooth Abscess Go Away on Its Own?

No, a tooth abscess will not heal on its own. If you suspect that your child may have a dental abscess, seek professional treatment from a dentist as soon as possible to prevent the infection from spreading and becoming a medical emergency. Never attempt to treat your child’s tooth abscess at home.

What If Your Child’s Symptoms Begin to Improve on Their Own?

Does that mean you no longer need to seek treatment? Unfortunately, no. As mentioned above, a tooth abscess will not heal without treatment. Even if your child’s symptoms seem to be improving, an abscessed tooth will still require an urgent dental visit. Sometimes one or more of a child’s symptoms will suddenly disappear even when the child’s condition is not truly improving.

For example, a child with a periapical abscess may experience sensitivity to cold drinks. If the infected dental pulp becomes necrotic (i.e., dies), it will no longer be able to send pain signals to the child’s brain. As a result, the tooth sensitivity could suddenly disappear even though the child’s condition is actually worsening rather than improving.

Similarly, a child who is experiencing intense pain due to an abscess may feel sudden relief if the abscess drains itself (i.e., if the pus leaks out). However, that relief will only be temporary. Until the infection is properly treated, it can continue to spread and may end up causing even more severe or widespread pain.

How Do You Treat an Abscessed Tooth in A Child?

In order to treat a periapical abscess and prevent the infection from spreading, a dentist must remove the infected tissue. Depending on the severity, this can be achieved either by a root canal or tooth extraction.

In some cases, the swelling around the child’s tooth may be so severe that these procedures cannot be performed safely. In such cases, the child may be prescribed antibiotics to control the infection and reduce swelling so that the root canal or extraction may be performed.

Emergency Dental Treatments for Kids in Hurst, Texas

If you suspect your child may have a tooth abscess, call Hurst Pediatric Dentistry at (817) 510-6400 right away and we will make an emergency appointment to see your child as soon as possible. Hurst Pediatric Dentistry’s Dr. Lin and Dr. Orynich are both board-certified pediatric dentists with significant experience treating dental abscesses.

Hurst Pediatric Dentistry is located in Hurst, Texas, and proudly serves pediatric patients from Hurst, Euless, Bedford, Colleyville, Keller, Southlake, Fort Worth, and the surrounding area.

This article is intended to provide general information about oral health topics. It should not be used to diagnose or treat any disease or as a substitute for the advice of a healthcare professional who is fully aware of and familiar with the specifics of your case. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.


  • Dr. Jin Lin is a board-certified pediatric dentist with a passion for helping children achieve healthier, more beautiful smiles. He earned his Bachelor of Science degree from Cornell University and his Doctor of Dental Medicine (D.M.D.) degree from the Harvard School of Dental Medicine. After graduating cum laude from dental school, he completed his post-doctoral pediatric dentistry training at Boston Children’s Hospital and the Harvard School of Dental Medicine, where he served as chief resident and worked with children with a wide variety of special medical and dental needs, including children with rare syndromes.