Dental abscess

Dental (periapical) abscesses are an acute infection of the periapical tissue around the root of the tooth.

Clinical presentation

Patients may present with pain, edema, and purulent discharge localized to the site of pathology with or without fever and tender cervical lymphadenopathy .


Dental caries result in damage to the tooth enamel, which allows bacteria access to the dental pulp. From here the infection spreads down the root canal and out of the apical foramen where abscess formation occurs .

Radiographic features

Early dental abscesses, within the first ten days, may not have any radiographic features .

Plain radiograph / OPG and CT
  • well-defined lucency at or distal to the root apex, usually <10 mm with or without surrounding (<22 mm) sclerosis
  • the tooth or teeth involved often show signs of caries
  • an empty socket may indicate recent extraction for infection

Treatment and prognosis

Some dental abscesses will spontaneously resolve but dental surgery and antibiotics are generally required . Most (~90%) will show some evidence of healing (bone filling the lucency) one-year post-treatment .


Dental abscesses can exert pressure on the root of the tooth, which contains the neurovascular bundle, and can lead to devitalisation of the tooth .

Complications range from contiguous or haematogenous spread of infection and include potentially fatal conditions :

Differential diagnosis

Possible differential considerations include:

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