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Protecting All Children's Teeth (PACT): A Pediatric Oral Health Training Program
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A dental abscess is a collection of purulent fluid caused by a bacterial infection.
Abscess: A localized collection of pus surrounded by inflamed tissue.

The most common cause of a dental abscess is extension of the dental caries process into the pulp of the tooth.

Pulp: The highly vascular sensitive tissue occupying the central cavity of a tooth.

Abscesses can also be caused by trauma to the tooth that allows bacteria to enter the pulp.

An abscess limited to the tooth structure (pulpitis) will often present with tooth pain from the increased pressure on the nerve endings within the pulp. This pain is often worsened with heat or cold exposure.

Abscess Progression
If the infection in the pulp extends beyond the tooth, a periapical abscess will develop.

The pressure caused by the expanding area of necrosis and inflammation causes visible swelling and may lead to slight extrusion of the tooth from the socket.

As the abscess expands, the pus will spread to contiguous surfaces along the path of least resistance to form a fistula to the maxillary, mandular, or palatal mucosa.

If the infection remains unchecked, an abscess can progress to facial, submandibular, or sublingual cellulits.

Facial cellulitis presents clinically with swelling, warmth, and tenderness to palpation along the jaw.

A child with facial cellulitis should be referred for immediate ER evaluation or admitted to the hospital for IV antibiotics.

Fast Facts
Extension of dental caries is the most common precipitating cause of dental abscesses.
Ludwig's angina is a medical emergency due to potential airway compromise.
The spread of a dental abscess can cause severe morbidity.

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