How Long Can a Tooth Infection Go Untreated?

By Sarah Malka, MD
Medically reviewed
August 17, 2021

A tooth infection, sometimes referred to as a dental abscess or abscessed tooth, can cause severe pain and discomfort.

While most people experiencing dental pain and infection get treated as soon as possible, some may choose to delay treatment because they have trouble getting an appointment with a dentist, or are worried about paying for ER or urgent care fees.

But untreated dental infections can lead to serious or long-standing complications over time.

In this article, I’ll describe the signs and symptoms of a tooth infection and when the infection can become dangerous.

I’ll also cover the possible issues caused by tooth infections, and the most common treatment and prevention options. Finally, I’ll discuss when it’s important to reach out to a dentist or healthcare provider. 

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Signs and Symptoms of a Tooth Infection

A tooth infection happens when bacteria enter the gums or the root of a tooth.

This can cause swelling, pain, inflammation, and sometimes an abscess, which is a pocket of pus in the gum.

Abscesses can occur in different places around the tooth, and sometimes may affect the surrounding bone and adjacent teeth.

Severe tooth decay, broken, chipped or cracked teeth, gum disease, and tooth injury can all create opportunities for bacteria to get into a tooth and cause infection.

The most common symptoms of a tooth infection include:

  • Severe, persistent, and throbbing toothache that can radiate to the jawbone, cheek, neck, or ear
  • Sensitivity to temperature, both hot and cold
  • Sensitivity to the pressure of chewing or biting
  • Sensitivity to air
  • Fever
  • Swelling in your face or cheek
  • Tender, swollen lymph nodes under your jaw or in your neck
  • Difficulty breathing or swallowing
  • Bitter taste in your mouth
  • Foul-smelling or bad breath
  • Gum redness and swelling
  • Loosening of the tooth
  • A tender lump on your gum 

If the abscess ruptures, you may experience a sudden rush of salty, foul-tasting fluid in your mouth and subsequent pain relief.

Are Tooth Infections Dangerous?

Thanks to improved dental hygiene, modern dentistry, and antibiotics, tooth infections are rarely life-threatening.

However, the longer you wait to get your infection treated, the more likely it is that the infection can spread to other areas, such as the jawbone, cheek, neck, and beyond.

In very rare cases, the infection can travel to the bloodstream, heart, or brain, which can be life-threatening.

For this reason, it’s important to seek medical attention as soon as you experience any of the symptoms of a tooth infection, and especially important to see a dentist for regular preventative care.

Complications of Tooth Infections

Tooth loss

If an infection within a tooth is left untreated, the affected tooth can become severely decayed.

In some cases, it may break or fall out. 

Infection of the bone

Not addressing the bacterial infection quickly enough can give the bacteria time to spread to the surrounding bone, causing an infection of the bone, or osteomyelitis.

People with this type of bone infection experience fevers and severe bone pain of the jaw.

Osteomyelitis can be painful, dangerous, and cause permanent damage to the jaw bone. It requires antibiotics via an IV, and sometimes surgery, for treatment.

Sinus irritation and infection of the blood vessels

Because your teeth and sinuses are located close to one another, an untreated, infected tooth can grow into a bacterial sinus infection. 

Though rare, an untreated tooth infection can also spread to the blood vessels in your sinuses and cause cavernous sinus thrombosis, a rare and life-threatening blood clot at the base of the brain. 

Septicemia

An untreated tooth infection can eventually lead to bacteria in the bloodstream, sometimes called blood poisoning, also known as bacteremia or septicemia.

If left untreated, septicemia can cause a severe whole-body infection called sepsis, which can be life-threatening.

Early signs of septicemia include:

  • High fever
  • Chills
  • Weakness
  • Sweating
  • Drop in blood pressure

Sepsis can become life-threatening very quickly.

If you experience any of these symptoms in addition to dental symptoms, discuss with a healthcare provider immediately. 

Ludwig’s angina

Another rare but serious risk of an untreated tooth infection is Ludwig’s angina.

Ludwig’s angina is a type of bacterial infection that occurs in the bottom of the mouth, under the tongue. Symptoms include:

  • Difficulty breathing
  • Difficulty swallowing
  • Drooling
  • Unusual speech
  • Tongue swelling and swelling under the jaw or tongue
  • Fever
  • Neck pain
  • Neck swelling
  • Redness in the neck or under the chin
  • Weakness and fatigue
  • Confusion or other mental changes

This can be a life-threatening emergency.

If you experience any of these symptoms, call 9-1-1, go to an ER, or speak with a healthcare provider right away.

Meningitis

If an infection of the tooth spreads to the brain, it can cause meningitis, a serious infection of the brain and spinal cord. 

Possible early symptoms of meningitis include:

  • Sudden high fever
  • Stiff neck
  • Severe headache 
  • Nausea or vomiting
  • Confusion or lethargy
  • Seizures
  • Light sensitivity
  • Loss of appetite or thirst
  • Severe purple skin rash

Meningitis can become life-threatening very quickly.

If you notice any of these symptoms, call 9-1-1, go to an ER, or speak with a healthcare provider right away.

Treatment

Usually, a tooth infection will not go away on its own. But most infections can be easily treated—if you seek care when you first notice symptoms.

Treatment plans will vary depending on the location and state of your infection. Most likely, your healthcare provider or dentist will recommend one of the following:

  • Incision and drainage: If the abscess is small, your dentist—or a healthcare provider—may be able to make a small incision to drain the pus and eliminate the infection. If there is pus present, the infection often needs this procedure in order to get better, and will not get better with antibiotics alone.
  • Root canal: If you have a tooth with severe inner infection, your dentist may decide to perform a root canal, a procedure which removes the tooth’s infected inner pulp and fills the gap with material to prevent another infection from forming.
  • Tooth extraction: In some cases, the tooth cannot be saved, and will need to be removed by a dentist to allow pus to drain from the abscess. 
  • Antibiotics: Most infections will require a dental procedure to address the source of the infection, and will not get better with antibiotics alone, but your dentist or healthcare provider may recommend a course of antibiotics to help fight off the remaining bacteria after one of the treatments mentioned above. 

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Prevention

You can reduce the risk of developing a tooth infection by practicing good oral hygiene and seeing your dentist or dental hygienist for regular checkups, exams, and cleanings.

Brush twice a day with a soft toothbrush and fluoride-containing toothpaste, and floss daily.

If you notice a chipped, loose, cracked, painful, or broken tooth—or gum pain or swelling—get evaluated by your dentist as soon as possible. Maintaining good oral health is the best way to prevent dental infections.

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K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Sarah Malka, MD

Dr. Sarah Malka is a board certified emergency medicine physician with K Health. She completed her residency at Harvard Medical School.