This blog is prompted by a phone call I received from a panicking family member. This family member said there was a boil or bubble under the lip in their gums near their tooth. They weren't having pain at this time but this is an abscess formation and can be the sign of a chronic issue.
The boil or bubble that was explained to me was a small, purplish nodule, soft and fluctuant. What happens is when a tooth becomes infected from a local irritation such as a foreign body, the need for a dental cleaning, or a large filling or restoration in the area the gums become chronically inflamed and can irritate the tooth near by. Additionally, if the tooth had dental work done on it, once, or several times, the nerve can become so irritated that it slowly dies.
In both scenarios the infection or the compromised nerve will harbor bacteria and the bacteria eventually need to spread from the inside of the tooth. This will cause a pain or irritation at the base of the tooth and with the pressure it needs to escape. It will look for the path of least resistance and usually pass through the gums to seek relief. When draining, there is no pain, but the source still needs to be treated. If the channel to the outside world becomes blocked then the abscess will begin to hurt. Then you definitely need it treated asap to preserve your sanity!
Many times an antibiotic will help, in the short term, but tooth pain will return and the area needs to be treated further. Clindamycin is a great drug if we know the tooth pain is of this origin, otherwise a broad spectrum antibiotic like Amoxicillin works too.
If you are experiencing any signs or symptoms of tooth pain, call your dentist. The true reason can only be identified with complete examination and x-rays to fully evaluate although signs and symptoms alone do tell a majority of the story in many cases.