How Does a Dentist Diagnose a Tooth Infection? My Step-by-Step Journey (2024)
Table of Contents
Why Timely Diagnosis of a Tooth Infection Matters
From the first dull ache to a sharp, stabbing pain, I’ve learned that tooth infections aren’t something you can just hope will go away. Waiting to see the dentist can make things way worse than just a toothache. Tooth infections—like a dental abscess or pulpitis—are more than just pain in your mouth; they can get worse quickly and hurt your general health. I had no idea before, but if you don’t deal with an infection, it can spread from your tooth and jaw to other parts of your body. Sometimes, you can get jawbone infection, swelling in your face, or even serious problems like sepsis or Ludwig’s angina (a rare but bad infection under your tongue). Dr. Joe Dental, a dentist I trust, once told me that an untreated abscess can turn serious very fast. Since then, any pain in my mouth became something I dealt with right away.
Recognizing the Signs: When I Knew to See a Dentist
I used to ignore little pains, hoping they’d fade away. That changed when I had my first real tooth infection. I remember waking up one morning with a strong, throbbing ache that didn’t go away, not even after painkillers. Eating ice cream? No way—cold stuff made my teeth feel like they were getting zapped. Soon my cheek looked a little swollen, almost like I’d been punched. I also tasted something funny and bad in my mouth and saw a small bump that looked like a pimple on my gum. My jaw under my chin felt sore, and I got a fever. All those things meant I had an infection. If you ever notice:
- Pain in your tooth that won’t let up
- Tooth that hurts with hot or cold, even after the heat or cold is gone
- Swollen face, cheek, or neck
- Fever or chills
- Bad breath or a yucky taste in your mouth
- A gum pimple (gum boil)
- Pain when you chew or bite
…don’t wait. When these things happened to me, I went to the dentist, and I’m glad I did.
Walking Through the Dental Diagnostic Process: What Really Happens
Going to the dentist because you think you have an infection can make anyone anxious. I know because I was nervous too. Here’s what really happens, step by step, so you’ll know what to expect.
1. Initial Consultation and Medical History Review
My dentist starts by asking about my symptoms—when did the pain start, how bad is it, what makes it worse, and if anything helps. She doesn’t just care about my tooth, but also wants to know about my overall health, any illnesses, dental work I’ve had, and any medicine I take. For me, she paid special attention to my diabetes, since it can make infections worse or change how to treat them. These questions may seem like a lot, but small things matter.
2. Comprehensive Visual Examination
Next is the part where the dentist looks around in your mouth. My dentist puts on gloves, uses a bright light, and a small mirror to look for swelling, red gums, tooth color changes, chips, cracks, deep holes (cavities), and the gum pimple (fistula) I mentioned before. She uses tools like a dental explorer and a probe to look for soft places and check how deep my gum pockets are.
She sometimes taps on my tooth and asks, “Does that hurt?” I used to think it was just for pain, but the tapping (percussion) can show if the thing holding the tooth or the bone around it is sore. Pushing along my gums (palpation) felt tender sometimes, a sign the infection was spreading.
3. Dental X-rays (Radiographs)
Looking with eyes isn’t enough, so dentists almost always take X-rays. My dentist takes periapical X-rays to show the whole tooth from root to crown. Sometimes, she takes bitewing X-rays to see between my teeth and look for hidden problems.
Dentists can find a lot in those blurry X-ray pictures—like dark spots (signs of infection), bone loss, deep cavities, abscesses, or stuck teeth. I once had a tooth that looked fine, but the X-ray showed a problem at the root—a hidden infection.
Dentists say that sometimes X-rays don’t show an infection if only a little bone is affected. That’s when they use other tests.
4. Pulp Vitality Testing
When my dentist did the “cold test,” I didn’t know what to expect. She put a very cold piece of cotton on my tooth. If the pain left quickly, the nerve inside was probably just fine. If the pain lasted even after the cold was gone, it usually meant the nerve had a big problem (irreversible pulpitis)—or was already dead (necrosis) if I didn’t feel anything.
She sometimes uses an Electric Pulp Tester (EPT), which sends a little electric tingle to the tooth. My job was to raise my hand when I felt it. If I didn’t feel anything, that was bad news—the nerve was dead. My dentist said these tests are over 80% reliable to show if the inside of the tooth is healthy.
5. Percussion and Palpation Tests
After the cold test, my dentist would tap my tooth gently (percussion). If it hurt, it could mean the stuff holding the tooth or the bone around it was inflamed.
She also pressed on my gums near the sore tooth (palpation) to check for tenderness or swelling. Once, I felt some pressure and dull pain, which pointed to an infection or abscess.
6. Periodontal Probing
Another important step is checking how deep the spaces (pockets) are between the tooth and gum. My dentist uses a thin, special stick (periodontal probe) to measure the gaps. Deep pockets can be a sign of gum disease or infection around the tooth. The first time I had really deep pockets, my dentist found both infection and bad gum disease. Every measurement tells part of the story.
7. Advanced Diagnostic Tools
Most of the time, the steps above are enough. But if infection hides on regular X-rays, dentists can use special tools. My dentist once sent me for a Cone Beam CT (CBCT) scan. This is a 3D X-ray that shows a super clear picture of tooth roots, bone, and hidden infections or cracks. CBCT shows things regular X-rays miss, especially in tough cases.
She also used a bright light (transillumination) to look for cracks. Dental diagnosis gets more advanced every year!
Understanding the Dentist’s Findings: Confirming an Infection
After the tests and exams, my dentist puts all the pieces together: what I told her, what she saw, what the pictures (X-rays/scans) showed. If my pain didn’t go away with temperature changes, if there was a dark spot on X-rays, or if there was no feeling during nerve tests, it usually meant pulp death or an abscess.
One time, my pain came and went, and the tests showed a quick, sharp pain. That meant reversible pulpitis—a smaller problem that could often be fixed by treating a cavity, not with a root canal.
The dentist uses everything together—my answers, test results, and X-rays—to know if the infection is just starting, has moved on to be more serious, or is now a true abscess in the bone.
Differential Diagnosis: Ruling Out Other Causes
Here is something I didn’t know before: not all tooth pain is an infection. For example, once I thought I had an infected back tooth, but Dr. Joe Dental figured out the pain was actually from a sinus infection. Sinus problems can make your upper teeth hurt—especially with allergies.
Problems with your jaw joint (TMD), nerve pain, cracks in teeth, and gum disease can all feel like an infection. Good dentists check all the tests, ask extra questions, and sometimes send you to a specialist for a closer look, like an endodontist.
After Diagnosis: Next Steps and Treatment Options
When my tests showed I had a tooth infection, the next step depended on how bad it was and if the tooth could be saved.
- Root canal treatment was the answer when the tooth could still be fixed. The dentist cleaned out the bad stuff, got rid of the infection, and sealed the tooth.
- Tooth removal (extraction) was needed when the infection had destroyed the tooth and could spread to my jaw.
- Antibiotics were only given if the infection had already started spreading. I learned the hard way that antibiotics alone can’t fix dental abscesses—they need real dental work done.
- Cutting and draining (incision and drainage) was needed for a big, painful abscess. The dentist numbed my mouth, then carefully let out the pus to get rid of pressure and let me heal.
Dentists will always make sure the problem area is fixed—antibiotics help for a while, but unless they get rid of what’s causing the infection, the pain comes back.
How I Prevent Future Tooth Infections
Since going through all that pain, I became pretty serious about dental care. I brush and floss every single day—it really works. If you don’t keep up with these small things, plaque turns into cavities, and then infections start.
Regular dental check-ups help catch problems early, even when I feel okay. X-rays and exams at check-ups help find hidden trouble.
I stay away from sugary snacks, drink more water, and get small problems fixed right away. After one bad infection following a filling, I never wait for dental work again. Dentists and hygienists will remind you of these habits during visits.
I also appreciate the work happening in dental labs—especially new materials. For those who need a custom crown, veneer, or a removable denture lab solution, working with a skilled crown and bridge lab or a digital dental lab can fix your bite and help stop future infections by closing up cracks or spaces where bacteria hide.
Conclusion: Why You Shouldn’t Wait to See a Dentist
If you remember one thing from my story—and from what good dentists like Dr. Joe Dental say—it’s that ignoring tooth pain or infection signs is asking for trouble. Dentists figure out tooth infections with a careful, step-by-step plan: looking at your symptoms, doing special tests, and using pictures like X-rays and CT scans to know what’s really going on.
Waiting to get checked doesn’t just risk your teeth; it can mess up your whole health. The sooner you get help, the more options you have and the less pain, time, and money you’ll spend later.
So if you ever feel the warning signs—pain, swelling, bad taste, a gum bump—trust yourself and see a dentist. Every little thing you do now could make a big difference for your dental health down the road.
