Most orofacial infections are of odontogenic origin. Dental pulp infection, as a result of caries, is the leading cause of odontogenic infection. Once bacteria invade the dental pulp an inflammatory reaction results in necrosis and a lower tissue oxidation-reduction potential. The infection progresses forming an abscess at the apex of the root, resulting in bone destruction. Depending on host resistance and bacteria virulence the infection may spread into the marrow, perforate the cortical plate and spread to the surrounding tissues.
The doctor may decide to cut open the abscess and allow the pus to drain or try therapy with antibiotics. Unless the abscess ruptures on its own, this is generally the only way that the infection can be cured. People with dental abscesses are typically prescribed pain relievers and, at the discretion of the doctor, antibiotics to fight the infection. An abscess that has extended to the floor of the mouth or to the neck may need to be drained in the operating room under anesthesia.