Signs of a tooth abscess
An abscess usually makes itself known, though the signs may arrive one at a time. Watch for:
- A throbbing pain in or around one tooth, often worse when you bite or lie down.
- Swelling of the gum, or of the face or jaw on that side.
- A small pimple or bump on the gum near the tooth, which may leak.
- A bad taste in your mouth, or salty fluid when the bump drains.
- A fever, or swollen, tender glands under the jaw or in the neck.
Why an abscess is urgent
Most abscesses start inside a tooth. Decay, a crack or an old injury lets bacteria reach the nerve, the nerve dies, and the infection works its way out through the tip of the root into the bone. Some start in a deep gum pocket instead.
Either way, an abscess is a collection of pus, and left alone the infection keeps going. It can destroy the bone around the tooth, and occasionally it spreads into the face and neck, which is a medical emergency.
So call as soon as you notice it. Tell whoever answers what has happened, mention any swelling or fever, and they will get you seen.
When to go to the emergency room instead
Some situations need a hospital before they need a dentist. Go to the emergency room now for any of these, then call us afterward and we will take care of the dental side:
- Swelling that is closing an eye or spreading down the neck.
- Difficulty breathing or swallowing.
- A suspected broken jaw.
- Bleeding that will not stop after firm pressure.
What to do until you are seen
Call first. Then, while you wait for your appointment:
- Do not squeeze or pop a bump on the gum. Pressing on it can push the infection deeper.
- Rinse gently with warm salt water a few times a day. It keeps the area clean and can ease the soreness.
- Take an over-the-counter pain reliever as the label directs. Do not hold aspirin or any tablet against the gum, because it burns the tissue.
- A cold pack wrapped in a cloth and held against the cheek can help with swelling.
- Do not start leftover antibiotics from the medicine cabinet. The wrong drug, or too short a course, can mask the infection without clearing it.
Will an abscess go away on its own?
No. If it bursts and drains, the pressure drops, the pain often eases, and it can feel as if it has cleared up. It has not. The source of the infection is still inside the tooth or the gum, and it builds up again.
Not every abscess hurts, either. Sometimes the only sign is a bump on the gum that comes and goes as it drains. And when the pain of a bad tooth suddenly stops, that can mean the nerve has died, not that the problem has gone.
Antibiotics alone do not fix it. They can hold back a spreading infection, but they cannot reach the source, so it returns once the course ends.
How a dental abscess is treated
The first job is to relieve the pressure. With the area numbed, the infection is drained, either through the tooth itself or through a small opening in the gum. Infected tissue can be harder to numb, so we check it is working before we start and add more if it is not.
Then the source has to go. A root canal cleans the infection out of the inside of the tooth and seals it, so you keep the tooth; a back tooth usually needs a crown afterward, because it becomes brittle. Most of the pain people associate with root canals is the abscess that came before one. If the tooth cannot be saved, it comes out, and our page on emergency extractions explains what that involves.
An abscess that starts in the gum is treated by cleaning out the pocket and treating the gum disease behind it.
Antibiotics are added when the dentist judges they are needed, for example when the infection is spreading or you have a fever. You will know which treatment we recommend, why, and what it costs before anything is done. See insurance for the plans we work with.
Questions patients ask
Will a tooth abscess go away on its own?
No. It may drain and stop hurting for a while, but the infection is still there and it comes back. The source has to be treated, with a root canal or by taking the tooth out.
Can I just take antibiotics for an abscess?
Antibiotics can calm a spreading infection, but they cannot clear the source inside the tooth or gum, so the abscess returns once the course ends. When the dentist judges they are needed, they are given alongside treatment, not instead of it.
Should I go to the emergency room for a tooth abscess?
Go straight to the emergency room if swelling is closing an eye or spreading down your neck, or if you have difficulty breathing or swallowing. Those need a hospital first. Otherwise, call us, and we will take care of the tooth.
Is it safe to pop an abscess on my gum?
No. Squeezing it can push the infection deeper, and it does nothing about the source. Rinse with warm salt water, leave it alone, and call.
Does treating an abscess hurt?
The area is numbed first, and because infected tissue can be harder to numb, we check it is working before we start. Draining the infection relieves the pressure behind most of the pain. The area can be tender for a little while afterward.