A tooth abscess is an infection that can cause throbbing pain, a swollen gum, a gum boil or swelling of the face. Some cases can wait for an urgent dental visit, but spreading swelling, breathing or swallowing trouble, high fever, or difficulty opening the mouth needs hospital emergency care.
What is a tooth abscess?
A tooth abscess is a pocket of pus caused by a bacterial infection. It can form when bacteria reach the inside of a tooth or get trapped in the tissues around the tooth. If you have a painful swelling, a pimple on the gum, or one side of your face is becoming puffy, don't assume it will settle on its own.
We often see people who have managed toothache for a few days and come in only when swelling appears. The swelling is a sign that the infection is active and needs dental treatment.
There are two common types. A tooth abscess can form at the tip of the root, often after deep decay, a crack in the tooth, or damage to the nerve that causes it to die. An abscess can also form in the gum, usually because infection develops in a gum pocket around the tooth.
A small pimple or boil on the gum is sometimes called a gum boil. It may release pus and leave a bad taste in the mouth. That drainage can reduce pressure and make the pain suddenly feel better, but the infection is still there.
What symptoms should you look for?
Abscess pain is often deep, throbbing and difficult to ignore. You may also feel pain when you bite down or tap the tooth. The gum may look raised, red or swollen, and swelling can spread into the cheek or jaw.
Other signs can include a bad taste in the mouth, fever, and tender glands under the jaw. Some people notice that the pain becomes worse when lying down, which is one reason a tooth abscess can feel especially troublesome at night. If that is happening, our guide to tooth pain at night explains what you can do until you are seen.
Don't be reassured just because the pain stops. If pus drains through the gum, pressure can drop and the tooth may feel much better for a while. The source of the infection can remain and flare again.
When is a tooth abscess an emergency?
Most dental abscesses need prompt dental care, but some warning signs mean you should not wait for a routine dental appointment.
| Sign | See a dentist within a day or two | Go to a hospital emergency now |
|---|---|---|
| Localised gum swelling or gum boil, no fever, breathing and swallowing normal | Yes | |
| Throbbing tooth pain or pain when biting, with no facial spread | Yes | |
| Facial swelling spreading towards the eye | Yes | |
| Swelling moving down the neck | Yes | |
| Difficulty swallowing or breathing | Yes | |
| High fever or feeling very unwell | Yes | |
| You cannot open your mouth properly | Yes |
If swelling is spreading towards the eye, moving down the neck, or affecting breathing or swallowing, go to a hospital emergency department straight away. The same applies if you have a high fever, feel very unwell, or cannot open your mouth properly.
If the swelling is limited to the gum or cheek and you otherwise feel well, call a dentist urgently. If you need an emergency dentist in Lucknow, call the clinic first so we can tell you how soon you should be seen and try to fit you into the schedule. You can also read our guide on what to do in a dental emergency.
What can you do before you see a dentist?
There are a few safe measures that may make you more comfortable until your appointment. They can help with abscess tooth pain relief, but they don't cure the infection.
- Rinse gently with warm salt water.
- Use painkillers only as directed on the pack or advised by a pharmacist.
- Place a cold compress on the outside of the face for short periods if there is swelling.
Do not put heat on the outside of the face. Heat can make swelling feel worse. Do not try to burst, squeeze or pierce a gum boil. You can push infection deeper into the tissues or cause more irritation.
Also avoid placing aspirin, tobacco or other substances directly on the gum. They can burn or damage the tissue without treating the source of the infection.
If pain is severe at night, you may be tempted to keep taking extra doses of pain medicine. Don't exceed the dose on the label, and don't combine medicines unless a doctor or pharmacist has told you that the combination is safe for you.
Will antibiotics cure the infection?
Sometimes antibiotics are needed, especially if there is spreading swelling, fever or signs that the infection is affecting more than the area around the tooth. But antibiotics alone usually do not remove the cause of a tooth abscess.
The infected source still has to be treated. Depending on what we find, that may mean draining the infection and then doing root canal treatment to clean and seal the inside of the tooth. If the tooth cannot reasonably be saved, extraction may be advised instead. Our guide on root canal or extraction explains how those choices are usually made.
If the abscess is mainly in the gum, treatment may involve cleaning the infected gum pocket and dealing with any trapped plaque, tartar or other local cause.
This is why taking leftover antibiotics at home is a poor substitute for an examination. Symptoms may settle temporarily while the source remains.
What happens at the dental appointment?
We first look at where the swelling is coming from. The painful tooth is checked, the gums are examined and, where needed, an X-ray is taken to see the roots and surrounding bone.
If there is a collection of pus that needs drainage, we may drain it. If the tooth is the source, we then discuss whether root canal treatment or extraction is the better option. If you're anxious about treatment, you can also read our page on whether a root canal hurts.
The exact treatment depends on the tooth, the amount of infection, whether the tooth can be restored, and your general health. We won't assume that every swollen gum needs an extraction, and we won't assume that every infected tooth can be saved.
Can a swollen gum settle without treatment?
It can settle for a while, especially if the abscess drains into the mouth. That does not mean the infection has healed. Bacteria may remain around the root or inside a deep gum pocket, and the swelling can return.
A recurring pimple on the gum is a common reason to get the area checked even when it is not painful. It is often the infection finding a route to drain.
With a swollen gum, the useful first step is to find the cause. Treatment for a gum abscess is different from treatment for an abscess at the root of a tooth.
When should you call us?
If you have a throbbing tooth, a gum boil, swelling from a tooth infection, or a swollen face, call early rather than waiting to see how bad it becomes. We see urgent dental cases, and we ask patients to call first so we can try to fit them in.
This is especially helpful if you are coming from across the city and need to know whether you should come to the clinic or go directly to a hospital.
You can call or book for an urgent assessment. If breathing or swallowing is difficult, swelling is spreading towards the eye or neck, you have a high fever, or you cannot open your mouth properly, go to hospital emergency care first.
Frequently Asked Questions
Can I wait until morning if a tooth abscess starts hurting at night?
If the pain is severe but swelling is localised and you can breathe, swallow and open your mouth normally, you can usually arrange urgent dental care in the morning. Use safe pain relief as directed, rinse with warm salt water and use a cold compress. If swelling is spreading or you feel very unwell, go to hospital emergency care.
What does a small pimple on the gum mean?
A small pimple on the gum can be a gum boil that allows pus from an infection to drain. It may come and go, and it may stop hurting after it drains. That improvement does not mean the infection has cleared. A dentist should check whether the source is the tooth root or a gum pocket.
Do I always need antibiotics for a tooth abscess?
No. Antibiotics may be prescribed when infection is spreading, there is fever, or there are other signs that the infection is affecting surrounding tissues. The source still needs dental treatment, such as drainage, root canal treatment, extraction, or cleaning of an infected gum pocket. Antibiotics alone usually do not remove the cause.
Where can I get urgent treatment for tooth swelling in Lucknow?
Haihyvanshi Dental Clinic & Implant Centre sees urgent dental cases on IIM Road, Jankipuram. Call the clinic first so the team can assess how urgent the problem sounds and try to fit you in. If you have breathing or swallowing difficulty, swelling towards the eye or neck, high fever, or trouble opening your mouth, go to a hospital emergency department.