Dental abscess

A dental abscess is a collection of pus that can form inside the teeth, in the gums, or in the bone that holds the teeth in place. It’s caused by a bacterial infection.

An abscess at the end of a tooth is called a periapical abscess. An abscess in the gum is called a periodontal abscess.

Dental abscesses are often painful, but aren’t always. In either case, they should be looked at by a dentist.

You should get help as soon as possible, because abscesses don’t go away on their own. They can sometimes spread to other parts of the face and neck and make you ill.

Symptoms of a dental abscess

Symptoms of an abscess in your tooth or gum may include:

an intense, throbbing pain in the affected tooth or gum that may come on suddenly and gets gradually worse
pain that spreads to your ear, jaw and neck on the same side as the affected tooth or gum
pain that’s worse when lying down, which may disturb your sleep
redness and swelling in your face
a tender, discoloured and/or loose tooth
shiny, red and swollen gums
sensitivity to hot or cold food and drink
bad breath and/or an unpleasant taste in your mouth

If the infection spreads, you may also develop a high temperature (fever) and feel generally unwell. In severe cases, you may find it hard to fully open your mouth and have difficulty swallowing or breathing.

Phone 999 if:

you have difficulty breathing or swallowing

Speak to your dentist if:

you have any symptoms of a dental abscess

Relieving your symptoms

While you’re waiting to see a dentist, painkillers can help control your pain.

Ibuprofen is the preferred painkiller for dental abscesses. If you’re unable to take it for medical reasons, you can take paracetamol instead.

Aspirin shouldn’t be given to children under 16.

If one painkiller doesn’t relieve the pain, taking both paracetamol and ibuprofen at the doses shown in the medicine leaflet may help. This is safe for adults, but not for children under 16.

It may also help to:

avoid hot or cold food and drink if it makes the pain worse
try eating cool, soft foods if possible, using the opposite side of your mouth
use a soft toothbrush

These measures can help relieve your symptoms temporarily, but you shouldn’t use them to delay getting help from a dentist.

Treatments for a dental abscess

Dental abscesses are treated by removing the source of the infection and draining away the pus.

Depending on the location of the abscess and how severe the infection is, possible treatments include:

removing the affected tooth (extraction) – this may be necessary if root canal treatment isn’t possible
root canal treatment – a procedure to remove the abscess from the root of an affected tooth before filling and sealing it
incision and drainage – where a small cut (incision) is made in the gum to drain the abscess (this is usually only a temporary solution)

Local anaesthetic will usually be used to numb your mouth for these procedures. More extensive operations may be carried out under general anaesthetic (where you’re asleep).

Antibiotics aren’t routinely prescribed for dental abscesses, but may be used if the infection spreads or is particularly severe.

Causes

Your mouth is full of bacteria, which form a sticky film on your teeth called plaque.

If you don’t keep your teeth clean, acids produced by the bacteria in plaque can damage your teeth and gums, leading to tooth decay or gum disease.

The following can increase your chances of developing a dental abscess:

poor oral hygiene – plaque can build-up on your teeth if you don’t brush and clean in between your teeth regularly
too much sugary food and drink – these cause growth of bacteria in plaque and may lead to decay that can result in an abscess
an injury or previous surgery to your teeth or gums – bacteria can get into any damaged parts of the teeth or gums
having a weakened immune system – this includes people with certain underlying health conditions, such as diabetes, and those having treatment, including steroid medication or chemotherapy

Preventing dental abscesses

You can reduce your risk of developing dental abscesses by keeping your teeth and gums as healthy as possible.

Do

use an interdental brush or floss at least once a day to clean between your teeth and under the gum line
brush your teeth with a fluoride toothpaste twice a day – spending at least 2 minutes each time
avoid rinsing your mouth with water or mouthwash after brushing because this washes the protective toothpaste away
cut down on sugary food and drinks – particularly between meals or shortly before going to bed
visit your dentist regularly – your dentist can suggest how often you should have a check-up, based on your oral health