Tooth abscess: symptoms and treatment explained

A tooth abscess is a pocket of pus caused by a bacterial infection, usually at the tip of a tooth root or in the gum beside it. Typical symptoms are a severe, throbbing toothache, swelling and a bad taste. It will not heal on its own and needs a dentist to drain it and treat the cause. At Toothi London an emergency appointment is £65. If your face is swelling quickly, or swelling is affecting your breathing, swallowing or eye, go to A&E or call 999 now.

An abscess forms when bacteria get into a part of the tooth or gum they cannot normally reach. The body fights the infection and pus collects in a small pocket. Because that pocket is trapped inside bone or tight gum tissue, pressure builds, and that pressure is what causes the intense, throbbing pain many people describe.

There are two main types, and the difference matters because it changes the treatment.

Your dentist will usually tell which type you have from an examination and an X-ray.

Symptoms vary from person to person, and some abscesses cause surprisingly little pain, especially if the nerve has already died. The most common signs are:

• ✓  Throbbing pain that can come on suddenly, get steadily worse and spread to your ear, jaw or neck on the same side.
• ✓  Pain when biting or touching the tooth, or a feeling that the tooth is slightly raised.
• ✓  Sensitivity to hot or cold that lingers after the trigger is gone.
• ✓  Swelling in the gum, cheek or under the jaw.
• ✓  A small spot or pimple on the gum that may burst and release a salty, unpleasant fluid.
• ✓  A bad taste or bad breath that does not go away with brushing.

If the pain suddenly eases, that does not always mean the problem has gone. Sometimes the abscess has burst and is draining, or the nerve has died. The infection is still there and still needs treating.

No. The source of the infection, whether that is a dead nerve inside the tooth or a deep gum pocket, stays in place until a dentist removes it. Pain may come and go, but the infection usually carries on quietly and can flare up again, sometimes more severely.

Antibiotics do not fix an abscess on their own. They may be prescribed when infection is spreading or you are unwell with it, to help bring that under control. They cannot reach the bacteria sealed inside a dead tooth or a deep pocket, so the cause remains and the abscess usually returns once the course ends. That is why NHS guidance says the tooth itself needs treatment.

Self-care can make you more comfortable while you wait to be seen. It will not treat the infection.

• ✓  Take your usual painkiller, following the packet instructions. Ask a pharmacist if you are unsure which is suitable for you.
• ✓  Use a cold compress on the outside of your cheek for short periods if it helps.
• ✓  Eat soft, cool foods and chew on the other side.
• ✓  Avoid very hot, cold or sugary food and drink if they set off the pain.
• ✓  Keep brushing gently with fluoride toothpaste and use floss or interdental brushes carefully.

Do not try to burst a swelling yourself, and do not put a painkiller tablet directly on the gum.

At your emergency appointment we examine the area, usually take an X-ray to see the root and bone, and explain what we find. The aim is always to drain the infection and remove its cause. Depending on the tooth, that means one of these approaches:

Often the first visit is a first-stage root canal (extirpation): we open the tooth, remove the infected nerve and dress it. This usually relieves the pain quickly and gives you time to plan the rest. Read more about root canal treatment at Toothi or tooth extractions.

We give you a written plan with the price before any treatment beyond your assessment. Every fee is listed on our fees page. For a periodontal abscess linked to gum disease, the gum pocket also needs ongoing care; see gum disease treatment.

Most abscesses start with decay, a crack or gum disease that has been building for some time. Catching those early is the most reliable way to prevent one.

• ✓  Brush twice a day with fluoride toothpaste, and spit rather than rinse afterwards.
• ✓  Clean between your teeth daily with floss or interdental brushes.
• ✓  Cut down on sugary snacks and drinks, especially between meals.
• ✓  Have regular check-ups so small problems are found before they reach the nerve. A check-up at Toothi is £55.
• ✓  Get a chipped or cracked tooth looked at even if it does not hurt.