Dental Abscess: Symptoms, Urgency and Treatment

An abscess is a pocket of infection, and it is the one dental problem where waiting genuinely carries risk. Most are dealt with straightforwardly. A small number become serious quickly, so the important part of this page is knowing which is which.

The short answer

A dental abscess is a collection of pus caused by bacterial infection, either at the root tip of a tooth whose nerve has died, or in a deep pocket beside a tooth from gum disease. It will not resolve on its own, because the source of the infection is still there. It needs draining and the cause treating, which means either root canal treatment from £305 or an extraction from £126. Antibiotics on their own do not cure an abscess; they buy time.

Go to A&E or call 999 now if

• Swelling is spreading towards your eye, or downwards into your neck
• You are having difficulty swallowing, breathing, or speaking
• You cannot open your mouth properly
• You have a fever and feel generally unwell with it
• The swelling is closing your eye, or you feel confused or very drowsy

Those are signs the infection is spreading beyond the tooth, which is uncommon but genuinely dangerous. Do not wait for a dental appointment. Out of hours and without those red flags, NHS 111 will direct you to the urgent dental service.

What an abscess feels like

• Severe, constant, throbbing pain, rather than the brief twinges of ordinary sensitivity. It often radiates to the ear, jaw or temple on the same side.
• The tooth feels raised or loose, and biting on it is exquisitely tender because the pressure has nowhere to go.
• Swelling of the gum next to it, sometimes with a visible boil, or of the face and jaw.
• Worse lying down, so it wakes you or stops you sleeping.
• A sudden foul or salty taste, which means it has partly discharged. The pain usually eases sharply at that moment, which fools people into thinking it has healed.
• Sensitivity to heat rather than cold is a common feature when the nerve is dying.
• Feeling unwell, with a temperature and swollen glands under the jaw.

The two traps

Pain stopping is not the same as getting better. When the nerve inside a tooth finally dies completely, the pain can disappear for weeks while the infection quietly continues at the root and the bone around it is destroyed. A great many neglected abscesses are ones that stopped hurting.

Antibiotics are not a treatment. They cannot reach inside a tooth, because there is no blood supply left in a dead nerve for them to travel through. They have a genuine role in controlling spreading infection and buying time until the tooth can be treated, but if you take a course and do nothing else, it will come back. Repeated courses without treating the cause is how people end up needing the tooth out rather than saved.

What treatment involves

The principle is drainage and then dealing with the source. That usually means one of:

• Root canal treatment, which removes the infected tissue from inside the tooth and keeps the tooth. From £305, and a back tooth will usually then need a crown from £600 to protect it.
• Extraction, from £126, which removes the source completely. Quicker and cheaper on the day, but leaves a gap to consider later.
• Incising the swelling to release the pus, where there is a fluctuant gum abscess, often alongside one of the above.
• Deep cleaning of the pocket, where the abscess is periodontal rather than coming from the tooth’s nerve. See gum disease.

On the NHS, urgent treatment is charged at Band 1, currently £27.90 in England.

What helps while you wait

Painkillers as directed on the packet, and ibuprofen tends to suit this well because the problem is inflammatory. Sleep propped up on extra pillows. Warm salty water rinses. Soft food, and chew on the other side. Do not apply heat to a facial swelling, do not try to squeeze or lance it yourself, and never hold an aspirin against the gum.

Not sure how urgent this is? Pick your symptom in our urgency checker and get a straight answer: call today, book this week, or self-care first.

Frequently asked questions

Will a dental abscess go away on its own?

No. It may burst and ease, and the pain may vanish entirely when the nerve dies, but the infection remains and the bone around the root continues to be affected. The source has to be treated.

Do I need antibiotics for an abscess?

Sometimes, to control spread or to make treatment possible, but never as the whole answer. The definitive treatment is draining the infection and dealing with the tooth. A course of antibiotics with no follow-up treatment reliably ends in it returning.

How quickly do I need to be seen?

Same day if there is facial swelling, fever, or pain that painkillers are not touching. Within a day or two otherwise. Immediately to A&E if any of the red flags at the top of this page apply.

Can I be seen if I am not a patient here?

Yes. Ring as early in the day as you can. We keep time in the diary for urgent problems and we will always tell you the cost before any treatment.

If you have swelling or pain that is stopping you sleeping, ring us first thing on 01625 574609. Prices are published on our fees page.

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