A dental abscess is a collection of pus caused by infection. It can be very painful and always needs prompt treatment — find out what to expect and what to do.
A dental abscess is a collection of pus (infected fluid) that builds up in or around a tooth or in the gum. It is caused by a bacterial infection.
There are two main types:
Periapical abscess — forms at the tip of the tooth root. Usually caused by untreated tooth decay that has reached the nerve, or by trauma to the tooth.
Periodontal abscess — forms in the pocket between the tooth and gum. Often associated with gum disease.
A dental abscess will not go away on its own and will not get better without treatment. It will continue to worsen over time. Antibiotics alone do not cure an abscess — the source of infection must be treated.
Signs and symptoms
A dental abscess typically causes:
A severe, throbbing toothache — the pain may radiate to the jaw, ear, or neck
Pain that gets worse when you lie down
Sensitivity to hot and cold
Swelling in the face, cheek, jaw, or gum
A tender, swollen lymph node under your jaw
A bad taste in your mouth — this may occur if the abscess drains
Difficulty opening your mouth
A high temperature (fever)
A pimple-like swelling on the gum near a tooth (a "dental sinus")
When this is a medical emergency
Go to your nearest Accident and Emergency department immediately or call 999 if you have:
Swelling that is spreading rapidly — to your neck, floor of the mouth, or eye area
Difficulty breathing or swallowing
A high fever (38°C or above) combined with feeling very unwell
Swelling that has closed one eye or is near your eye
A feeling of general illness with a rapid heartbeat
A spreading dental infection can be life-threatening if it reaches the airway. Do not delay in seeking emergency care if you have any of these symptoms.
You can also call NHS 111 for urgent dental advice if your dental practice is closed.
How is a dental abscess treated?
Treatment always involves addressing the source of infection. Your dentist will discuss which option is most appropriate for your situation:
Incision and drainage — your dentist makes a small opening in the swollen area to allow the pus to drain out. This gives immediate relief from pressure and pain.
Root canal treatment — if the tooth can be saved, this treatment removes the infected nerve tissue from inside the tooth, cleans the root canals, and seals them. The tooth is then usually restored with a filling or crown.
Extraction — if the tooth cannot be saved, removing it allows the infection to drain and heal. Your dentist will discuss replacement options if appropriate.
Antibiotics — these may be prescribed if the infection has spread beyond the tooth (spreading swelling, fever), or if you have a compromised immune system. Antibiotics are a supporting measure, not a cure — the infection source must still be treated.
Pain relief while you wait for treatment
While waiting for your dental appointment, you can take the following steps to manage pain:
Take over-the-counter pain relief such as paracetamol or ibuprofen as directed on the packet. You can alternate them if one alone is insufficient — seek pharmacist advice on how to do this safely. Avoid ibuprofen if you have asthma, cardiovascular disease, stomach problems, kidney issues, take blood-thinning medications, or are pregnant.
Do not apply heat or a hot water bottle to the face — heat can encourage the infection to spread.
Try eating on the opposite side of your mouth.
Avoid very hot, cold, or sweet food and drinks that aggravate the pain.
Do not delay — contact your dental practice for an emergency appointment as soon as possible.
Preventing dental abscesses
Dental abscesses are largely preventable:
Attend regular dental check-ups — decay and gum disease caught early are far less likely to progress to an abscess.
Brush twice daily with fluoride toothpaste and clean between teeth daily.
If you injure or crack a tooth, see your dentist promptly — even if it is not painful.
Do not ignore toothache or sensitivity — early treatment prevents complications.
This leaflet is for general information only and does not replace professional dental advice. If you think you have a dental abscess, seek dental advice promptly. Treatment outcomes vary between patients depending on individual circumstances.
When to Seek Urgent Help
If you have a dental abscess with facial swelling, difficulty breathing or swallowing, a high temperature, or swelling that is spreading to your neck or eye, go to your nearest A&E immediately or call 999. This is a medical emergency.
References
Aligned with guidance from: NICE, SDCEP, FGDP(UK).