The most common tooth abscess symptoms are a severe, throbbing toothache, pain when you bite, swelling in the gum or face, a pimple-like lump on the gum and a bad taste in your mouth. An abscess is a pocket of infection that needs dental treatment, as it won’t clear up by itself. If swelling is spreading or you have trouble breathing or swallowing, call 000.
Below, you’ll find how to recognise an abscess, when it becomes a hospital emergency and what to do until you’re seen. You can also read what counts as a dental emergency for other urgent problems.
When a tooth abscess is a hospital emergency
A dental infection can occasionally spread into the deeper tissues of the face and neck, which can be life-threatening. Call 000 or go to your nearest hospital emergency department if you have:
- difficulty breathing, swallowing or talking
- swelling spreading to your eye, down your neck or into the floor of your mouth, or a raised tongue
- trouble opening your mouth
- a fever, chills or you feel very unwell with facial swelling
- bleeding that won’t stop after 15–20 minutes of firm pressure
- a possible broken jaw, or a recent knock to the head with loss of consciousness, vomiting or confusion
If it’s after hours and you’re not sure how serious your symptoms are, call healthdirect on 1800 022 222 for 24/7 nurse advice.
Common tooth abscess symptoms
Symptoms can vary from person to person, and some abscesses cause surprisingly little pain. Look out for:
- a constant, throbbing toothache that may spread to your ear, jaw or neck
- pain when you bite or chew, or a tooth that feels higher than the others
- sensitivity to hot or cold
- red, swollen or tender gums around one tooth
- swelling in your cheek, jaw or under your chin
- a small lump or blister on the gum, sometimes called a gum boil
- a bad taste or smell, especially if pus drains into your mouth
- tender, swollen glands under your jaw
- a loose tooth or a tooth that has darkened in colour
Symptoms that are easy to miss
If the lump on your gum bursts, the pain may ease quickly as the pressure drops. That doesn’t mean the infection has gone. The source is still there and the abscess will usually return, so it still needs treatment.
A front tooth that was knocked months or years ago can also develop an abscess slowly, with only mild tenderness or a greyish colour change as the first sign.
Types and causes of a dental abscess
At the tip of the root
This is the most common type. It develops when bacteria reach the nerve inside the tooth through deep decay, a crack, a large or leaking filling, or damage from an old injury. The nerve dies and infection builds up at the end of the root.
In the gum beside the tooth
A gum abscess forms in the pocket between the tooth and gum. It’s often linked to gum disease, or to something lodged under the gum, such as a popcorn husk.
Around a wisdom tooth
A partly erupted wisdom tooth can trap food and bacteria under the flap of gum over it, causing painful swelling at the back of the mouth.
What to do until you see a dentist
Call our emergency dentist in North Sydney as soon as you notice symptoms. We aim to see urgent problems as soon as possible, often on the same day. In the meantime:
- rinse gently with warm salty water a few times a day
- take over-the-counter pain relief such as paracetamol or ibuprofen, taken as directed on the pack, if it’s safe for you
- hold a cold pack wrapped in a cloth against the outside of your cheek for 10–15 minutes at a time
- sleep with your head raised, drink plenty of water and eat soft food on the other side
Avoid these
- Don’t squeeze, pop or cut the lump on your gum.
- Don’t use heat on your face, as it can encourage swelling to spread.
- Don’t put aspirin or other tablets on the gum.
- Don’t take leftover antibiotics or anyone else’s medication.
How a dentist treats an abscess
At our North Sydney clinic, your dentist will examine the area, test the tooth and usually take an X-ray to find the source of the infection. Treatment aims to drain the infection and remove its cause. Depending on the tooth, this may involve:
- Draining the abscess to relieve pressure and pain.
- Root canal therapy, which cleans the infected nerve space inside the tooth and seals it, so the tooth can often be kept.
- Tooth extraction, if the tooth is too badly damaged to save.
- Cleaning under the gum for a gum abscess, or treating the area around a wisdom tooth.
Antibiotics may be prescribed if the infection is spreading or you’re unwell, but they don’t usually fix the problem on their own. Without treatment of the source, the infection tends to come back. Your dentist will explain your options, the risks and the likely costs before starting.
Reducing your risk
Most abscesses start with problems that can be found early. Brush twice a day with fluoride toothpaste, clean between your teeth daily and keep up regular check-ups. See a dentist promptly for toothache, a broken tooth or bleeding gums rather than waiting for them to settle.
Frequently asked questions
Can a tooth abscess go away on its own?
No. The pain may ease if the abscess drains, but the source of infection remains inside the tooth or gum. It needs dental treatment to stop it returning or spreading.
Do I need antibiotics for a tooth abscess?
Not always. Antibiotics may be prescribed if the infection is spreading or you feel unwell, but the main treatment is draining the infection and treating the tooth. Only take antibiotics prescribed for you.
When is a tooth abscess an emergency?
Call 000 or go to hospital if you have trouble breathing or swallowing, swelling spreading to your eye, neck or floor of the mouth, trouble opening your mouth or a fever with facial swelling.
What should I do if the lump on my gum bursts?
Rinse gently with warm salty water and book a dental visit soon. The pain may ease, but the infection is still there and needs treatment.
Need help now?
North Sydney Dentistry is at Level 1, Suite 102/71 Walker St, North Sydney, a two-minute walk from North Sydney station. We’re open Monday to Friday, 9am to 6pm, and keep time aside for urgent problems where we can. Call (02) 8090 1108 or book online.
This article is general information only and is not a substitute for advice from your own dentist or doctor. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
