A dental abscess is a pocket of pus caused by a bacterial infection, either at the tip of a tooth root or in the gum beside it. It is one dental problem that will not clear up by itself, so this is a get seen soon situation, not a wait and see one.
How to recognise it
- Throbbing pain in a tooth or the gum, often worse when lying down and sometimes spreading to the ear, jaw or neck on the same side
- Swelling of the gum, face or jaw, and the tooth may feel loose or raised
- A bad taste or smell in the mouth, especially if the abscess leaks
- Sensitivity to hot and cold and pain on biting
- Feeling generally unwell, or a high temperature
What to do today
1. Phone your dentist and say you think you have an abscess. NHS practices must offer urgent appointments to their own patients, and an abscess counts.
2. No dentist? Call NHS 111 or use 111 online. They will triage you and can book an urgent NHS appointment, usually the same day for an abscess. The charge is £27.90, or free if you are exempt.
3. Private emergency dentists offer same day slots, typically £80 to £400 for the appointment, with the actual treatment charged on top.
Antibiotics on their own are not the treatment. The infection has to be drained and the cause dealt with, so a dentist is unavoidable.
While you wait to be seen
- Take paracetamol or ibuprofen at the normal dose. Ibuprofen is often more effective for dental pain, and the two can be used together if you can take both.
- Never hold an aspirin against the gum. It burns the tissue and does not help.
- Rinse with warm salt water. Eat soft food on the other side, avoid very hot or cold drinks, and sleep propped up.
- Do not try to burst or squeeze a swelling.
When it is A&E or 999, not the dentist
Go to A&E or call 999 if:
- The swelling is spreading to your eye, under your tongue, or down your neck
- You have difficulty breathing or swallowing, or cannot open your mouth properly
- You have a high fever and feel very unwell, or the swelling is getting rapidly worse
A spreading dental infection can become serious quickly. A&E will not do dental work but will treat the infection and refer you on.
How it is treated
The dentist will drain the abscess, then either treat the tooth with a root canal to save it or extract it, depending on its condition. On the NHS both are Band 2 treatments at £76.60, unless the tooth then needs a crown, which moves the course to Band 3. Antibiotics are added when the infection has spread or you have a fever.
This is general information, not clinical advice. If you are in doubt, call NHS 111.