Image of a woman holding her swollen cheeck in pain

Swelling - Dental Abscess

When to go to A+E

  • If you have a swelling in or around your mouth/neck and it is making it difficult for you to breathe, speak or swallow.
  • If you notice a swelling around your eye.
  • If you have a swelling and/or fever and are unable to get into your dentist or GP.

When to see an emergency dentist

  • Pain from your tooth or gum that can't be controlled with painkillers and is causing sleep loss.
  • Redness/swelling/puffiness of the face.
  • Swelling of the gum that does or doesn't burst.
  • A tender and/or loose tooth.
  • Unpleasant taste.

What to do if you have a swelling

  • Take over the counter painkillers (Ibuprofen/Paracetamol). Make sure you aren't allergic and that they don't interact with any other medication you are taking. Stick to the recommended dosages and do not give Aspirin to children under the age of 16.
  • Apply cold compress to the swelling to try and help reduce it. Wrap up ice with a cool damp towel and hold on the swollen area.
  • Brush your teeth gently in case food has been trapped between your teeth.
  • Swirl with a warm salty mouth rinse. Place a teaspoon of salt in a glass of hot water and wait for it to be cool enough to swirl.
  • Avoid hot or cold food/drink if it makes the pain worse.

Finally, book an appointment with an emergency dentist near you.

Causes

Abscess – This is caused by a bacterial infection in and around your tooth. There are two main types of abscess that can affect your tooth:

Dental Abscess – This is caused by an accumulation of bacteria inside and/or around the end of your tooth and is normally cause by tooth decay or dental trauma.

Gum Abscess – This is caused by an accumulation of bacteria between the gum and the tooth, and is often found in patients with pre-existing gum disease.

Please note, this is not an exhaustive list and there are other types of oral abscesses and variations of those described above.

Emergency Treatment

An abscess left untreated can be life-threatening. If the infection spreads and is not drained, it can block the patient's airway and prevent them from breathing. An infection that is not treated can also affect the rest of the body causing sepsis.

An emergency dentist has five options to deal with an abscess

  1. Incise and drain the abscess – The dentist will anaesthetise the area and incise the swelling to drain any infection quickly to stop it spreading. This is a temporary solution, and further treatment is likely to be needed.
  2. Tooth extraction – The source of the infection is the tooth itself, so by extracting the tooth any remaining infection should be removed by the body's own immune system.
  3. Root Canal Treatment – This is the only way to save a tooth if it has a bacterial infection inside or on the end of the tooth. There is no guarantee root canal treatment will be successful, however the aim is to try and clean the root canal system inside the tooth, with the hope of preserving it.
  4. Antibiotics – If there are other signs of infection, such as a raised temperature, the dentist may suggest antibiotics to reduce the infection, prior to completing any definitive treatment.
  5. Root Surface Debridement – If you have a gum abscess, the dentist may anaesthetise the area and manually clean the localised infection.

Prevention

The best ways to prevent oral health problems include:

  • Visit your dentist regularly at a time period specified by your dentist. Children should visit the dentist every 6 months from when their first teeth appear.
  • Brush your teeth twice daily for two minutes with an appropriate fluoride toothpaste for your age.
  • Clean between your teeth with interdental brushes daily, and use a daily non-alcohol based fluoride mouthwash.
  • Reduce the amount and the frequency of sugar in your diet.
  • Don't smoke and limit your alcohol consumption to the recommended amounts.