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A dental abscess is a collection of pus that forms in your teeth or gums as a result of a bacterial infection.
The main symptom of a dental abscess is a severe, throbbing pain at the site of the abscess. The pain usually comes on suddenly and then gets gradually worse over a few hours or a few days.
Read more about the symptoms of a dental abscess.
There are two types of dental abscess:
Both types of dental abscess are caused when bacteria builds up inside your mouth. This usually occurs due to a combination of:
Read more about the causes of a dental abscess.
You should make an appointment with a dentist as soon as possible if you think you may have a dental abscess.
Your dentist will be able to drain away the pus from the abscess and, if necessary, remove any teeth that have been damaged by the infection.
This type of treatment should not be too painful because local anaesthetic will be used to numb the affected area of your mouth.
Unlike some other types of infection, a dental abscess will not get better on its own and must be treated by a dentist. With appropriate treatment, the bacterial infection that causes a dental abscess can usually be successfully cured.
Read more about how a dental abscess is treated.
It is rare for complications to develop as a result of a dental abscess, but they can be serious if they do occur. For example, the infection may spread to nearby bone (osteomyelitis).
Read more about the complications of a dental abscess.
If you have severe pain, you may need emergency out-of-hours dental treatment.
Depending on your individual circumstances, you may have to pay a fee for your treatment.
The main symptom of a dental abscess is an intense, throbbing pain in your affected tooth or area of gum.
The pain usually comes on suddenly and may gradually get worse over a few hours to a few days.
Sometimes, the pain may spread to your ear, lower jaw and neck on the same side as the affected tooth.
Other symptoms of a dental abscess can include:
The following symptoms can be a sign of the infection spreading to other parts of your body:
If you develop any of these symptoms and you are not due to see a dentist straight away, you will need to access NHS emergency dental services. In this situation, you can call:
Alternatively, you could visit the accident and emergency (A&E) department of your local hospital.
A dental abscess occurs when bacteria infect and spread inside a tooth or your gums.
Your mouth is full of bacteria, which combine with small particles of food and saliva to form a sticky film called plaque, which builds up on your teeth.
Eating and drinking food and drink high in carbohydrates (sugary or starchy) causes the bacteria in plaque to turn the carbohydrates into the energy they need to reproduce. Acid is also produced.
The combination of bacteria and excess acid can lead to the formation of a dental abscess. This can either occur when bacteria spread into:
When a periapical abscess develops, plaque bacteria infect your tooth as a result of dental caries (tiny holes caused by tooth decay) that form in the hard outer layer of your tooth (the enamel).
Dental caries break down the enamel and the softer layer of tissue underneath (dentine) and eventually reach the centre of your tooth (pulp). This is known as pulpitis. The dental pulp in the middle of the tooth dies and the pulp chamber becomes infected.
The bacteria continue to infect the pulp until it reaches the bone that surrounds and supports your tooth (alveolar bone), where the periapical abscess forms.
A periodontal abscess occurs when plaque bacteria affect your gums, causing severe gum disease (also known as periodontitis).
Periodontitis causes inflammation (redness and swelling) in your gums, which can make the tissue surrounding the root of your tooth separate from the base of your tooth.
The separation creates a tiny gap called a periodontal pocket, which allows bacteria to enter and spread and can be very difficult to keep clean.
The periodontal abscess is formed by the build-up of bacteria in the periodontal pocket. A periodontal abscess may also occur as a result of:
Risk factors for a dental abscess include:
If you think that you may have a dental abscess, you must see a dentist as soon as possible.
Your dentist will carry out some tests to determine whether your symptoms are being caused by a dental abscess. For example, they may:
In some cases, your dentist may be able to confirm a diagnosis by simply asking you about your symptoms.
Your dentist may refer you for treatment in hospital if you have a dental abscess and you:
The only way to cure a dental abscess is with dental treatment.
Your doctor will be able to advise you, but they cannot provide the treatment needed to cure an abscess.
Your dentist will treat your abscess using dental procedures and, in some cases, surgery (see below).
A dental abscess can be very painful, but you can use over-the-counter painkillers from your local pharmacy to control the pain while you are waiting for dental treatment.
If one painkiller fails to relieve the pain, taking both paracetamol and ibuprofen at the same time can often be effective (this is safe for adults, but not for children under 16 years of age).
However, you should make sure you leave six hours before taking another combined dose.
Also, always read and follow the information on the packet about how much to take and how often, and do not exceed the maximum stated dose.
Accidental overdoses have been reported in people who take too many painkillers when trying to relieve the pain of a dental abscess.
Painkillers cannot treat or cure a dental abscess, so they should not be used to delay dental treatment.
Follow the advice below to take painkillers safely:
Other self care techniques that can help include:
The first and most important step in treating a dental abscess is to cut out the abscess and drain away the pus containing the infectious bacteria.
Your dentist will carry this out under local anaesthetic. This means you will be awake throughout the procedure, but the affected area will be numb so you will feel little to no pain.
If the abscess is inside one of your teeth (a periapical abscess), root canal treatment will usually be recommended. This involves drilling into the affected tooth to release the pus and removing any damaged tissue from the centre (pulp). A filling will then be inserted into the space to prevent further infection.
If there is a pocket of pus inside an area of gum (a periodontal abscess), your dentist will drain the pus and clean out the pocket. They will then smooth out the surfaces of the root of your tooth by filing below your gum line to help your tooth heal and prevent further infection.
Antibiotics are not routinely prescribed to treat dental abscess because:
Antibiotics are usually only required if:
If antibiotics are required, an antibiotic called amoxicillin is usually recommended. If you are allergic to amoxicillin, which is a type of penicillin, metronidazole can usually be prescribed as a precaution.
If you have a periapical abscess and your infection reoccurs, you may need to be referred to an oral surgeon who will surgically remove any further diseased tissue.
If you have a periodontal abscess and your infection reoccurs, you may be referred to an oral surgeon who will be able to reshape your gum tissue to permanently remove the periodontal pocket.
In some cases, a dental abscess infection can reoccur even after dental and surgical procedures. If this happens, or if your tooth is severely broken down, it may need to be removed altogether (extracted).
With appropriate dental treatment, a dental abscess can usually be easily cured. However, in rare cases, complications can occur.
Most complications arise due to the spread of the bacterial infection when an abscess is left untreated. Some possible complications are outlined below.
If a dental abscess is left untreated, a fluid-filled cavity may develop at the bottom of the root of your tooth. This is known as a dental cyst.
Osteomyelitis is an infection of the bone. It is caused by the bacteria in a dental abscess spreading through your bloodstream.
Osteomyelitis can cause symptoms such as fever, nausea (feeling sick) and severe pain in the affected bone, which can often be in the area surrounding a dental abscess.
However, as the infection is spread through your blood, it is possible for it to affect any bone in your body. Osteomyelitis can be treated by taking oral antibiotics or injecting them into a vein.
Read more osteomyelitis.
Sinusitis is an infection of the small air-filled cavities inside your skull.
It is usually the cavities behind your cheekbones that can become infected as a complication of a dental abscess. These are known as the maxillary sinuses.
Symptoms of sinusitis include:
Sinusitis often clears up without treatment but, if necessary, antibiotics may be prescribed.
Read more about sinusitis.
Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.