Dental abscess: signs, urgent care and when to call 999

Abscess symptoms can overlap with other dental problems, so they need assessment rather than guesswork.

• Throbbing tooth or gum pain that may spread to the jaw, ear or neck.
• Pain when biting, chewing or touching the tooth.
• Swelling of the gum, cheek, jaw or nearby tissues.
• A bad taste, bad breath, pus or fluid from the gum area.
• Sensitivity to hot or cold, or a tooth that feels raised or loose.
• Fever, tiredness, feeling unwell or swollen glands.
• Difficulty opening the mouth fully, swallowing or speaking.

A dental abscess usually develops when bacteria reach tissues inside or around a tooth. The exact cause depends on dental assessment.

• Tooth decay reaching the nerve inside a tooth.
• A cracked, broken or heavily worn tooth that lets bacteria in.
• Gum disease creating infected pockets around teeth.
• Food or bacteria trapped around a partly erupted wisdom tooth.
• A failed or leaking filling, crown or previous root canal treatment.
• Trauma to a tooth, even if the crack or injury is not obvious.
• Medical vulnerability, including reduced immunity, may increase the risk from dental infection.

1. 1Contact your own dentist for urgent advice where possible. If you cannot access a dentist and need urgent help, use NHS 111.
2. 2Use pain relief only if it is suitable for you and follow the packet instructions. Ask a pharmacist if you are unsure.
3. 3Keep the area clean with gentle brushing. Adults may rinse gently with warm salty water if they can do so safely.
4. 4Choose soft foods, avoid chewing on the painful side, and avoid very hot, cold or sweet triggers.
5. 5Do not place aspirin or other medicines directly on the gum or tooth.
6. 6Do not take someone else's antibiotics or leftover antibiotics.
7. 7Do not squeeze, pierce or try to drain a swelling yourself.
8. 8Do not use the NHS waiting-list pathway for a dental emergency. It is for routine waiting-list interest, not urgent pain, swelling, infection or trauma.

A suspected dental abscess needs urgent dental advice because the source usually needs dental treatment. Pain relief or antibiotics alone do not remove the underlying source of infection.

• Tooth or gum pain with swelling, pus, fever or a bad taste.
• Pain that is severe, worsening, affecting sleep or not settling with suitable pain relief.
• A painful lump on the gum or swelling that is getting bigger.
• Pain on biting with a tooth that feels raised, loose or changed.
• Symptoms linked to a broken tooth, recent dental treatment or wisdom tooth swelling.
• Children, people who are pregnant, and people who are clinically vulnerable or immunocompromised should seek advice promptly if infection is suspected.

If you cannot contact your own dentist and need urgent advice, call NHS 111 or use 111 online. NHS 111 can advise the next step but does not guarantee an appointment.

• Swelling of the mouth, lips, tongue, throat or neck with difficulty breathing, swallowing or speaking.
• Severe swelling affecting the ability to open one or both eyes.
• Rapidly worsening facial swelling, especially if it is spreading towards the eye, throat or neck.
• Difficulty opening your mouth, drooling, confusion, severe weakness or feeling seriously unwell.
• Heavy mouth bleeding that will not stop, serious face or jaw injury, or head or facial injury with loss of consciousness, vomiting or double vision.

If you are unsure whether symptoms are life-threatening, NHS 111 can help you decide what to do. Call 999 immediately if breathing or swallowing is affected.

A dentist may examine the tooth, gum, bite, swelling and nearby tissues. They may take an X-ray or arrange further assessment if the infection appears to be spreading.

Treatment may include addressing the source of infection, draining pus, root canal treatment, removing the tooth, cleaning infected gum areas, repairing a broken restoration, or prescribing medicine when clinically appropriate. The right option depends on assessment, diagnosis, consent, suitability and fees explained by the practice.