A dental abscess is a pocket of pus caused by a bacterial infection in or around a tooth or gum. It can be extremely painful, but it can also be surprisingly misleading. Sometimes the pain comes and goes. Sometimes swelling appears before the pain becomes severe. Occasionally, the pain eases because the infection has started to drain — but that does not mean the infection has gone away.
A dental abscess is not something to “wait out”. Unlike a mouth ulcer or mild gum irritation, an abscess usually needs dental treatment to remove the source of infection. Painkillers may help you cope for a short time, and antibiotics may sometimes be used when infection is spreading, but the underlying dental problem normally still needs to be treated by a dentist.
This guide explains what a dental abscess is, the symptoms to watch for, what causes it, how it is treated, what you can do while waiting for help, and when it becomes a medical emergency.
If your main symptom is tooth pain and you are not sure whether it is an abscess, you may also find our guide to toothache causes, relief and when to see a dentist useful. To find local dental services, you can also search our UK dentist directory or use our dentists near me page.
What is a dental abscess?
A dental abscess is a collection of pus caused by infection. It can form inside a tooth, at the root of a tooth, in the gum, or in the tissues around the jaw. The infection is usually bacterial and often develops when bacteria enter areas they should not reach — for example through tooth decay, a cracked tooth, gum disease, trauma, or a failed filling.
The NHS describes a dental abscess as a build-up of pus in the teeth or gums that needs urgent treatment by a dentist and will not go away on its own. That point is important. Even if the pain improves, the infection may still be present and may return or spread.
There are two main types of dental abscess:
- Periapical abscess: this starts at the tip of the tooth root, usually because infection has reached the pulp inside the tooth. It is often linked to deep decay, trauma or cracks.
- Periodontal abscess: this starts in the gum or supporting tissues around the tooth. It is often linked to gum disease, deep gum pockets or trapped debris.
In real life, you may not know which type you have. Both can cause pain, swelling and infection. Both need dental assessment.
What does a dental abscess feel like?
Many people imagine a dental abscess as unbearable toothache with a swollen face. That can happen, but abscess symptoms are not always so obvious at the start. Some begin as a dull ache. Some feel like pressure. Some cause pain when biting before any swelling appears. Others cause a small pimple-like swelling on the gum that releases a bad-tasting fluid.
A dental abscess may cause:
- severe, throbbing toothache or gum pain;
- pain that spreads to the jaw, ear, neck or temple;
- pain when biting or chewing;
- sensitivity to hot or cold food and drinks;
- a swollen gum near the painful tooth;
- facial, jaw or cheek swelling;
- a bad taste in the mouth;
- bad breath;
- pus around a tooth or gum;
- a small spot, boil or “gum pimple” near the tooth;
- fever or feeling generally unwell;
- swollen glands in the neck or under the jaw;
- difficulty opening the mouth fully.
The pain is often described as deep, pulsing or throbbing. It may be worse when lying down, because pressure changes can make inflamed tissues feel more painful. Some people find the pain keeps them awake, while others notice it most when chewing.
Early warning signs that may be easy to miss
Not every dental abscess begins dramatically. Sometimes the early signs are subtle enough that people delay care. A tooth may feel slightly “high” when you bite. A gum may feel tender in one small area. A tooth that used to be sensitive may suddenly become more painful with heat. You may notice a bad taste that comes and goes, or a small swelling that drains and then returns.
These signs matter because abscesses are often easier to treat earlier. Waiting until the pain is severe or the face is swollen can make treatment more urgent and more stressful.
Book dental advice promptly if you notice:
- one tooth becoming increasingly painful;
- pain when biting on a specific tooth;
- a gum swelling near one tooth;
- pus, a bad taste or a pimple-like bump on the gum;
- toothache that wakes you at night;
- pain that improves briefly but keeps coming back;
- swelling around a wisdom tooth;
- feeling unwell alongside dental pain.
What causes a dental abscess?
A dental abscess happens when bacteria multiply in a space where the body cannot clear the infection easily. The immune system responds, pus collects, pressure builds, and the surrounding tissues become inflamed.
Tooth decay
Deep tooth decay is one of the most common reasons for a dental abscess. Decay starts in the hard outer layers of the tooth. If it is not treated, it can progress deeper until bacteria reach the pulp — the soft inner part of the tooth containing nerves and blood vessels. Once the pulp becomes infected, the infection can travel down the root and form an abscess at the tip.
This is why cavities should not be ignored, even if they are not painful yet. Early decay may need a filling. Deep decay may need root canal treatment or extraction.
Cracked or broken tooth
A crack can let bacteria enter the tooth. Sometimes the crack is obvious, such as after biting something hard or after an injury. Other times it is hidden and only causes pain when biting. Cracked teeth can be difficult to diagnose without a dental examination and sometimes an X-ray or special tests.
Gum disease
Gum disease can create pockets around teeth where bacteria collect. If a pocket becomes blocked or infected, a periodontal abscess can form. This type of abscess may be associated with swollen gums, bleeding, bad breath, loose teeth or pain when chewing.
Wisdom tooth infection
Partly erupted wisdom teeth can trap food and bacteria under the gum flap. This can cause inflammation and infection at the back of the mouth. Pain may spread to the jaw, ear or throat, and you may find it hard to open your mouth fully. If the infection worsens, swelling and fever can develop.
Dental trauma
A knock to a tooth can damage the pulp even if the tooth does not immediately break. Sometimes the tooth changes colour later, becomes tender, or develops an abscess weeks, months or even years after the injury.
Failed or leaking dental work
Old fillings, crowns or root canal treatments can sometimes fail or leak, allowing bacteria to enter. A tooth that has already had treatment can still become infected again, especially if it cracks, the restoration breaks down, or bacteria reach the root.
Is a dental abscess serious?
Yes, it can be. Most dental abscesses can be treated successfully by a dentist, especially when dealt with early. But an abscess is an infection, and infections can spread. This is why facial swelling, fever, difficulty swallowing, difficulty breathing, swelling around the eye, or swelling spreading into the neck should never be ignored.
The seriousness depends on where the infection is, how far it has spread, your general health, and whether you have symptoms suggesting the infection is affecting deeper tissues. People with a weakened immune system, poorly controlled diabetes or certain medical conditions may be at higher risk of complications and should seek advice promptly.
It is also important to understand that pain is not the only measure of danger. A dental abscess can sometimes become less painful if it drains through the gum, but the infection may still need treatment.
When is a dental abscess an emergency?
A dental abscess needs urgent dental treatment, but some symptoms mean you need emergency medical help rather than waiting for a dental appointment.
Contact a dentist urgently or use NHS 111 if:
- you have toothache with swelling in the gum, jaw, cheek or face;
- pain is severe or not improving with usual pain relief;
- you have pus, a bad taste or a gum boil near the tooth;
- you have fever or feel generally unwell;
- you cannot sleep or eat because of the pain;
- you have difficulty opening your mouth;
- a wisdom tooth area is painful, swollen or worsening;
- you have swollen glands with dental pain;
- you cannot contact your usual dentist.
If you need urgent dental care and cannot access a dentist, the NHS advises using NHS 111 online or calling 111. You can also read the NHS guidance on how to find an emergency or urgent NHS dentist appointment.
Go to A&E or call 999 if:
- swelling is making it difficult to breathe;
- swelling is making it difficult to swallow or speak;
- the swelling is spreading to your neck;
- the area around your eye is swollen;
- you feel very unwell, confused, faint or severely drowsy;
- you have signs of sepsis, such as severe illness, rapid breathing, mottled skin or extreme weakness;
- there has been significant facial trauma;
- bleeding cannot be controlled.
The NHS toothache advice says to go to A&E if the area around the eye or neck is swollen, or if swelling in the mouth or neck is making it difficult to breathe, swallow or speak. These are emergency warning signs because swelling in these areas can affect the airway or indicate that infection is spreading.
What to do while waiting for dental help
While you are waiting to speak to a dentist or attend an urgent appointment, you can take steps to reduce pain and avoid making the situation worse. These measures are for temporary comfort only. They do not treat the abscess itself.
Use pain relief safely
Paracetamol or ibuprofen may help some people with dental pain. Always follow the instructions on the packet and do not exceed the recommended dose. Ibuprofen is not suitable for everyone, including some people with stomach ulcers, kidney disease, certain heart conditions, those taking blood-thinning medicines, and some people who are pregnant. Ask a pharmacist if you are unsure what is safe for you.
Do not put aspirin directly on the tooth or gum. It can burn the soft tissues and will not treat the infection.
Rinse gently with warm salt water
A warm salt-water rinse may help soothe the area and keep it clean. Mix half a teaspoon of salt in a mug of warm water, rinse gently, and spit it out. Do not swallow salty water. Do not use very hot water. Salt-water rinses may ease discomfort, but they will not cure an abscess.
Avoid chewing on the painful side
If biting makes the pain worse, avoid chewing on that side until you have been assessed. Choose softer foods and avoid hard, crunchy or sticky foods that could crack the tooth further or aggravate the area.
Keep brushing gently
It can be tempting to avoid the painful area completely, but plaque and trapped food can make gum inflammation worse. Brush gently with fluoride toothpaste. If cleaning between the teeth is possible without severe pain, do so carefully. Do not poke or squeeze the swelling.
Use a cold compress for facial swelling
A cold compress on the outside of the cheek may reduce discomfort. Wrap a cold pack or ice in a cloth and use it for short periods. Do not apply ice directly to the skin. Avoid using heat on facial swelling unless a clinician advises it.
What not to do with a dental abscess
Dental abscess pain can be frightening, and people often search for quick fixes. Some home approaches can be harmful or can delay proper treatment.
- Do not try to pop or drain the abscess yourself. This can spread infection or damage the gum.
- Do not take leftover antibiotics. They may be unsuitable, out of date, the wrong dose, or may partly mask symptoms while the source remains.
- Do not ignore swelling. Swelling can mean infection is spreading.
- Do not put aspirin on the gum. It can cause burns.
- Do not use alcohol as pain relief. It can irritate tissues and interact with medicines.
- Do not pull your own tooth. This can cause severe bleeding, broken roots, infection and permanent damage.
- Do not rely on painkillers for days. Pain relief may hide the warning signs while the infection continues.
How dentists treat a dental abscess
The aim of treatment is to remove the source of infection and allow the pus to drain. The exact treatment depends on where the abscess is, how severe it is, whether the tooth can be saved, and your general health.
Dental examination and X-ray
The dentist will usually examine the painful area, check the gum, test the tooth, and may take an X-ray. An X-ray can show decay, infection around the root, bone changes, a failed root canal, or other problems that are not visible from the outside.
Draining the abscess
If pus has collected, the dentist may drain it. This relieves pressure and helps clear infection, but drainage alone may not be enough if the source remains inside the tooth or gum.
Root canal treatment
If the abscess is caused by infection inside the tooth and the tooth can be saved, root canal treatment may be recommended. This involves removing infected tissue from inside the tooth, cleaning and shaping the root canals, and sealing them. The tooth may then need a filling or crown to protect it.
Extraction
If the tooth is too damaged to save, or if root canal treatment is not suitable, the dentist may recommend removing the tooth. Extraction removes the source of infection, although further planning may be needed later if you want to replace the missing tooth.
Gum treatment
If the abscess is related to gum disease, treatment may involve cleaning the pocket around the tooth, draining infection, removing trapped debris, and planning further periodontal care. Gum-related abscesses may need ongoing maintenance to reduce the risk of recurrence.
Antibiotics
Antibiotics may be used in some cases, especially if infection is spreading, there is facial swelling, fever, swollen glands, or the person is at higher risk of complications. However, antibiotics alone are not usually enough because they do not remove the source of the infection. A tooth with infected pulp, deep decay or a gum pocket still needs dental treatment.
Why antibiotics alone often do not fix a dental abscess
This is one of the most common misunderstandings about dental abscesses. Because an abscess is an infection, it seems logical to expect antibiotics to cure it. But dental infections often sit inside a tooth, around a dead nerve, or in a pocket where antibiotics may not fully reach or solve the underlying problem.
If bacteria are entering through a cavity, crack, failed filling or gum pocket, the source remains unless it is treated. Antibiotics may reduce the spread of infection for a while, but the abscess can return. This is why dental treatment — such as drainage, root canal treatment, gum treatment or extraction — is often needed.
Can a dental abscess go away by itself?
No, not reliably. The pain may improve temporarily, especially if the abscess drains. But the infection can remain and flare up again. In some cases, it can spread. If you have symptoms of a dental abscess, arrange dental advice even if the pain has settled.
A gum boil that appears and disappears is a common example. It may drain pus, reduce pressure and make you feel better for a while. But it often means there is still infection tracking from the tooth or gum to the surface.
Dental abscess in children
Children can develop dental abscesses in baby teeth or adult teeth. A child may not describe the pain clearly. They may refuse food, chew on one side, wake at night, cry when brushing, have bad breath, develop a gum swelling, or appear generally unwell.
Do not ignore a dental abscess in a baby tooth. Baby teeth are important for eating, speech and guiding adult teeth into place. Infection can cause pain, affect sleep and eating, and sometimes spread.
Seek urgent dental advice if a child has toothache with swelling, fever, pus, facial swelling, difficulty opening the mouth, or if they seem very unwell. If swelling affects breathing or swallowing, call 999 or go to A&E.
Dental abscess during pregnancy
Dental infections during pregnancy should be taken seriously. Some people delay dental care because they are worried about treatment while pregnant, but untreated infection can also carry risks. Tell the dentist you are pregnant so they can choose appropriate treatment and advise on safe pain relief.
In the UK, NHS dental care is free during pregnancy and for 12 months after your baby is born if you have a valid maternity exemption certificate. Toothache, swelling or suspected abscess should not be left until after pregnancy.
Dental abscess and medical conditions
Some people should seek advice especially promptly if they suspect a dental abscess. This includes people with poorly controlled diabetes, weakened immune systems, certain heart conditions, those taking immune-suppressing medicines, and people who have had certain types of surgery or cancer treatment. If you are medically vulnerable or unsure, tell the dental team when you call.
Dental infections can also make blood sugar control harder in people with diabetes. If you have diabetes and develop dental swelling, fever or significant pain, seek urgent advice.
How to reduce your risk of another dental abscess
Not every abscess can be prevented, but many are linked to decay, gum disease, cracks or delayed dental care. Prevention is not glamorous, but it is often the difference between a simple filling and a painful infection.
Brush twice daily with fluoride toothpaste
Brush last thing at night and one other time each day. Spit out after brushing rather than rinsing heavily with water, so fluoride remains on the teeth for longer.
Clean between your teeth
Floss or interdental brushes help remove plaque and food from areas a toothbrush cannot reach. This is particularly important if food often gets trapped between the same teeth.
Reduce frequent sugar exposure
How often you have sugar matters. Sipping sugary drinks or snacking on sweet foods throughout the day gives bacteria repeated chances to produce acid. Keeping sugary foods and drinks to mealtimes can reduce decay risk.
Do not ignore broken fillings or cracked teeth
A broken filling or cracked tooth can create an entry point for bacteria. Getting it checked early may prevent deeper infection.
Treat gum disease early
Bleeding gums, bad breath, gum recession and loose teeth should not be ignored. Gum disease can create pockets where infection can develop.
Have dental check-ups based on your risk
Some people need more frequent dental checks than others. Your dentist can advise based on your teeth, gums, medical history and risk of decay or gum disease. NICE has guidance on dental recall intervals, supporting a personalised approach rather than one fixed schedule for everyone.
NHS or private treatment for a dental abscess?
If you are registered with a dentist, contact them first and explain your symptoms clearly. Mention swelling, fever, pus, difficulty opening your mouth, whether painkillers are helping, and whether you feel unwell. If you cannot contact your dentist, or you do not have one, use NHS 111 for urgent dental advice.
Access to NHS dentistry can be difficult in some areas. Some people choose private urgent dental care if they cannot get an NHS appointment quickly, or if they want more appointment flexibility. If you book privately, ask about consultation fees, X-rays, drainage, temporary treatment, root canal costs, extraction costs and follow-up fees before agreeing to treatment where possible.
You can search for local services through our dentist directory, look for dentists near you, or browse top-rated dentist pages where available.
Frequently asked questions about dental abscesses
How do I know if I have a dental abscess?
You may have a dental abscess if you have throbbing tooth or gum pain, swelling, pain when biting, pus, a bad taste, fever, swollen glands or a pimple-like bump on the gum. However, only a dentist can confirm the diagnosis. If you suspect an abscess, seek dental advice urgently.
Can a dental abscess be painless?
Yes, sometimes. A dental abscess may become less painful if it drains, or if the nerve inside the tooth has died. A painless gum boil, bad taste or recurring swelling can still indicate infection and should be checked by a dentist.
Will antibiotics clear a dental abscess?
Antibiotics may help when infection is spreading or there are general symptoms such as fever or facial swelling, but they often do not remove the source of the problem. Dental treatment such as drainage, root canal treatment, gum treatment or extraction may still be needed.
Should I go to A&E for a dental abscess?
Most dental abscesses should be treated by a dentist or urgent dental service. Go to A&E or call 999 if swelling affects breathing, swallowing or speaking, if swelling spreads to the neck or eye area, or if you feel seriously unwell.
What happens if a dental abscess bursts?
If an abscess bursts, you may notice a bad taste and temporary pain relief as pus drains. This does not mean the infection has gone. Rinse gently with warm salt water and contact a dentist urgently.
Can I drain a dental abscess myself?
No. Do not try to pop, squeeze or cut an abscess. This can spread infection, damage tissue and make the problem worse. A dentist can drain an abscess safely and treat the cause.
How quickly should a dental abscess be treated?
A suspected dental abscess should be assessed urgently, especially if there is swelling, fever, severe pain, pus or feeling unwell. If you cannot get a dental appointment and symptoms are worsening, use NHS 111. If breathing or swallowing is affected, call 999 or go to A&E.
Can a dental abscess spread to the jaw or face?
Yes. A dental abscess can spread into surrounding tissues, causing facial swelling, jaw pain, swollen glands or more serious infection. This is why swelling with toothache should be taken seriously.
Can a dental abscess make you tired or unwell?
Yes. Infection can cause fever, tiredness, swollen glands, headache, loss of appetite or feeling generally unwell. These symptoms suggest the infection may be more significant and needs urgent advice.
The bottom line
A dental abscess is a dental infection that needs prompt attention. It may cause severe toothache, swelling, pus, a bad taste, fever or pain when biting — but symptoms can vary. The pain may even improve temporarily, especially if the abscess drains, but the infection can still remain.
Use pain relief safely, keep the area clean, avoid chewing on the painful side and contact a dentist urgently. If you cannot access a dentist, use NHS 111 online or call 111. Go to A&E or call 999 if swelling affects breathing, swallowing or speaking, spreads to the neck or eye area, or you feel seriously unwell.
For local dental care, search our UK dentists directory or use dentists near me. For related symptoms, see our guide to toothache causes, relief and when to see a dentist.
This article is for general information only and is not a substitute for professional dental or medical advice. If you have severe pain, swelling, fever, difficulty swallowing or breathing, or you feel very unwell, seek urgent help.
