Dental abscess - Treatment 

Treating a dental abscess 

Video: how to look after your teeth

Once your abscess has been successfully treated, it is important to look after your teeth to prevent further problems.

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Caring for your tooth

To limit the pain and pressure on your dental abscess you should:

  • avoid very hot or cold food and drink
  • eat cool, soft foods using the opposite side of your mouth from the abscess
  • use a soft toothbrush and avoid flossing around the affected tooth

Fear of the dentist

Dental abscesses often occur in people who have not seen a dentist for many years because they are afraid to go.

Being afraid of the dentist can have a number of possible causes, such as the thought that treatment will hurt, or the sounds and smells bringing back memories of bad experiences during childhood.

The good news is that most dentists understand their patients’ fears, and they are able to make dental treatment as painless and as stress free as possible.

Over the years, advances in technology have also improved dentistry significantly. Nowadays, treatment is often completely painless.

Read more about overcoming a fear of the dentist.

The only way to cure a dental abscess is with dental treatment.

Your GP can give you advice, 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).

Painkillers

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.

Ibuprofen is the preferred painkiller for dental abscesses, but if you are unable to take it for medical reasons, you can take paracetamol instead.

If one painkiller fails to relieve the pain, taking both paracetamol and ibuprofen at the same time can often work (this is safe for adults, but not for children under 16).

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.

To take painkillers safely, follow this advice:

  • do not take ibuprofen if you are asthmatic or if you have a stomach ulcer, or you have had one in the past
  • do not take more than one painkiller at a time without first checking with your GP or pharmacist; this can be dangerous, because many over-the-counter products contain similar painkillers and overdosing is possible when combining products
  • ibuprofen and paracetamol are both available as liquid preparations for children
  • aspirin is not suitable for children under 16 
  • if you are pregnant or breastfeeding, you should take paracetamol

Self care

Other self care techniques include:

  • avoiding anything that makes the pain worse, such as hot or cold foods or cold air
  • holding cooled water or crushed ice around the tooth can sometimes ease the pain
  • the pain can often feel worse when you are lying flat, so lying propped up may help ease pain

Dental treatment

Your dentist will first discuss with you which treatment is appropriate. This could be:

Antibiotics

Antibiotics are not routinely prescribed to treat dental abscesses because:

  • draining the abscess is a more effective treatment
  • using antibiotics to treat non-serious infections makes them less effective at treating more serious infections (this is known as antibiotic resistance)

Antibiotics are usually only required if:

  • there are signs of severe infection
  • there are signs the infection is spreading, such as swelling of your face or neck
  • you have a high risk of complications  for example, people with a weakened immune system or diabetes

If antibiotics are needed, an antibiotic called amoxicillin or phenoxymethylpenicillin is usually prescribed. If you are allergic to penicillin, clarithromycin may be prescribed instead.

In cases where the infection is severe or spreading, metronidazole may be prescribed. If you are allergic to metronidazole, clindamycin may be prescribed.

Reoccurring infection

If you have a periapical abscess and your infection returns, you may need to be referred to a specialist for further treatment.

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).




Page last reviewed: 14/05/2014

Next review due: 14/05/2016

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Comments

The 20 comments posted are personal views. Any information they give has not been checked and may not be accurate.

shannon0708 said on 31 July 2014

My mother currently has a dental abscess, and I have never seen her in so much pain. She has basically been screaming in agony constantly for five days straight, and in these five days has eaten nothing but a couple of spoonfuls of mashed potato.

Having been on antibiotics for a few days, and on cocodamol, I decided to ring 111 as I could not get her a sooner dental appointment (the antibiotics and cocodamol was prescribed by her GP). Basically said there's nothing she can do, and to deal with it.

Today I managed to get her an emergency appointment at the dentist, who pulled her tooth causing the problem out. It being a wisdom tooth- when the anaesthetic eased off she was in the worst pain she has ever been in. Again rang 111- was lucky enough to speak to the most rude and unhelpful girl. She had a disgusting attitude, and didn't offer any help at all. She was impatient (bearing in mind she could probably hear my mom screaming in pain in the background) and there was no compassion. To be honest you could just tell she did not want to be at her job at that moment in time, she doesn't care for individuals' health, and she was just reading from a script. I thought this was awful. Where has the compassion of the health care system gone to?

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yam yamed said on 14 January 2014

Hi ya nessy123 sorry to hear about your dental probs ive just returned from the birmingham dental hospital my treatment is still ongoing but so far they av been very helpful, if you get there for 7.30 they will see and treat u the same day , the address is st chads queensway b-ham b4 6nn, tel:0121 466 5000.its only 5 min walk from snowhill railway station , hope this info Helps you , good luck

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nessy123 said on 13 January 2014

I've had a periodontal abscess for a very long time now. I have been to many dentists and, I have had numerous teeth out - and nothing has helped! I am still in excruciating pain day and night, unable to eat properly or sleep, my health is deteriorating all because dentists have not been able to remove the problem.

Does any one know of a good (preferably nhs) dentist who has dealt with this problem (and cured it) before who I can contact. I am in the Midlands but will travel just about anywhere if it gets rid of the problem.

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Jimbo77 said on 17 December 2013

I have unfortunately had a fair few abscesses, I have one now, they are the most painful things to endure, I am lucky to have a good dentist (private) who will see me immediately if I am in pain. They can effect the whole side of your face and be so excruciating that you can’t pinpoint the source of the pain, the relentlessly pound away and can literally drive you insane.

Here are some of the things that have helped me with the pain, if they help one person out there then it’s worth the time to write the post. Dont get stressed and keep as still as possible, try not to move about if you can, also stay as vertical as possible (sit up instead of slouch), when I go to bed I try and use a bean bag instead of a pillow to keep me up. Try not to touch it or rub it, it may give you seconds of relief but the pain will come back with vengeance. I find holding tap water in my mouth around the area helps a lot and I carry a water bottle around with me while I have an abscess. Ibuprofen and Codeine are the painkillers that best work for me (nurofen plus) but they will take a while to dull the pain, also paracetamol if I need it, I actually find alternating them works best. They wont get rid of the pain but they will take the edge off and doing the other things above makes it bearable.

If you cant get hold of your dentist then find the nearest emergency dentist, I live very rural, but with a bit of traveling its totally worth it compared to the suffering, the sooner you can get on top of it the better.

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Tootyfruity88 said on 27 November 2013

I have recently had to endure one of these, and it is the most painful thing I have ever experienced and have gave birth 3 times! I have to say I think emergency dentists need to become more available, these things are treated as serious yet I had no dentist open and available to me when my face began to swell. I had the pain for about 1 week but I was going to wait it out until my appointment (I had an abscess before and my old dentist couldn't see me to fix it till months after the x-ray so I thought why not, WRONG!) Friday evening the pain became unbearable, Saturday I had the beginning of swelling. Painkillers together do not work after 3 hours, our emergency dentist is only open until 4:30pm on weekdays.Our A&E department can't even deal with dental either, going to work with this thing was not the easiest of tasks! on the Monday I went straight to the dentist, It was drained and I was prescribed 2 types of antibiotics, 4 days later I am in no pain but still very swollen.

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Iliko said on 24 November 2013

This is all good, why do not you say if it is covered by NHS treatment or not? Why do not you -NHS list exact scenarios where NHS Dentist should cover it and put millions of us out of misery. The dentists are fooling us because of your flaky description of covered items. Please elaborate it with real live examples and suggestions what to do in if situations!

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Nanny McPhee said on 08 November 2013

I am used to the pain of injury- various fractures, renal colic and childbirth, but nothing could have prepared me for the pain I have suffered over the last dew days. The first "emergency" appointment I was given was in 6 days. Luckily I was told by a friend to phone back. Turned up this morning. Dentist could immediately tell the offending tooth. Penicillin and antibiotic and then root canal treatment. Still taking all kinds of painkillers. Wish I had not left it so long. The pain gets so bad that you cannot tell the source- cheek, other jaw on same side, ear -excruciating. Will never wait 6 days again. had not had toothache for 20 years. At least I will know in future.

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MWilson said on 05 October 2013

I have registered with a new dentist recently. He is NHS and private. He examined my teeth and took X-rays and said that I had gum disease and this required deep cleaning. He said that he couldn't do this on the NHS as they didn't allow enough time and that the pay was poor. He said that he would do it privately at a cost of £400.00.I was shocked at the price but agreed because I don't want to lose my teeth. I had my first treatment on Wednesday 2nd October 2013. He also said that I needed a crown but that it could be done on the NHS. I have paid £220.00 so far, which includes the examination. This treatment will be provided over 3 more appointments. All in all this will cost £641.00. He said that I should have this clean every 3 - 6 months. I definitely won't be having this done again as I simply can't afford to.

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BonnieLassX said on 13 September 2013

ok so i have had toothache/abscess pain for over a week now!! i have a hole in my bottom left molar and half the tooth has already fallen out over the last year or more. i went to dentist who has made me wait four weeks for tooth abstraction and a filling. i am in agony! most nights crying rolling around the bed in agony! i have got antibiotics that well, didnt work but past 2 days it stopped then since yesterday its been constant pain again! i am so annoyed and frustrated with this :( the pain is right up my jaw down my neck (no swelling yet). this pain is 10 out of 10 ! iv took about 20+ painkillers since 4-5 days ago! i am still taking them now i can't sit here without taking them over these days iv had paracetamol and neurofen plus! (which states 3 days usage i know). i cannot handle this :( help !! i literally cant even talk or open my mouth it hurts so much :(

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Becki_273 said on 09 September 2013

Kateab - if the dentist says have it out, have it out! The infection or abscess will return with a vengeance! I'm in agony now because I didn't listen to my dentist first time around..... The last time I had a tooth out I had 5 injections to numb the area and they didn't work I felt everything! But I would much prefer that a millions times over than the pain I'm experiencing now! All I want to do is smash my head against a wall!

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Becki_273 said on 09 September 2013

I've had problems with both top wisdom teeth since they both came through. My left rotted from the inside out almost immediately leaving a painful infection leading to a week of antibiotics then then the tooth out. Last August I noticed similar pain in my right wisdom tooth so went back to the dentist, same issue so another course of antibiotics and arranged an appointment to have the tooth out. On both occasions I had an infection not an abscess. Unfortunately for me the same day I seen the dentist I was involved in a serious car crash meaning I couldn't go back and have the tooth out for a number of months. When I had some what recovered from the car crash my tooth didn't cause any problems - even though half of my tooth had snapped off. I assumed the nerve was dead and as I'm not a huge fan of the dentist I decided I wouldn't go until it hurt....... Biggest mistake I have ever made! Now over a year on I have had excruciating pain in the whole right side of my head, tooth pain, ear ache, sinus pain and headaches all on the right side. Been to the dentist today (phoned 8:10am appointment 8:40 - pretty awesome if you ask me!) I have an angry abscess on the right side of my mouth. On antibiotics now and as many painkillers as I can physically take! As I'm going away towards the end of the month my dentist (nhs) has advised I have it out after returning. Sympathetic to the fact I don't want to eat soup for a week on holiday and that the extraction could prevent me from flying! - never knew that! My saving grace is a magic little tube of over the counter gel. It is well worth the money! It is a local anaesthetic gel that you apply directly to the effected area relieving majority of pain. Well worth a go if you have any form of tooth ache :)

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KateAB said on 30 January 2013

Is it always essential to do root canal treatment or extraction for an abscess which has been treated with antibiotics and has cleared up? Is the problem likely to recur if not treated using dental procedures?

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Musto said on 06 December 2012

The dental abscess topic was fully reviewed in March this year and has since been updated with the correct advice which is to seek treatment from a dentist if you have an abscess. Apologies for any confusion caused by the misleading advice previously given.

Editorial team, NHS Choices

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mrsscruffybadger said on 22 November 2012

GPs are usually not trained in dentistry and have been strongly advised (by the GMC and GDC) NOT to give antibiotics for dental problems but to advise the patient to see a dentist, and dental treatment should be available in an emergency in all areas of the country, even if you are not registered with a dentist.
This is because there have been a number of cases where something very serious has been missed through inappropriate treatment, or the right treatment has been delayed because the patient has felt a bit better with the antibiotics and then not seen a dentist, resulting in big dental problems down the line, or sometimes an extremely unwell patient who has had to be admitted to hospital through inappropriate prescribing. Please, please look at current guidance for GPs and change your advice here to patients.
To pass oneself off as a dentist (or as having dental competency) is as illegal as to pass oneself off as a doctor if you are not trained as one, and this is what patients who expect us to prescribe antibiotics for dental problems are asking us to do.
It is not only inappropriate, it is potentially dangerous! PLEASE review your guidance.

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yodrak said on 02 November 2012

I have an agonizing tooth Abscess and on antibiotics for 5 days with no effect. Help.......

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Kellytoon80 said on 17 October 2012

I had an abscess 3 weeks ago, on a lower molar, pain started off in my jaw and within 2 days I was in complete agony, and the tooth (Which was already broken) was extremely tender. I booked an appointment with a dentist for a visit 2 days later, however by the next day my face was extremely swollen on the one side. Off I went to the dentist and was presricbed 2 lots of antibiotics as it was a bad infection. Over the next few days the swelling went down, and a week later I had the tooth removed. It's healing ok, but I still have slight swelling well it's more hard than anything and every so often I get sharp shooting pains where it was, not sure what to do, but I have a dental check up in 2 weeks. Has anyone else experience this?

Thank you

Ps NHS Direct were very helpful when I was in extreme agony and advised me what painkillers would work best.

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scottishwildcat said on 30 May 2012

I see nothing in the article that contradicts your experience. Seemed pretty clear to me that it was suggesting you only visit your GP until you can get to see your dentist. After that, it's up to your dentist to look after you.

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Mars Express said on 26 September 2011

"Your comment is held until after you have activated your account. Please check your email and follow the instructions provided"


I have not been provided with any instructions, but I have only waited for two hours!!!!!!!

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Mars Express said on 26 September 2011

It is over two hours, and still I have not received my email verification!!!!!!!!!!!!!!!!!!!!!!!!!!!!

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Mars Express said on 26 September 2011

This wed sites states: "If you have a dental abscess, you may not be able to see a dentist straight away. If this is the case, your GP can give you advice about painkillers and caring for your tooth and prescribe antibiotics if necessary."

"If your pain is particularly severe, your GP may prescribe a stronger painkiller, such as codeine phosphate. "

"Your GP may prescribe an antibiotic, such as amoxicillin or metronidazole"

I have just spoken to my GP about severe pain from a tooth infection - for which my Dentist had prescribed Amoxicillin, but which appears not to be working - and I was told that it is illegal for a GP to intervene after dental treatment. I cannot see my Dentist (closed), but that made No difference. My GP still refused to treat me.

Don't you think the above web statements, implying that GPs can intervene in dental problems, are misleading?

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