The only way to cure a dental abscess is with dental treatment.
Your GP 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).
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 ibuprofen 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 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:
- 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 the same time without first checking with your GP or pharmacist; this can be dangerous because many over-the-counter products contain similar painkillers and it is possible to overdose when combining products
- ibuprofen and paracetamol are both available as liquid preparations for children
- aspirin is not suitable for children under 16 years of age
- if you are pregnant or breastfeeding, you should take paracetamol
Self care
Other self care techniques that can help include:
- avoid 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
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
Antibiotics are not routinely prescribed to treat dental abscess 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 that the infection is spreading, such as swelling of your face or neck
- you have a weakened immune system
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.
Reoccurring infection
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).
