A tooth abscess in Honolulu usually starts as a throbbing ache that keeps getting worse. This guide shows you the warning signs, the 4 treatments a dentist may use, and when swelling means the ER. Dr. Eugene M. Azuma, DDS, a Georgetown University School of Dentistry graduate, wrote it for patients in Honolulu.
Most people with an abscess fear losing the tooth and paying for a trip to the wrong place. Those worries are fair, because an abscess will not heal without treatment. The infection can spread to the jaw, the neck, or the blood if it is left alone. If you already know you need care, start with emergency dentistry in Honolulu and call the office the same day.
What is a tooth abscess?
A tooth abscess is a pocket of pus caused by a bacterial infection in or around a tooth. Dentists sort it into 3 main types by where it forms. A periapical abscess sits at the root tip, while a periodontal abscess forms in the nearby bone and gum.
The periapical type is the classic abscessed tooth, and it usually starts with deep decay or a fracture. That damage lets bacteria reach the pulp, the soft core of nerves inside the tooth. Once bacteria get in, the pulp dies and the infection drains through the root into the jawbone.
A gingival abscess stays in the gum and is the mildest of the three types. A periodontal abscess usually grows out of untreated gum disease, where deep pockets trap bacteria against the root. All three need a dentist to find the source, because the pus is the symptom and the infection is the cause.
What are the signs of a tooth abscess?
The most common sign of a tooth abscess is a constant, throbbing toothache that can spread to the jaw, neck, or ear. Some people notice one sign at first, and others wake up with several. Having 2 or more of the signs below is a strong reason to call a dentist that same day.
- A throbbing toothache that does not ease as the hours pass
- Sharp pain when you bite down or chew
- Sensitivity to hot or cold that lingers
- A pimple-like bump on the gum near the sore tooth
- A bad taste or bad breath that brushing does not fix
- Swelling in the gum, cheek, or jaw
- Tender, swollen lymph nodes under the jaw
- Fever, or a sense of feeling unwell
Pain that wakes you at night deserves extra attention, since it often means pressure is building in the bone around the root. Pain relievers may dull it for a few hours without touching the infection. Write down when each sign started, because that timeline helps the dentist judge how far the infection has moved.
Will a tooth abscess go away on its own?
A tooth abscess will not go away on its own, because the body cannot clear bacteria from a dead pulp. Cleveland Clinic notes that antibiotics do not remove the cause. The tooth still needs 1 of 3 dental treatments, which are drainage, a root canal, or removal.
National hospital records show how often an untreated abscess ends with a hospital bed instead of a dental chair. A Journal of Endodontics study from September 2013 counted 61,439 US hospital stays for periapical abscess from 2000 to 2008. The average stay ran about 3 days, and 66 of those patients died in the hospital.
How is a tooth abscess treated?
Treatment for a tooth abscess has 2 goals, which are draining the infection and removing its source so it does not return. Many patients need two of the four tools in the table below. The emergency page for this practice lists root canals, extractions, and tooth infection care among its services.
| Treatment | What it does | When it is used | Keeps the tooth? |
|---|---|---|---|
| Incision and drainage | Opens the abscess so pus can drain | Swelling that needs fast relief | Yes, as a first step |
| Root canal | Removes the infected pulp and seals the root | The tooth can still be restored | Yes, often with a crown |
| Extraction | Removes the tooth and the infection source with it | The tooth is too damaged to repair | No |
| Antibiotics | Slow the spread of bacteria | Fever, spreading swelling, or weak immunity | Only alongside other treatment |
Saving the tooth is usually the better long-term choice, since a root canal keeps your natural bite. Extraction is still right for a tooth with a deep fracture. Your dentist should explain why one option fits your tooth better, and results vary from person to person.
When does a swollen face from a tooth infection mean the ER first?
A swollen face from a tooth infection means the emergency room comes first when it comes with fever, trouble breathing, or trouble swallowing. Mayo Clinic advises going to an ER right away for those breathing signs. Go to the ER first if you notice any of the 6 signs below, even at 2 in the morning.
- Trouble breathing or swallowing
- Swelling that spreads toward the eye, the neck, or under the tongue
- A fever along with facial swelling
- Trouble opening your mouth more than a finger width
- A racing heartbeat, confusion, or feeling faint, which can point to sepsis
- Swelling that grows bigger over a few hours
In Honolulu, the emergency department at The Queen’s Medical Center on Punchbowl Street can control swelling and start antibiotics tonight. A hospital ER is not set up to treat the tooth itself. See a dentist within a day or two, and read about same-day dental emergencies in Honolulu to learn what else can wait.
Tooth abscess warning signs
Call a dentist the same day
2 or more of these signs is a strong reason to call.
- ✓A throbbing toothache that does not ease
- ✓Sharp pain when you bite down or chew
- ✓Sensitivity to hot or cold that lingers
- ✓A pimple-like bump on the gum
- ✓A bad taste or bad breath that brushing does not fix
- ✓Swelling in the gum, cheek, or jaw
- ✓Tender, swollen lymph nodes under the jaw
- ✓Fever, or feeling unwell
Go to the ER first
Any 1 of these signs, even at 2 in the morning.
- !Trouble breathing or swallowing
- !Swelling toward the eye, the neck, or under the tongue
- !A fever along with facial swelling
- !Trouble opening your mouth more than a finger width
- !A racing heartbeat, confusion, or feeling faint
- !Swelling that grows bigger over a few hours
Questions about a sore tooth? Call (808) 528-2221.
What should you tell the dental office when you call?
When you call about a possible abscess, give the office 4 facts in the first minute. Say where it hurts, when it started, whether anything is swollen, and whether you have a fever. A clear description helps the front desk move you ahead of routine visits.
Mayo Clinic notes that weaker immunity raises the risk of a spreading infection, so mention any such condition. Diabetes and cancer treatment are both worth naming in that first call. Your dentist may want to see you sooner, or may check with your physician before choosing an antibiotic.
Bring a list of your medicines and allergies, especially any allergy to an antibiotic such as penicillin. If you took a pain reliever, note the time and dose. These details take about two minutes to gather, and they make the visit faster and safer for you.
Get the Infection Out and Keep the Tooth When It Can Be Saved
An abscess feels urgent because it is, and most abscesses can be treated well once a dentist finds the source. Dr. Eugene M. Azuma, DDS, Hawaii Dental License DT-1658, earned his dental degree at the Georgetown University School of Dentistry. He also holds a BA in Zoology from the University of Hawaii at Manoa. The Meet the Doctor page covers his training in more detail.
The goal of that first visit is to get you out of pain and clear on the tooth. Call (808) 528-2221 if you notice any of the signs above. If it is after hours and nothing is swollen, request an appointment at dreugeneazuma.com. Results vary, and the right treatment depends on what the exam and x-rays show.
What Else Do People Ask About a Tooth Abscess?
What happens if a tooth abscess bursts?
When a tooth abscess bursts, pus drains into your mouth with a salty or foul taste, and the pain often eases quickly. Mayo Clinic notes that a ruptured abscess can bring a lot of pain relief, yet the infection remains. Rinse with warm salt water and call a dentist the same day.
How can I relieve pain from an infected tooth?
Warm salt water rinses and an over-the-counter pain reliever can ease the pain for a few hours. MedlinePlus warns never to place aspirin directly on your tooth or gums, since it can cause mouth ulcers. Follow the label, and ask your physician before any new medicine.
How long does facial swelling last from a tooth infection?
Facial swelling from a tooth infection usually starts to go down within a few days of treatment. Cleveland Clinic notes that full recovery after abscess treatment may take a few days. Swelling that keeps growing after treatment is a reason to call the office again, and healing times vary.
What is an abscess in the cheek and what are its symptoms?
An abscess in the cheek is usually a tooth infection that has spread into the soft tissue of the face. The cheek turns swollen, warm, and tender, and chewing on that side may hurt. The NHS advises emergency care for a lot of swelling or trouble opening your mouth, so do not wait it out.
