Tooth Abscess · Emergency Dentist Murrieta
Tooth Abscess: Signs, Dangers, and What to Do Today
A tooth abscess is a pocket of pus from a bacterial infection, either at the tip of a tooth's root or in the gum beside it. It doesn't heal on its own, even when the pain eases. Call (951) 412-0127 today so I can drain it and treat the tooth that caused it. If swelling is spreading toward your eye or down your neck, or you have a fever or trouble swallowing, go to an emergency room first.
Warning signs
How can you tell an abscess from an ordinary toothache?
An abscess usually announces itself with more than pain. The tooth throbs, it hurts to bite or tap on it, and something changes in the gum: a small bump like a pimple, a bad taste when that bump drains, or swelling you can see in the mirror. An ordinary toothache from a cavity tends to come and go with hot, cold, or sweets. An abscess keeps going on its own.
That last pair surprises people. When the nerve inside a tooth dies, the pain can stop, and patients take that as good news. It isn't. The infection carries on at the root tip, and it's often what shows up as an abscess weeks later. MedlinePlus notes the same thing: a toothache can quiet down once pressure is relieved while the infection stays put.
Danger signs
When is a tooth abscess a hospital emergency?
It becomes a hospital problem when the infection has started to spread beyond the tooth. That is rare, but it happens, and it's the reason I don't let abscesses wait.
Call 911 or go to the nearest emergency room if you have any of these: swelling spreading toward your eye, under your jaw, or down your neck; a fever with the tooth pain; trouble swallowing, breathing, or opening your mouth; or feeling confused or very ill. Mayo Clinic describes how an untreated abscess can spread to the jaw, the neck, and the bloodstream. Once you're stable, call (951) 412-0127. The hospital can treat the infection, but the tooth that started it still has to be treated, or it comes back.
Everything short of that, including a swollen gum, a painful tooth, or a draining bump, belongs with a dentist today, not next week. Read the emergency dentist page for how same-day visits work here and what to do on the way in.
Causes
What causes a tooth abscess?
Bacteria get somewhere they shouldn't, either inside the tooth or down along the root, and the body walls the infection off into a pocket of pus. Where it starts decides how I treat it.
| Type | Where it starts | Common causes I see |
|---|---|---|
| At the root tip (periapical) | Inside the tooth, after the nerve dies | Deep decay, a crack, an old knock to the tooth, a large old filling or crown that leaked |
| In the gum (periodontal) | In a deep pocket between the gum and the root | Untreated gum disease, or something like a popcorn hull pushed under the gum |
| Around a wisdom tooth | Under the flap of gum over a partly erupted tooth | Food and bacteria trapped under the flap |
A tooth that's had a root canal can still get an abscess if bacteria get back in through a crack or a leaking crown. Diabetes, smoking, and a weakened immune system make infections harder to fight and quicker to spread, so I want to see those patients sooner rather than later.
What to do now
What should you do today if you think you have one?
1Call
Call (951) 412-0127 and tell us where the swelling is and whether you have a fever. That tells us how soon you need to be seen, or whether a hospital comes first. On a weekend or a holiday, call anyway; I can come in for an emergency.
2Take the edge off the pain
For most healthy adults, ibuprofen alone or paired with acetaminophen works best for tooth pain. That's the ADA's first-line recommendation for adults and teens. Follow the label, and check with your physician if you've been told to avoid either one.
3Rinse, and use cold
Rinse gently with warm salt water, a teaspoon in a cup, several times a day. Use a cold pack on the outside of the cheek, 15 minutes on and 15 off. Never put heat on a swollen face.
4Leave the bump alone
Don't squeeze or poke it with a needle. If it drains on its own, rinse with salt water, and keep your appointment anyway. Draining isn't the same as healing.
An aspirin held against the gum burns the tissue and does nothing for the infection. Swallow your pain reliever; don't place it on the tooth.
Antibiotics
Will antibiotics clear it up?
Not by themselves. Antibiotics can calm the infection around a tooth, but the source of it, a dead nerve inside the tooth or a deep gum pocket, is still there when the pills run out. That's why the American Dental Association's guideline, summarized by the CDC for dentists, says most adults with tooth pain and swelling should be treated at the tooth, with over-the-counter pain relief if needed, rather than with antibiotics.
Antibiotics have a real place when an infection is spreading, when there's a fever or swollen glands, or when treatment can't happen soon. When I prescribe them, it's alongside draining the abscess and treating the tooth, not instead of it. And please don't start a leftover bottle from the cabinet. A partial course quiets the symptoms, hides how serious things are, and makes the next infection harder to treat.
Treatment
How do I treat an abscessed tooth?
I find the tooth responsible, drain the infection, and then either save the tooth or remove it. Finding the right tooth comes first, because an abscess can make three teeth on one side feel sore. I test each one with cold and with tapping, take a digital X-ray, and, when the infection may be near the sinus or the X-ray isn't clear, a 3D cone-beam scan here in the office.
| Option | When it fits | What to expect |
|---|---|---|
| Drain and root canal | The tooth is solid enough to keep | The infection drains through the tooth, the canals are cleaned and sealed, and a crown usually follows. A same-day CEREC crown is $1,200 without insurance. |
| Extraction | The tooth is cracked through, badly decayed, or not worth saving | The infection drains through the socket. For a tooth that isn't a wisdom tooth, my fee is $195–$450 without insurance, depending on how difficult it is. |
| Gum treatment | The abscess started in a gum pocket and the tooth's nerve is healthy | I drain and clean the pocket. Most of these patients then need a full mouth deep cleaning so the next pocket doesn't fill up. |
| Specialist referral | Calcified or curved canals, a failed old root canal, or an impacted tooth | I relieve the pain first, then send you to an endodontist or oral surgeon I trust and handle the handoff. |
I'd rather save a tooth than pull it when saving it makes sense, and I'll tell you honestly when it doesn't. Either way, you get the diagnosis, your options, and a written price before anything starts. The exam with digital X-rays is $20 for new patients. A root canal is quoted after the exam because the fee depends on which tooth it is.
Decision boundaries
What looks like an abscess but isn't?
Plenty of sore spots in the mouth aren't abscesses, and some of them need no dental treatment at all. These are the ones people most often mistake for one.
| What you notice | More likely | How it differs |
|---|---|---|
| A painful white or yellow sore on the inside of the lip or cheek | Canker sore | Sits on the soft tissue, not over a tooth, and heals in a week or two |
| Several upper back teeth ache at once with a stuffy nose | Sinus pressure | Teeth test normal, and the ache changes when you bend over |
| Sharp pain days after a tooth was pulled | Dry socket | An empty-looking socket and pain without swelling or pus |
| Sore gum between two teeth after eating | Food trapped under the gum | Often settles within a day once floss gets it out; call if it swells |
| Pain only when you release a bite, no swelling | Cracked tooth | The nerve may still be healthy, so a crown alone can fix it |
If you can't tell which one you have, call. It's quicker for me to look than for you to guess, and a $20 exam settles it.
Patient reviews
What do patients say about being treated for an infected tooth?
Dr. Nguyen is such an amazing dentist. He is extremely honest. I thought I needed a crown after my root canal but he thought a filling was a better idea so it cost way less money than I thought it would. He got me in for a root canal at the endodontist for a bad infection/abcess I had within 2 days! Edith, his receptionist is so nice and helpful as well. Amazing dentist! Thank you both for all of your help!
— Danielle D'Souza · Google review
Since starting with Promenade Dental Care I have had cleanings, fillings, teeth replaced, root canal and crown replacement yesterday. I have never gone to a more gentle caring dentist. Love my dentist!
— Lucille Leake · Google review
FAQ
What else do people ask about a tooth abscess?
Can a tooth abscess go away on its own?
No. The swelling can go down and the pain can stop, especially if the abscess drains, but the infection stays at the root or in the gum pocket until the tooth is treated or removed. An abscess that seems to settle often flares again weeks or months later, and sometimes it's bigger the second time.
The bump on my gum drained and the pain stopped. Do I still need to come in?
Yes. The bump is a drainage tract, a little tunnel the infection made to let pressure out. Pressure relief feels like healing, but the source is still there. It's a good time to come in, though, because a tooth that isn't throbbing is easier to treat.
Can I pop the bump on my gum myself?
Please don't. Squeezing or poking it with a pin can push bacteria deeper and injure the gum, and it doesn't touch the cause. If it opens on its own, rinse gently with warm salt water and call to be seen.
Can a tooth with a root canal or a crown still get an abscess?
Yes. Bacteria can get back in through a crack, decay at the edge of a crown, or a canal that wasn't fully sealed years ago. The tooth won't feel cold or hot because the nerve is gone, so the first sign is usually soreness when you bite or a bump on the gum. Depending on what I find, the tooth may be retreated, which I often refer to an endodontist, or removed.
Is it safe to wait a few days to be seen for an abscess?
Not long. With no fever and no spreading swelling, I want to see it within a day or two. If it flares up on a Friday night, don't plan on riding it out until Monday: call, because I can come in on a weekend for an emergency. With spreading swelling, fever, or trouble swallowing, it can't wait at all, and the first stop is a hospital. Teeth that wait also tend to lose the chance to be saved.
Why is abscess pain worse at night?
Lying flat sends more blood to your head, and the pressure in an inflamed tooth goes up with it, so the throbbing gets worse at night. Sleeping propped up on an extra pillow helps. It's also why an abscess so often sends people looking for a dentist at 2 AM.
Can a tooth abscess make me feel sick all over?
It can, and that's a warning sign. Fever, chills, swollen glands, or feeling wiped out mean the infection is affecting more than the tooth. Call the same day, and go to an emergency room if there's also swelling spreading toward your eye or neck or trouble swallowing.
What will treating my abscess cost without insurance?
The new-patient exam with digital X-rays is $20 during weekday office hours. If I see you before 8 AM or after 5 PM on a weekday, or on a weekend or a holiday, that visit is $85. The $85 covers only the exam and X-rays; the treatment costs the same as it would on a weekday. If the tooth needs to come out and it isn't a wisdom tooth, my fee is $195–$450 depending on difficulty. If it can be saved, the root canal is quoted after the exam, and a same-day CEREC crown afterward is $1,200. Those are prices without insurance; with a PPO plan, my team checks your benefits first.
Swollen gum or a throbbing tooth?
Call and tell us where it hurts and whether you have a fever. Someone answers 24 hours a day, same-day time is held open every weekday, and weekend emergencies are seen by arrangement.
How emergency visits workPromenade Dental Care · Dr. Bao Nguyen, DDS
26957 Date St, Suite B4, Murrieta, CA 92563
Mon, Tue, Thu 9 AM–5 PM · Wed, Fri 9 AM–3 PM · weekend emergencies by arrangement