Dental swelling is a red flag that should never be ignored. It almost always indicates a dental abscess, a pocket of pus caused by a bacterial infection. Unlike a regular toothache, an abscess signifies that the infection has broken out of the tooth and is spreading into the surrounding gum, bone, and soft tissues of the face.

At Emergency Dentist London, we treat facial swellings as high-priority emergencies. If left untreated, the infection can spread to the neck, airway, or bloodstream (sepsis), becoming life-threatening.

Identifying a Dental Abscess

Symptoms of an abscess can escalate quickly over 12-24 hours. Look out for:

Visual Swelling: A lump on the gum, or visible asymmetry in the face/cheek.

Throbbing Pain: Intense, continuous pain that may radiate to the ear or neck.

Redness and Heat: The skin over the swelling may feel hot to the touch.

Bad Taste: A sudden foul taste in the mouth if the abscess ruptures and drains pus.

Systemic Signs: Fever, feeling generally unwell (malaise), or swollen lymph nodes under the jaw.

DANGER SIGNS: Go to A&E Immediately

If you experience any of the following, do not wait for a dentist. Go straight to the nearest hospital Emergency Department:

Swelling that is closing your eye.

Swelling in the neck or floor of the mouth affecting breathing or swallowing.

Difficulty opening your mouth (Trismus) less than 2 fingers width.

High fever with confusion or rapid heart rate.

Types of Dental Abscesses

1. Periapical Abscess

Forms at the tip of the tooth root. This is usually the result of untreated tooth decay or a dying nerve. The infection builds pressure inside the bone until it breaks through to the gum.

2. Periodontal Abscess

Forms in the gum pocket next to the tooth root. This is often caused by trapped food, tartar buildup, or advanced gum disease. The tooth might feel loose and the gum will be red and shiny.

Treatment: "Pus Must Be Drained"

There is a medical saying: "Ubi pus, ibi evacua" (Where there is pus, let it out). Antibiotics alone are often not enough to cure a dental abscess because drugs cannot penetrate the abscess cavity effectively. Physical intervention is required:

Incision and Drainage

We numb the area and make a small incision in the gum swelling. This allows the pus to drain out, instantly relieving the immense pressure and pain. We then wash the area with sterile saline.

Root Canal Treatment

To stop the abscess coming back, we must remove the source. A root canal cleans the bacteria from inside the tooth that is feeding the abscess.

Extraction

If the tooth is fractured or the bone support is destroyed, removing the tooth acts as the ultimate drainage, allowing the infection to clear up rapidly.

The Role of Antibiotics

We may prescribe antibiotics (like Amoxicillin or Metronidazole) alongside treatment if there is evidence of spreading infection (fever, facial swelling).

However, they are not a substitute for dental treatment. Without fixing the tooth, the infection will simply return once the pills run out.