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Emergency!
Where to look first when a tooth gets hurt or something urgent happens.
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Emergency!
A collection of infection associated with a tooth. This page explains what it is and what a dentist may do. An abscess is not something to manage at home — contact your dentist, or your local emergency services if your child is unwell.
Call your dentist or your local emergency number.
This section is waiting for reviewed guidance. Step-by-step advice for the first few minutes is being written by a pediatric dentist and has deliberately not been drafted here. Until it appears, contact your dentist or your local emergency services — they can tell you what to do for your child now.
This section is waiting for reviewed guidance too. Things to avoid are as important as things to do, and both belong with the dentist who is writing them rather than with this website.
An infection associated with a tooth has become established. The AAPD describes odontogenic infections — infections originating from a tooth — as usually arising from the death of the living tissue inside the tooth, from gum disease, or from other dental conditions, and notes they may involve one tooth or more than one.
What it looks like varies, and this page does not describe signs for you to match against, because doing so would invite exactly the kind of self-assessment that leads to waiting. If you think there may be an infection, that is reason enough to ring.
The AAPD states that odontogenic infections are usually managed with pulp therapy or extraction, and that those associated with swelling may need incision and drainage. It adds that cases with signs affecting the whole child — it names cellulitis, fever and swollen lymph nodes — require adjunctive antibiotic therapy.
The consistent theme is that antibiotics support treatment rather than replace it: the AAPD states plainly that they should not replace source control and drainage. Treatment of the tooth itself may mean pulp treatment or removing the tooth, depending on what the dentist finds.
There are germs making a sore spot near your tooth. The dentist knows how to clear it out so it stops hurting. Telling a grown-up now is the right thing to do.
The swelling has gone down — do we still need to go? Ring your dentist and say so. An infection settling on the surface does not mean the source has been dealt with, and the AAPD is explicit that treating the source is central rather than optional. Let the dentist decide whether an appointment is still needed.
The AAPD states that antibiotics are indicated to halt local spread and control swelling, but should not replace source control and drainage. In other words they are usually part of treatment rather than the whole of it. What your child needs is for your dentist to determine.
The AAPD states that odontogenic infections are usually managed with pulp therapy or extraction, and that infections associated with swelling may need incision and drainage. Which applies depends on the tooth and on what is found. There is more on Pulpotomy and Baby tooth extractions.
If your child has facial swelling, difficulty breathing or swallowing, or seems unwell in themselves, contact your local emergency services. Otherwise contact your dentist and let them advise. This page does not set thresholds, because judging them requires seeing the child.
Every clinical statement on this page comes from the American Academy of Pediatric Dentistry document below. The step-by-step guidance in the sections above is being written separately by a pediatric dentist and is not drawn from this source.
This website is for education only and does not replace care from your dentist, physician, or emergency services.