Explore MySmileEd
Emergency!
Where to look first when a tooth gets hurt or something urgent happens.
Ask Cozy
What would you like to learn?
TRY ASKING
Browse by topic
Emergency!
A pocket of infection near a tooth. This page explains what to do first, what not to do, and what a dentist may do. An abscess does not clear up on its own, so your child needs to see a dentist soon.
Call your dentist today and say it may be an abscess. Call 911 or go to an emergency department right away if your child has trouble breathing, swallowing or speaking, trouble opening the mouth, heavy swelling inside the mouth or on the face, a swollen or painful eye, or seems very unwell. A swollen face or jaw, a fever or swollen glands in the neck can mean the infection is spreading, and the AAPD says fever or facial swelling warrant emergency treatment.
Follow these steps while you arrange care.
Please avoid these things:
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.
The first-aid steps and warning signs follow NHS guidance on dental abscess and the American Academy of Pediatric Dentistry (AAPD). The NHS page is written for the UK, so emergency numbers differ by country. What the dentist may do comes from the AAPD documents below.
This website is for education only and does not replace care from your dentist, physician, or emergency services.