A dental abscess is a bacterial infection that produces a pocket of pus inside or around a tooth. Without treatment, the infection spreads – sometimes rapidly – into the jaw, face, and neck. If you have facial swelling, fever, or difficulty swallowing, this is a medical emergency. Call us now on (07) 3325 2444 or go to your nearest hospital emergency department.
This page has been reviewed by Dr Harvey Sandhu BDS (U.K), principal dentist at Albany Creek Dental with over 30 years of clinical experience treating dental infections.
What Is a Dental Abscess?
A dental abscess is a localised collection of pus caused by bacterial infection within a tooth, the surrounding gum, or the jawbone. Pus is the body’s response to infection – a mixture of dead white blood cells, bacteria, and broken-down tissue.
The infection follows a predictable pathway:
- Bacteria enter the tooth through tooth decay, a crack, or a leaking filling
- Bacteria reach the dental pulp – the living tissue inside the tooth containing nerves and blood vessels
- The pulp becomes inflamed (pulpitis) and eventually dies (necrosis)
- Bacteria multiply inside the hollow root canal and spread through the root tip into the surrounding jawbone
- The immune system responds by sending white blood cells, which die and accumulate as pus
- Pus builds pressure at the root tip, causing throbbing pain
- Pus eventually drains through the gum, forming a pimple-like bump called a gum boil (sinus tract)
According to the Australian Institute of Health and Welfare (AIHW), dental infections accounted for over 70,000 potentially preventable hospital admissions in Australia in a single year – meaning patients delayed treatment until the infection became severe enough to require hospitalisation.
A dental abscess connects directly to general toothache symptoms. Persistent or worsening toothache is often the first warning sign that an abscess is forming beneath the surface.
What Are the 3 Types of Dental Abscess?
Dental abscesses fall into three categories based on location and cause. Each type requires a different treatment approach.
1. Periapical Abscess (Tooth Tip)
A periapical abscess forms at the tip of the tooth root, inside the jawbone. This is the most common type of dental abscess. It develops when untreated tooth decay, a cracked tooth, or a failed root canal allows bacteria to reach and kill the dental pulp.
Symptoms include severe throbbing pain, pain when biting down, sensitivity to hot temperatures, and eventual gum swelling near the affected tooth. A visible sign is a pimple-like bump on the gum above or below the tooth – a gum boil through which pus drains.
Treatment requires root canal treatment to remove the infected pulp, or extraction if the tooth is unsalvageable.
2. Periodontal Abscess (Gum Pocket)
A periodontal abscess forms inside the gum pocket alongside the tooth root. It develops when advanced gum disease (periodontitis) creates deep pockets that trap food and bacteria. The gum pocket seals over, trapping the infection inside.
The tooth itself may be alive and healthy – the infection lives in the gum, not the nerve. Symptoms include swelling of the gum alongside one tooth, pain when touching the gum, a bad taste in the mouth, and the affected tooth may feel slightly raised or loose.
Treatment involves draining the abscess, deep cleaning the pocket (scaling and root planing), and sometimes reshaping the gum with a gingivectomy.
3. Gingival Abscess (Gum Surface)
A gingival abscess forms on the surface of the gum and does not involve the tooth or the periodontal ligament. It is the least serious type of dental abscess. It occurs when a foreign body – such as a popcorn kernel or food debris – becomes trapped under the gum, or from trauma such as hard brushing or biting into hard food.
Symptoms include a localised painful swelling on the gum, redness, and tenderness near the gum margin. Treatment involves removing the foreign body, cleaning the area, and sometimes making a small incision to drain any accumulated pus.
The table below compares the three types of dental abscess across key clinical features:
| Feature | Periapical Abscess | Periodontal Abscess | Gingival Abscess |
|---|---|---|---|
| Location | Root tip, inside bone | Gum pocket alongside root | Gum surface only |
| Pulp status | Dead or infected | Usually alive | Alive |
| Common cause | Decay, crack, failed root canal | Advanced gum disease | Foreign body or trauma |
| Pain severity | Severe, throbbing | Moderate, localised | Mild to moderate |
| Tooth involved? | Yes – nerve is dead | Yes – but nerve alive | No |
| Treatment | Root canal or extraction | Deep cleaning, drainage | Drainage and cleaning |
What Are the Symptoms of a Dental Abscess?
Symptoms of a dental abscess range from mild discomfort to life-threatening complications. The colour-coded lists below group symptoms by urgency level so you can determine how quickly you need care.
Emergency symptoms – call now or go to hospital:
- Severe, throbbing pain that does not respond to painkillers
- Facial swelling (cheek, jaw, under the eye, or neck)
- Fever or chills
- Difficulty opening the mouth (trismus)
- Difficulty swallowing or breathing
- Swelling affecting the eye or spreading down the neck
- Red streaks on the skin of the face or neck
- Rapid heartbeat or feeling generally very unwell
Urgent symptoms – book a same-day appointment:
- Throbbing tooth pain, especially when lying down
- Pain when biting or chewing
- Sensitivity to hot temperatures (lingering pain)
- Swollen gum near the affected tooth
- Visible pimple or bump on the gum (with or without pus drainage)
- Bad taste or foul smell in the mouth (pus draining)
- Swollen lymph nodes under the jaw or neck
- Tooth feels “raised” or higher than neighbouring teeth
Monitor symptoms – book within a few days:
- Dull ache that comes and goes
- Mild sensitivity to temperature
- Small pimple on the gum that drains and refills
- General feeling of unwellness without severe pain
When Is a Dental Abscess a Medical Emergency?
A dental abscess becomes a medical emergency when the infection spreads beyond the local area around the tooth. Once bacteria enter the surrounding tissues, they travel through facial spaces with dangerous speed.
The infection spreads along several pathways:
- Infection from upper teeth spreads into the maxillary sinus
- Infection from lower molars spreads into the submandibular space, then into the airway – a condition called Ludwig’s angina that blocks the airway and is life-threatening
- Infection reaches the brain through blood vessels (rare but documented in medical literature)
- Sepsis develops – a systemic inflammatory response that leads to organ failure and death
A study published in the Journal of Endodontics found that deep neck infections from dental sources carry a mortality rate of 1-2% when the infection reaches the mediastinum (the central chest cavity).
The Australian Dental Association (ADA) advises that any dental infection accompanied by facial swelling, fever, or difficulty swallowing requires immediate medical attention – not a routine dental appointment.
Red flags requiring immediate hospital attention:
- Swelling spreading down the neck
- Swelling closing or affecting the eye
- Difficulty breathing or swallowing
- High fever (38.5°C or above)
- Confusion, drowsiness, or lethargy
If you have any of these symptoms, go to the nearest hospital emergency department immediately. Do not wait for a dental appointment.
For urgent abscess symptoms that are not immediately life-threatening, call our emergency dentist on (07) 3325 2444. Same-day appointments are available.
How Do We Diagnose a Dental Abscess?
Diagnosis of a dental abscess involves a systematic 7-step clinical assessment. Dr Harvey Sandhu BDS performs this assessment during your emergency consultation at Albany Creek Dental.
- Symptom history – We record the onset, duration, pain severity, and progression of swelling. This determines how far the infection has spread.
- Visual examination – We look for facial swelling, gum redness, visible pus, and a gum boil (parulis) on the gum surface.
- Digital X-ray – A periapical X-ray shows a dark radiolucent area at the root tip, indicating bone destruction from infection. We use low-radiation digital X-rays for immediate, high-resolution imaging.
- Percussion test – Tapping the tooth vertically. Pain on percussion indicates inflammation at the root tip, confirming a periapical abscess.
- Pulp vitality test – A cold test or electric pulp tester determines whether the nerve is alive. An abscessed tooth with a dead nerve feels nothing – this confirms pulp necrosis.
- Periodontal probing – Measuring gum pocket depths. A deep pocket that drains pus indicates a periodontal abscess rather than a periapical one.
- Palpation – Pressing on the gum over the root tip. Tenderness and swelling confirm the abscess location and the extent of tissue involvement.
What Are the Treatment Options for a Dental Abscess?
Treatment of a dental abscess follows a four-step protocol. The specific approach depends on the type of abscess, severity of infection, and whether the tooth can be saved.
Step 1: Infection Control (Antibiotics)
Antibiotics are prescribed when the infection has spread beyond the tooth – signs include facial swelling, fever, or swollen lymph nodes. The standard prescription is Amoxicillin 500mg three times daily for 5-7 days. Patients with penicillin allergies receive Clindamycin 300mg four times daily. For severe or anaerobic infections, Metronidazole 400mg is added.
Antibiotics control the spreading infection temporarily. They do not cure the abscess. The source – dead nerve tissue or an infected gum pocket – requires definitive treatment, or the abscess returns as soon as the antibiotic course ends.
Cost: $40-$70 for the prescription (not including the consultation fee).
Step 2: Drainage
Drainage involves making a small incision in the gum or accessing the root canal to release trapped pus. This provides immediate pain relief by releasing the pressure that has built up inside the tissue. The area is then irrigated with saline or antiseptic to flush out remaining bacteria.
Cost: $150-$250 (often included in the emergency consultation fee).
Step 3: Source Treatment (Root Canal or Extraction)
Root canal treatment removes the infected and dead pulp from inside the tooth, cleans and shapes the root canals, and seals them to prevent re-infection. The tooth is then restored with a filling or crown. Cost: $1,000-$2,000 depending on the number of canals and tooth position. Learn more about root canal treatment.
Tooth extraction is necessary when the tooth is unsalvageable – extensive decay, root fracture, or a large abscess that does not respond to root canal treatment. Cost: $250-$500. After extraction, the socket heals over 4-6 weeks. Learn more about dental extractions.
Step 4: Follow-Up
We review healing at 1 week, 4 weeks, and 3 months to confirm the infection has resolved. A follow-up X-ray at 3-6 months confirms bone regeneration at the root tip.
How Much Does Dental Abscess Treatment Cost?
The table below outlines treatment costs at Albany Creek Dental. Prices are in Australian dollars and represent the typical range for each procedure.
| Treatment | Approximate Cost | Health Fund Coverage |
|---|---|---|
| Emergency consultation + diagnosis | $95-$150 | Often covered (general dental) |
| Antibiotics (prescription) | $40-$70 | PBS or health fund prescription cover |
| Abscess drainage | $150-$250 | Often covered |
| Root canal treatment (anterior tooth) | $1,000-$1,300 | Partially covered (major dental) |
| Root canal treatment (molar) | $1,500-$2,000 | Partially covered (major dental) |
| Tooth extraction | $250-$500 | Often covered (general dental) |
| Surgical extraction (complex) | $350-$600 | Often covered (major dental) |
Albany Creek Dental is a preferred provider for HCF, BUPA, and CBHS members, with No Gap dental available for eligible patients. HICAPS on-the-spot claiming is available at every appointment. The Child Dental Benefits Schedule (CDBS) covers up to $1,095 over two years for eligible children aged 2-17.
What Happens If a Dental Abscess Is Left Untreated?
An untreated dental abscess follows a predictable progression. The timeline below shows how quickly a localised infection becomes a systemic emergency.
Day 1-3: Pain intensifies. Pus accumulates at the root tip. Localised gum swelling appears around the affected tooth.
Week 1: Pus may drain through the gum, forming a gum boil. Pain temporarily decreases because pressure releases. Many patients mistakenly believe the infection is healing – it is not. The source remains active inside the tooth.
Week 2-4: Infection spreads into the surrounding bone and soft tissue. Facial swelling develops. Lymph nodes under the jaw and neck enlarge and become tender.
Week 4 and beyond: Infection enters deep facial spaces. Cellulitis – a spreading tissue infection – develops. The risk of Ludwig’s angina (airway obstruction), cavernous sinus thrombosis (blood clot spreading to the brain), and sepsis increases significantly.
A study in the Australian Dental Journal found that 11% of dental abscesses presenting to emergency departments already showed signs of systemic involvement – including fever, rapid heartbeat, and spreading cellulitis – at the time of presentation.
Untreated abscesses cause the following consequences:
- Tooth loss – the tooth becomes unsalvageable as infection destroys the supporting bone
- Jawbone loss – infection dissolves the alveolar bone surrounding the root
- Sinus infection – upper tooth abscesses spread into the maxillary sinus
- Deep neck infection – lower molar abscesses spread into the neck spaces
- Sepsis and hospitalisation – systemic infection requiring intravenous antibiotics
- Rare but documented outcomes: brain abscess, mediastinitis, death
How Can You Prevent Dental Abscesses?
Dental abscesses are almost entirely preventable through consistent oral hygiene and regular professional care. The following eight measures reduce abscess risk to near zero.
- Brush twice daily with fluoride toothpaste. Fluoride kills decay-causing bacteria and strengthens tooth enamel against acid attack.
- Floss daily. Decay between teeth accounts for approximately 40% of all cavities and is invisible without X-rays. Flossing removes the bacteria that cause interdental decay.
- Attend 6-monthly dental check-ups. Decay that causes no symptoms is detected and treated before it reaches the nerve – preventing abscess formation entirely.
- Treat cracks early. A cracked tooth allows bacteria to reach the nerve. A dental crown binds the tooth together and prevents bacteria entering through the crack.
- Address gum disease. Periodontal pockets are a direct pathway for gum abscesses. Gum disease treatment removes bacteria from deep pockets and reduces abscess risk.
- Replace old fillings. Worn or leaking fillings allow bacteria to seep under the filling surface and reach the nerve. Our dental fillings page explains when replacement is necessary.
- Wear a mouthguard for sport. Dental trauma cracks teeth, leading to nerve death and abscess. A custom sports mouthguard absorbs impact and protects teeth from fracture.
- Limit sugar. Sugar feeds the bacteria (Streptococcus mutans) that produce acid and cause tooth decay. Reducing sugar intake lowers the bacterial load in the mouth.
Frequently Asked Questions
Can a dental abscess go away without treatment?
No. An abscess is an active infection that requires professional treatment. Pain may decrease temporarily if the abscess drains through the gum, but the infection persists and recurs. Antibiotics alone do not cure the source – the dead nerve or infected gum pocket requires root canal treatment or extraction. Without treatment, the infection spreads. Read more about related symptoms on our toothache page.
How long until antibiotics work on a dental abscess?
Antibiotics begin reducing infection within 48-72 hours. Swelling and pain typically decrease within 3-5 days. Antibiotics are a temporary measure – the source of the infection (dead nerve tissue inside the tooth) remains and causes the abscess to return once the course finishes. Root canal treatment or extraction eliminates the source permanently.
Can I pop a dental abscess myself?
No. Squeezing or puncturing an abscess at home forces bacteria deeper into the tissues, accelerating the spread of infection. Professional drainage in a sterile dental environment is safe and provides immediate pain relief. The gum boil visible on the gum is a drainage tract from the root tip – the actual infection sits deep inside the jawbone.
Is a dental abscess contagious?
The bacteria that cause dental abscesses (Streptococcus, Prevotella, Fusobacterium) transfer through saliva. Developing an abscess requires pre-existing decay, a crack, or gum disease that allows bacteria to penetrate deep into the tooth. Kissing or sharing utensils with someone who has an abscess does not cause an abscess in a healthy mouth.
Will pulling the tooth fix the abscess?
Extracting the infected tooth removes the source of infection, allowing the socket to heal. Extraction leaves a gap that affects chewing, causes adjacent teeth to shift, and leads to bone loss over time. Root canal treatment eliminates the infection while saving the tooth. Our dentists assess whether the tooth can be saved before recommending extraction.
Can I fly with a dental abscess?
Flying with an untreated dental abscess is dangerous. Changes in cabin pressure cause trapped gas inside an infected tooth to expand, causing severe pain (barodontalgia). Cabin pressure changes also accelerate the spread of infection into deeper facial spaces. The Australian Dental Association recommends treating all dental infections before air travel – complete your antibiotic course and have the source treated before flying.
Suspect an Abscess? Do Not Wait
A dental abscess does not resolve on its own. The longer you wait, the further the infection spreads – into the bone, the face, the neck, and eventually the airway.
Call now: (07) 3325 2444
Same-day emergency appointments are available. Our emergency dentist team reserves appointment slots every day for urgent dental infections.
Albany Creek Dental
4/698 Albany Creek Rd, Albany Creek QLD 4035
Serving: Albany Creek, Aspley, Bridgeman Downs, Carseldine, Eatons Hill, McDowall, and Warner.