Dental abscess - Treating a dental abscess

The only way to cure a dental abscess is with dental treatment.

Your GP can give you advice, but they cannot provide the treatment needed to cure an abscess.

Your dentist will treat your abscess using dental procedures and, in some cases, surgery (see below).

Painkillers

A dental abscess can be very painful, but you can use over-the-counter painkillers from your local pharmacy to control the pain while you are waiting for dental treatment.

Ibuprofen is the preferred painkiller for dental abscesses, but if you are unable to take it for medical reasons, you can take paracetamol instead.

If one painkiller fails to relieve the pain, taking both paracetamol and ibuprofen at the same time can often work (this is safe for adults, but not for children under 16).

Always read and follow the information on the packet about how much to take and how often, and do not exceed the maximum stated dose.

Accidental overdoses have been reported in people who take too many painkillers when trying to relieve the pain of a dental abscess.

Painkillers cannot treat or cure a dental abscess, so they should not be used to delay dental treatment.

To take painkillers safely, follow this advice:

• do not take ibuprofen if you are asthmatic or if you have a stomach ulcer, or you have had one in the past
• do not take more than one painkiller at a time without first checking with your GP or pharmacist; this can be dangerous, because many over-the-counter products contain similar painkillers and overdosing is possible when combining products
• ibuprofen and paracetamol are both available as liquid preparations for children
• aspirin is not suitable for children under 16 
• if you are pregnant or breastfeeding, you should take paracetamol

Self care

Other self care techniques include:

• avoiding anything that makes the pain worse, such as hot or cold foods or cold air
• holding cooled water or crushed ice around the tooth can sometimes ease the pain
• the pain can often feel worse when you are lying flat, so lying propped up may help ease pain

Dental treatment

Your dentist will first discuss with you which treatment is appropriate. This could be:

• root canal treatment
• removing an affected tooth
• in some cases, surgery 

Antibiotics

Antibiotics are not routinely prescribed to treat dental abscesses because:

• draining the abscess is a more effective treatment
• using antibiotics to treat non-serious infections makes them less effective at treating more serious infections (this is known as antibiotic resistance)

Antibiotics are usually only required if:

• there are signs of severe infection
• there are signs the infection is spreading, such as swelling of your face or neck
• you have a high risk of complications – for example, people with a weakened immune system or diabetes

If antibiotics are needed, an antibiotic called or phenoxymethylpenicillin is usually prescribed. If you are allergic to penicillin, clarithromycin may be prescribed instead.

In cases where the infection is severe or spreading, metronidazole may be prescribed. If you are allergic to metronidazole, clindamycin may be prescribed.

Reoccurring infection

If you have a periapical abscess and your infection returns, you may need to be referred to a specialist for further treatment.

In some cases, a dental abscess infection can reoccur even after dental and surgical procedures. If this happens, or if your tooth is severely broken down, it may need to be removed altogether (extracted).