Abscess vs Swelling: An Essential Guide

Our expert emergency dentists help explain the main differences between an abscess and swelling including what essential steps you should take if you are experiencing these.

Although swelling and abscess are two common dental issues, they are two different conditions.

Swelling

Swelling can be caused by many different things, primarily it is a sign of bacterial infection. If the swelling starts to affect your ability to breath or ability to see, then you ought to attend A&E for management.

Swelling refers to a build-up of fluid or inflammation in the tissues surrounding a tooth or in the gums. It can be caused by a number of factors, such as an infection, trauma, or a blocked salivary gland.

Swelling can cause discomfort or pain, and it may be accompanied by redness, tenderness, and warmth in the affected area.
Swellings in the mouth are often caused by dental abscesses. They are effectively when spaces fill up with pus and cells from your body’s immune system. They can affect your gums, teeth or the bone surrounding your teeth.

If they affect the gums it can be because food/debris/bacteria have got stuck in the gums and the build-up of bacteria cause the abscess to form.

If the abscess is related to teeth, it is because decay has got to the nerve of the tooth and it has effectively ‘died’. As a result, the bacteria travel out of the tooth through the roots.

The body tries to ensure the bacteria do not travel any further so therefore it creates the abscess. Though decay is the most common cause it can also be due to injury to teeth (trauma).

Abscess

An abscess is a collection of pus that has formed in response to an infection. It can occur in the tooth, the gums, or the bone that supports the teeth.

The most common cause of an abscess is a bacterial infection that has spread from the tooth’s root to the surrounding tissues. Abscesses can cause significant pain, and they may be accompanied by swelling, fever, and general malaise.

Which is the most serious?

While swelling and abscess can have some similar symptoms, abscess is generally considered a more serious condition that requires prompt treatment. If you suspect you have an abscess or any other dental issue, it is important to see a dentist as soon as possible to get an accurate diagnosis and appropriate treatment.

Some of the signs and symptoms you might experience include:

• Throbbing pain in the tooth or surrounding area. This pain may spread to other parts of your head on the same side
• Swelling in the area, which may be tender and warm to touch
• Pain to both hot and cold foods/drinks
• Foul breath or taste in your mouth
• A general feeling of being unwell and fever in some cases

Self-help advice

• Pain killers – paracetamol/ibuprofen. Please ensure you read the label, are not allergic to the medication and do not exceed the maximum dosage
• Applying cold pressure to the area
• Rinsing with salt water

Professional treatment available (following detailed history and examination)

• Incision and drainage – this involves making a small cut to allow the build-up of fluid/infection to be released. Can be very uncomfortable but is often the most effective treatment
• Extraction – this involves local anaesthetic followed by extraction of the offending tooth
• De-nerving the tooth – this involves local anaesthetic and drilling into the offending tooth before dressing it with antibacterial dressing. The tooth will then need root canal treatment
• Prescription – often antibiotics. Please note, antibiotics are not always indicated, nor are they a definitive treatment option. The tooth causing the problem will still need to be treated

If your swelling relates to wisdom teeth, please see our Wisdom teeth page