It's late, the tooth is throbbing, there's a swelling on the gum that looks for all the world like a spot, and a small voice is saying "just pop it". You may have a sterilised needle on the side already. I understand the logic completely. You're in pain, the swelling looks like the problem, and popping things is oddly satisfying. You're not the only one who has stood in the bathroom weighing it up.
The short answer: please don't. Bursting a tooth abscess yourself doesn't cure it, because the infection is coming from inside the tooth or the gum pocket underneath, and a needle can't reach that. At best you get a few hours of relief and a false sense that it's sorted. At worst you push infection into the surrounding tissue, or hide the fact that it's spreading. What fixes it is draining it properly and treating the tooth, which is a same-day job for my emergency dentist team in Harlow or Enfield wherever I can manage it. Elsewhere, or out of hours, call NHS 111.
Call 999 or go to A&E, not a dentist, if:
- you're finding it hard to breathe, swallow or speak
- swelling is spreading towards your eye, down into your neck, or under your tongue in the floor of your mouth
- you can't open your mouth properly because of the swelling
- you have signs of sepsis. The NHS lists these as: breathing very fast; being confused, having slurred speech or not making sense; blue, pale or blotchy skin (on black or brown skin this may be easier to see on the palms of the hands or soles of the feet); a very high or very low temperature, feeling hot or cold to the touch, or being shivery; a rash that does not fade when you press it
Put the needle down and pick up the phone. Call your nearest Minti practice and tell reception it's an abscess. I keep same-day appointments for pain and swelling wherever I can.
- Nuffield Dental Practice, Harlow: 01279 424 038
- Church Langley Dental, Harlow: 01279 306 690
- Enfield Smiles, Enfield: 020 8804 4320
Evening, weekend, or nowhere near us? Call NHS 111, not your GP; the NHS is clear a GP can't give you dental treatment.
Why does popping an abscess not fix it?
Because the swelling isn't the disease. It's the symptom. A tooth abscess is a pocket of pus fed by bacteria living in a dead nerve inside the tooth, or in a deep gum pocket beside it. The lump on your gum is where that pus has collected or found a way out. It's the smoke, not the fire.
Let the pus out and you've cleared the smoke. The bacteria are still in the tooth, still multiplying, and the pus comes back. That's exactly why gum boils come and go for months; I've explained that cycle in dental abscess vs gum boil. The only things that end it are removing the source, with root canal treatment or taking the tooth out, or cleaning out the pocket if it's a gum abscess. Nothing you can do with a needle, a pin or a fingernail touches that.
What can go wrong if you burst it at home?
I'll keep this bit straight, because it matters.
- Spreading the infection. Spread of infection is listed as a possible complication of draining an abscess even when a dentist does it, with anaesthetic, a sterile blade and suction. At home, with a needle and a bathroom mirror, you have none of those safeguards.
- It won't drain properly. A dentist drains an abscess only once it's ready and soft, through an opening the right size and depth, and often keeps it open with a small drain. A pinprick releases a little, seals over, and the pressure builds again.
- Pain, and plenty of it. Abscesses are drained under local anaesthetic for a reason.
- Hiding the danger. This is the one I worry about most. Relief after bursting can convince you it's over, so you don't ring anyone. Meanwhile the infection can carry on into the jaw, the neck or the face. A dental infection that spreads can be serious, and in rare cases life-threatening. Signs a tooth infection is spreading covers what to watch for.
And the thing that never gets mentioned: if a swelling is big, tight and hot, it isn't the kind to be touched at all. That's the kind that needs urgent professional care, sometimes in hospital.
What if it has burst on its own?
That happens, and it's not your fault. You'll usually notice a sudden foul or salty taste, a bit of blood or pus, and the pain easing. Rinse gently with warm salt water, don't squeeze what's left, and ring me the same day. The relief is real but the infection is not gone; the abscess has simply found a drain. There's more on the taste itself in pus and a bad taste from a tooth.
What should you do instead tonight?
Three things, none of them heroic.
- Ring for an appointment. Us if you're near Harlow or Enfield, NHS 111 if you're not or it's out of hours. Say the word "abscess"; it moves you up the list.
- Take the edge off. The NHS suggests ibuprofen or paracetamol, taken as the packet says. Don't take more than the recommended dose to chase the pain.
- Be kind to the area. Soft food, chew on the other side, a soft toothbrush, and skip very hot or very cold drinks. Warm salt water rinses are fine.
What I'd skip: heat packs on the face, anything alcoholic held against the tooth, and any internet remedy involving garlic, clove oil or a hot needle. None of them reach the source. If you're wondering whether the infection might just settle on its own, I've answered that in can a tooth infection go away without antibiotics?
What will I do differently?
This is why I'd rather you came in. First a quick look, a gentle tap on the tooth and an X-ray to find the source. Then, depending on what I find, I numb the area and either drain the swelling through a small opening, start root canal treatment so the pus can escape through the tooth, or take the tooth out if it can't be saved. If the infection has spread beyond the tooth or you're feeling unwell with it, I'll add antibiotics as a back-up, but they're never the main event.
When does a tooth abscess need urgent help?
The NHS advice for a suspected dental abscess is to see a dentist as soon as possible. It doesn't get better by itself, and the longer the source is left, the more likely the tooth is lost.
Call us today if:
- there's a swelling on your gum, a throbbing tooth, or a bad taste
- the abscess has burst, whether by itself or because you got there before reading this
- your face or jaw is swollen or your neck glands are up
- you have a temperature or feel unwell with it
Reminder: trouble breathing, swallowing or speaking, swelling heading for your eye, neck or under your tongue, a mouth you can't open, or any of the NHS sepsis signs at the top of this page is 999 or A&E, not a dentist.
If you're near Harlow or Enfield, I'd much rather drain it properly and fix the tooth than have you attempt surgery over the bathroom sink. Ring your nearest Minti practice, say it's an abscess, and we'll do our best to see you the same day. Anywhere else, or out of hours, call NHS 111.
This article is general information, not a diagnosis. An abscess needs examining in person to find the cause.
