Treatment of a dental abscess or phlegmon
A gum abscess, also known as a dental abscess or gingival abscess, is an infection that causes inflammation, pain and a build-up of pus in the gums, around the root of the tooth or in the surrounding tissues. It is one of the most common dental emergencies and also one of the most frequently asked questions. This article provides detailed information on gum abscesses, including symptoms, treatment and prevention, so that you can make informed decisions about your oral health.
At Udemax Clinics, we treat patients every week for abscesses caused by tooth decay, infections, wisdom teeth, old root canal treatments or trauma. It is essential to seek treatment at a dental clinic at the first sign of infection to ensure you receive a proper diagnosis and treatment. In this guide, you will find everything you need to know to identify, relieve and understand the treatment for an abscess.
What exactly is an abscess?
A dental abscess is a bacterial infection that causes pus to form and visible swelling in the gums, face or cheek. The root cause of a dental abscess is always a bacterial infection, which can enter through deep cavities, periodontal disease or trauma. Tooth decay is one of the main causes of dental abscesses, as if left untreated, it can progress to the tooth’s pulp and cause an infection leading to an abscess.
It may appear in:
- The gums (gingival abscess)
- The root of the tooth (periapical abscess)
- Around a wisdom tooth (pericoronitis)
- Following a deep cavity
- After a blow to the teeth
- Even after a tooth extraction or root canal treatment
- The tissues supporting the tooth, such as the alveolar bone and the periodontal ligament (periodontal abscess); this type of abscess is more serious as it affects deeper structures.
There are different types of dental abscesses, such as periapical, periodontal and gingival abscesses, and each requires a specific diagnosis and treatment. It is important to be aware of the symptoms of a gum abscess: severe pain, swelling, redness, the presence of pus and, occasionally, a fever or general malaise. If the infection is left untreated, it can spread and affect other parts of the body, leading to systemic complications.
Why do abscesses form? (Main causes)
The main cause of a gum abscess is a dental infection, which can be triggered by various factors affecting oral health.
The most common causes are:
- Deep cavities that reach the dental pulp.
- Injuries or fractures to the teeth.
- Periodontal diseases such as gingivitis or periodontitis.
- Previously performed dental treatments that were not carried out properly.
If an abscess is not treated properly and promptly, serious consequences and complications can arise. These include the spread of infection to other areas of the mouth or even to other parts of the body, the loss of the affected tooth, and risks to general health such as endocarditis or sepsis, which can be life-threatening.
Maintaining good oral health is essential for preventing abscesses. Correct use of a toothbrush, dental floss and mouthwash, along with other hygiene measures, helps to reduce the risk of infection. It is important to visit the dentist for regular check-ups, at least once or twice a year, as the dentist can detect problems early on and prevent complications.
The most effective way to prevent abscesses includes following a balanced diet, avoiding excessive sugar intake and managing risk factors such as diabetes, as people with this condition are more prone to periodontal infections.
Periodontal diseases
Excessive build-up of bacterial plaque and tartar can irritate the gums and facilitate the development of infections that may lead to a periodontal abscess. Furthermore, conditions such as gingivitis or advanced periodontitis can create pockets in the gums where bacteria accumulate, infecting the tissues that support the teeth.
Measures you can take at home to prevent infections include brushing your teeth two or three times a day, flossing and using mouthwash, as well as maintaining a healthy diet and visiting the dentist regularly.
Deep tooth decay
Tooth decay progresses by penetrating the tooth until it reaches the nerve, causing an infection in that area. This infection leads to a build-up of pus, which in turn causes an abscess to form.
Wisdom teeth
If they erupt at an angle or only partially, the gum becomes inflamed and is prone to infection. This inflammation can cause severe pain and make it difficult to open the mouth or chew. The build-up of bacteria in this area leads to the formation of pus, which causes increased pressure and the characteristic swelling associated with an abscess.
Old root canal treatments
If any bacteria remain inside, an infection develops which can lead to the formation of an abscess.
Recent tooth extraction
If the area becomes infected or an unstable blood clot forms, the face may swell.
Blows to the teeth or tooth fractures
When the dental nerve dies, bacteria begin to multiply in that area, leading to the formation of an abscess. This bacterial infection causes pus to build up and results in inflammation and pain in the gum or in the tissues surrounding the affected tooth.
How can I tell if I have an abscess? (Symptoms)
Typical symptoms
- Swelling of the gums, cheek or jaw
- A throbbing pain that gets worse when chewing
- Sensitivity to heat
- A bitter taste or discharge of pus
- Bad breath
- Fever or general malaise
Specific symptoms that many users are looking for
A painless abscess can be dangerous, as it is often linked to periodontitis or chronic abscesses that do not present obvious symptoms. A swollen face without toothache may indicate an internal abscess, which requires professional treatment. A hard lump on the gum is usually an encapsulated infection, whilst a lump that comes and goes may be due to internal drainage of pus.
The difference between a phlegmon and an abscess
In dentistry:
- Abscess = a collection of pus
- Phlegmon = a painful inflammation associated with an abscess or infection
There are different types of abscesses, such as periapical abscesses and periodontal abscesses. The type of abscess determines the diagnosis and appropriate treatment, as, for example, a periodontal abscess affects the tissues supporting the tooth and may require a specific approach.
In practice, people use both terms to mean the same thing.
How do you treat an abscess? The real treatment (without the myths)
An abscess doesn’t go away on its own. The swelling may subside, but the infection is still there.
Professional dental treatment is essential for treating a gum abscess. Patients should never attempt to drain the abscess at home or self-medicate, as this can spread the infection and make the situation worse. It is essential that patients visit a dental practice for an individual assessment and follow-up, where the dentist will determine the most appropriate treatment based on the cause and severity of the condition.
Treatment always depends on the cause:
If the abscess is caused by deep tooth decay
Treatment may include antibiotics if there is an infection, root canal treatment in Mallorca to remove the affected nerve, the fitting of a crown or dental restoration, and in some cases, the extraction of the affected tooth.
If it’s because of a wisdom tooth
Treatment may involve administering antibiotics, cleaning the affected area and removing the tooth if it is misaligned.
If it is periodontal (gums that have receded or pulled away)
Thorough cleaning and treatment of periodontitis, also known as scaling, are essential. In addition, a local or systemic antibiotic may be prescribed as necessary, and a periodontal check-up should be carried out to ensure gum health and prevent the infection from returning.
If a large abscess forms
Treatment for a dental abscess involves draining the abscess – which must only be done in a dental practice and never at home – administering antibiotics, and carrying out definitive treatment on the affected tooth.
What can I do to reduce swelling in my face? (Practical solutions)
You can do | You can’t do |
Apply a cold compress to the outside of the cheek | To burst it |
Take painkillers as prescribed by a healthcare professional | Applying heat (makes the infection worse) |
Lukewarm saltwater rinses (not hot) | Taking antibiotics without a prescription or self-medicating for several days without seeing a dentist |
Practise gentle hygiene | Bite down on the gum |
How long does an abscess last?
It depends on the condition of the tooth: with antibiotics, improvement usually occurs within 48 to 72 hours. However, if the underlying cause of the problem is not treated, the abscess may return. Following drainage, the swelling generally subsides within 24 to 48 hours. In the case of wisdom teeth, the abscess may recur until the affected tooth is extracted. If it does not subside with antibiotics, this is a sign that drainage or definitive treatment is required.
How can you tell if an abscess is serious? (Signs that require urgent medical attention)
Go to A&E if:
- Swelling that spreads towards the eye or neck
- High fever
- Difficulty breathing or swallowing
- Very severe pain
- Limited mouth opening
- An abscess that doesn’t clear up with antibiotics
- Children with sudden swelling
Lateral pharyngeal or deep mandibular abscesses can be dangerous if left untreated.
Abscess in children
Abscesses in children are usually caused by:
- Advanced tooth decay in milk teeth
- Blows
- Periodontal infections in immature gums
In children, the infection progresses more rapidly → always treat as an emergency.
Abscess following root canal treatment or tooth extraction
Abscess following root canal treatment
This may be due to:
- Residual bacteria
- Infected accessory ducts
- Root cracks
It is treated with antibiotics, retreatment or apical surgery.
Abscess following extraction
It is normal to experience swelling during the first few days.
It is abnormal if pus, a foul smell or a fever develops.
11. Can an abscess be drained at home?
No. Attempting to do so may cause the infection to spread, leading to a systemic infection and an increased risk of facial cellulitis. For this reason, drainage should only be carried out in a clinic.
12. Preventing future abscesses
- The correct use of a toothbrush, dental floss and mouthwash as part of good preventive dental care is essential for preventing infections such as gum abscesses.
- Brushing your teeth two or three times a day, flossing and using mouthwash helps prevent dental abscesses.
- Going for regular dental check-ups, at least once or twice a year, helps to spot problems early and prevent infections that can lead to abscesses.
- Eating a balanced diet and limiting excessive sugar intake helps to maintain good oral health and reduces the risk of developing dental abscesses.
- Regular checks
- Early treatment of tooth decay
- Periodontal check-up
- Removal of problematic wisdom teeth
- Avoid breaking hard foods
- Good daily hygiene
When should you visit Clínicas Udemax?
At Udemax Clinics, we treat dental abscesses by identifying the cause using X-rays or CBCT scans, controlling the infection with antibiotics where necessary, draining the abscess if required, and treating the underlying cause, whether through root canal treatment, extraction or scaling. You can book an urgent appointment, particularly if the discomfort persists for more than 24 to 48 hours or if there is swelling.
