Will a dental abscess go away on its own?

No. A dental abscess does not resolve on its own. The swelling may seem to reduce if the abscess bursts spontaneously (forming a fistula), but the bacterial infection remains active in the bone or surrounding tissue and continues to progress. Without treatment, the risk is that the infection spreads to the deep tissues of the neck, the floor of the mouth or, in the most serious cases, the bloodstream (sepsis). A dental abscess always requires a dentist visit.

What to do while waiting for the dentist with a dental abscess?

While waiting for your appointment, taking an over-the-counter painkiller helps (ibuprofen is preferred over paracetamol for its anti-inflammatory effect). Drink plenty of cool water and avoid heat on the swollen area — no hot water bottle, no hot food or drink. Rinsing with warm salt water can provide temporary relief. Do not try to pierce or squeeze the abscess yourself. Antibiotics without a prescription are not appropriate and do not replace treatment.

Will antibiotics cure a dental abscess?

Antibiotics reduce the systemic bacterial infection and can bring down fever, but they do not eliminate the source of the abscess. If the cause is a necrotic pulp or an infected periodontal pocket, the infection returns as soon as the antibiotics stop unless the cause is treated. Your dentist prescribes antibiotics when needed as a support to treatment, not as an alternative to it.

When is a dental abscess a genuine emergency?

Go to A&E without waiting for a dentist appointment if you experience: difficulty swallowing or opening your mouth, swelling spreading down towards the neck, difficulty breathing, a high fever (above 38.5°C) that does not respond to painkillers, or confusion and a feeling of serious general illness. These signs indicate the infection has spread and require urgent intervention.

Can the tooth with an abscess be saved?

In most cases yes, if treated in time. A periapical abscess is treated with root canal therapy: the dentist removes the infected pulp, disinfects the canal and seals the tooth. A periodontal abscess is treated by cleaning the infected pocket. Extraction is only considered when the tooth structure or the bone damage is too advanced to allow the tooth to be saved.

How long does pain last after abscess treatment?

After drainage and the start of treatment, pain improves significantly within 24 to 48 hours. Some discomfort in the hours immediately after the appointment is normal and manageable with painkillers. Swelling may take a few more days to reduce completely. If pain intensifies after 48 hours or fever returns, contact your dentist.

Dental Abscess: Symptoms, What to Do and When It Is an Emergency

What is a dental abscess?

A dental abscess is a collection of pus caused by a bacterial infection. It forms when bacteria colonise the pulp of the tooth (the inner tissue containing nerves and blood vessels), or the tissues surrounding the root or the adjacent gums. The body responds to the infection by sending white blood cells: the pus that accumulates is the result of this battle between the immune system and the bacteria.

Not all abscesses are the same. The two most common types are the periapical abscess, which originates from the necrotic pulp of a decayed or traumatised tooth and collects at the root tip, and the periodontal abscess, which forms in the gum pocket in the presence of periodontitis. Treatment depends on the type.

Dental abscess examination at Dr. Luigi di Bari Dental Studio, Manfredonia

Symptoms: how to recognise a dental abscess

The signs are often clear, although their intensity varies depending on how advanced the infection is:

Throbbing, continuous pain, often intense, radiating towards the jaw, ear or neck
Swelling of the cheek or the gum tissue near the affected tooth
Extreme sensitivity to heat, cold and pressure (biting down is very painful)
Fever, sometimes with chills and a general feeling of being unwell
Persistent bad breath or an unpleasant taste in the mouth (a sign the abscess may have partially drained)
Swollen, tender lymph nodes in the neck or jaw area
In some cases, a small visible bump on the gum near the tooth: this is a fistula, a channel the body has created to drain pus towards the surface

When it is a genuine emergency. Go to A&E immediately — do not wait for a dentist appointment — if you experience difficulty swallowing or opening your mouth, swelling spreading towards the neck, difficulty breathing, a fever above 38.5°C that will not come down, or confusion and a feeling of serious general illness. These signs indicate the infection has spread to the deep tissues and requires urgent intervention.

The fistula: when the swelling seems to go down on its own

One of the most common mistakes is thinking the abscess has healed when the swelling suddenly reduces. What has actually happened is that pressure has overcome the resistance of the tissues and the pus has found an outlet, often through a small gum fistula. The pain eases, the cheek goes down. The infection, however, remains active in the bone or pulp. Spontaneous drainage is temporary: without treatment the infection continues to progress deeper.

What to do while waiting for your appointment

A dental abscess needs to be seen by a dentist as soon as possible. While waiting, a few measures can reduce discomfort without making things worse:

Take an over-the-counter painkiller: ibuprofen is preferred because it also has an anti-inflammatory effect; paracetamol is an alternative if ibuprofen is not suitable. Follow the recommended dosage
Drink plenty of cool water and eat soft food at room temperature
Avoid heat on the swollen area: no hot water bottle, no warm compresses, no hot food or drinks. Heat encourages the spread of the infection
Rinsing with warm salt water can provide temporary relief
Do not press on, pierce or try to drain the abscess yourself

Antibiotics alone are not enough. A GP or A&E may prescribe antibiotics to control the systemic spread of the infection. But antibiotics do not remove the source of the abscess: if the pulp is necrotic or there is an infected periodontal pocket, the infection tends to return as soon as you stop taking them unless the cause is addressed. Definitive treatment always requires the dentist to deal with the underlying cause.

How a dental abscess is treated

The goal of treatment is twofold: drain the pus and eliminate the source of the infection. The options depend on the type and severity.

Periapical abscess

The treatment of choice is root canal therapy. The dentist removes the infected pulp, cleans and disinfects the root canals, and seals the tooth. In many cases drainage happens through the canal itself during the first appointment: pain reduces significantly within a few hours. If the abscess is very large or there is a major collection of pus, a small incision in the gum may be needed to encourage drainage before proceeding with the root canal.

Periodontal abscess

Here the infection originates from the periodontal pocket. Treatment involves draining the abscess, deep cleaning of the pocket (scaling and root planing) and, if necessary, systemic antibiotic therapy. The tooth can usually be saved if it is treated in time and the patient then follows a periodontal maintenance plan.

When extraction is necessary

Extraction is the last option, not the first. It is considered only when the tooth structure is too compromised to be saved, or when the bone loss is so advanced that preservation is impossible. Even in these cases, once healing is complete, replacing the tooth with a dental implant is an option worth exploring.

Swollen tooth or pain that will not go away?
Contact us for an urgent assessment. A dental abscess cannot wait.

Can a dental abscess be prevented?

Yes, in most cases. A periapical abscess almost always originates from an untreated cavity that has reached the pulp, or from an unmanaged dental trauma. A periodontal abscess originates from neglected periodontitis. The preventive measures are the same ones that apply to oral health in general:

Regular dental check-ups, at least once a year
Professional hygiene every 6 months (or more frequently if indicated)
Correct brushing twice a day and daily use of dental floss
Do not put off treating a cavity: a small cavity takes minutes to fix; a cavity that has reached the nerve requires root canal therapy
Tell your dentist immediately about any trauma to a tooth, even if it does not hurt straight away

Article by Dr. Luigi di Bari, Dental Studio in Manfredonia (FG). Last updated: June 2026.

Dental Abscess: What It Is, How to Recognise It and What to Do (Without Waiting)

What is a dental abscess?

Symptoms: how to recognise a dental abscess

The fistula: when the swelling seems to go down on its own

What to do while waiting for your appointment