Dental infections and facial swelling
Most tooth infections are treated by your own dentist and settle quickly once the cause is dealt with. A few spread into the face and neck, and these are emergencies best managed in a hospital. These are the questions we are asked most often.
If you have difficulty breathing, cannot swallow your saliva, or your voice has changed, call 000 or go to the nearest emergency department now.
About dental infections
Why do I need treatment and not just antibiotics?
An abscess is a pocket of infection fed by a tooth. Antibiotics cannot reach it well, so the infection usually returns unless the source is removed. Draining the abscess, cleaning out the root canal or removing the tooth is what cures it. Research shows that when the tooth is treated, antibiotics add little for an infection that has not spread.
When are antibiotics needed?
When the infection is spreading into the face or neck, when you have a fever or feel unwell, or if your immune system is weakened. They are given alongside treatment of the tooth, not instead of it. Please tell your dentist about any antibiotic allergy and what happened when you took it.
Who is more at risk of a serious infection?
People with diabetes, a weakened immune system (for example from chemotherapy, steroids or some arthritis medicines), and older people. If this applies to you, do not wait to see whether a swelling settles.
Where to go
I have a toothache or a small gum swelling. Who should I see?
Your own dentist, as soon as possible. Most localised infections are treated in the dental chair the same day, by draining the infection, starting a root canal treatment or removing the tooth.
When should I go to a hospital emergency department?
Go to your nearest public hospital emergency department if you have any of the following. Spreading infections need hospital care, often with intravenous antibiotics and surgery, and public hospitals have the on-call teams and facilities to provide it around the clock.
- Swelling that is spreading, especially under the jaw, under the tongue or around the eye
- Difficulty opening your mouth that is getting worse
- Difficulty swallowing
- Fever, or feeling generally unwell
- Swelling that keeps getting worse 1 to 2 days after starting antibiotics
Can Oromax see me for a facial swelling?
We do not run an emergency service for spreading infections; a hospital emergency department is the right place for those. Once the infection has been treated, your dentist can refer you to us if a tooth such as a wisdom tooth still needs to be removed, so the problem does not come back.
How quickly will I feel better?
Most people feel better within a day or two of the source being treated. Swelling can take several days to go down. If it is getting worse rather than better, seek care again.
Preventing infections
- Regular dental check-ups, so decay is treated before it reaches the nerve
- Do not ignore a tooth that has been painful and then stopped hurting; the nerve may have died
- Have a partly erupted wisdom tooth that keeps getting infected assessed, as removal usually stops the problem
References
- Cope AL, et al. Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults. Cochrane Database Syst Rev. 2024. doi:10.1002/14651858.CD010136.pub4
- Therapeutic Guidelines. Oral and Dental. tg.org.au
This page is general information to help you prepare for your consultation. It does not replace an assessment and advice about your own situation.