Is a Tooth Abscess an Emergency? Will The ER Drain an Abscess?

What is a Tooth Abscess?

A tooth abscess, also called a gum abscess or dental abscess, is a collection of pus around a tooth. Pus is a thick, oozing white or yellow-white liquid resulting from a bacterial infection.

When the body sends an inflammatory response to fight off the infection, the buildup of cells increases pressure at the infection site, leading to severe pain.

Can Popping a Gum Abscess Kill You?

Regardless of where the infection began, it will spread if left untreated.

In many cases, the infection spreads outward in a small pimple-like swelling that can drain and release pressure (called a fistula). This type of abscess may not hurt at all.

In other cases, the infection spreads inward to some deadly areas. If a dental infection spreads to the bloodstream, it can lead to septicemia.

An infection that spreads to the soft tissues under the tongue can block the airway. If an infection spreads upward from the upper teeth, it can reach the brain. These situations can be deadly, so the sooner you get treatment, the better.

What Causes a Tooth Abscess?

The direct cause of dental abscesses is an infection that may begin inside or around the tooth. Tooth decay, tooth injury, and gum disease can all lead to abscesses.

Tooth abscesses arising from inside the tooth are called endodontic infections. They involve the nerves and blood vessels within the tooth. Usually, endodontic infections are caused by large cavities, cracks, or trauma. Eventually, endodontic infections spread to the end of the tooth’s root, infecting the bone surrounding the root.

Dental abscesses can also result from infections that begin in the gums and bone surrounding a tooth. These are called periodontal infections. It is important to know the difference when it comes to treatment if you want to save the tooth.

Endodontic infections usually require root canal treatment, and periodontal infections may require deep cleanings or gum surgery. If you do not want to save the tooth, the treatment is extraction for either type of infection.

Your dentist can readily distinguish between endodontic and periodontal infections because they look quite different on a dental x-ray, although sometimes combined infections can occur.

Is a Tooth Abscess a Dental Emergency?

Because it is difficult to predict how a dental infection will spread, it is best to assume that any tooth abscess is an emergency.

Any visible swelling in the gums, whether it causes pain or not, could be dangerous, and you should seek urgent dental care. 

The goal of emergency treatment is to stop the spread of the infection. This will typically involve prescription antibiotics. 

In severe cases, it can involve intravenous antibiotics and an incision and drainage procedure, in which a surgeon “opens” the swelling to allow the pus to drain out. This relieves pressure and reduces pain.

You should never attempt to drain an abscess on your own at home. Opening a swelling without sterile instruments and infection control worsens the infection by introducing different types of bacteria into the area.

When to Go to the ER for a Tooth Infection

You can visit the emergency room (ER) for a dental emergency (such as a tooth abscess).

However, the ER will only be able to treat you if the underlying condition is health-related. The ER will bill you through your health insurance, not dental insurance.

You will need to visit an emergency dental clinic if you have a life-threatening abscessed tooth. ER doctors can prescribe IV or oral antibiotics and pain medications until you can book an appointment with your dentist for treatment. 

In some cases, they may admit you if the infection has spread so they can monitor your breathing. 

Summary

You should seek dental care if you notice any swelling or pain in your mouth. The earlier you catch a tooth abscess, the lower the risk of the infection spreading. 

To access care, you should call your local dentist or oral surgeon.