Quick answer
A dental abscess is a pocket of infection from a dead tooth nerve or advanced gum disease: throbbing pain, a bad taste, a gum pimple that may leak, sometimes facial swelling and fever. It cannot heal on its own and antibiotics alone only pause it; the source inside the tooth or gum must be treated (drainage, root canal treatment, or extraction). Same-day dental care is warranted. Go to a hospital emergency department instead if swelling affects the eye or spreads under the jaw, or if there's difficulty swallowing or breathing, or high fever with feeling very unwell.
What's actually happening
When a tooth's nerve dies (deep decay, a crack, an old injury) or a gum pocket seals over, bacteria multiply in a closed space and pressure builds: the classic deep throb that hates lying down. The body may vent it through a small gum pimple that leaks salty fluid and eases the pain; relief by leak is drainage, not healing, and the factory underneath keeps producing.
Tonight, safely
- Paracetamol or ibuprofen as directed; they can be alternated (confirm with your pharmacist)
- Sleep propped up; horizontal raises the pressure and the throb
- Warm salt-water rinses; cold compress outside the cheek for comfort
- Never a heat pack on a swollen face (it draws infection outward through tissues) and never aspirin held on the gum
- Call us first thing: (02) 9723 5757; abscesses are triaged as same-day
Why antibiotics alone never finish it
Antibiotics travel in blood, and the inside of a dead tooth has no blood supply; the bacterial reservoir is beyond their reach. They're prescribed when infection is spreading, to shrink the battlefield, but the definitive step is always physical: drain the pus, then treat the source with root canal treatment or extraction. 'The antibiotics fixed it last time' means the abscess is between episodes, not gone, and each cycle risks more bone.