It’s 4:30 on a Friday afternoon. The phone rings at our Torrance office. A woman on the other end sounds panicked. Her right cheek is swollen. She’s had a dull ache all week, but today it turned into a throbbing, pounding pain that won’t quit. She can barely open her mouth. She’s asking, “What do I do?”
I get this call more often than you’d think. And I want to be straight with you — a tooth abscess is not something you can sleep off. It’s an active infection sitting inside your body. It will not get better on its own.
But here’s the good news: if you know what to do right now (and what not to do), you can manage things until you get into the chair. Let me walk you through it.
What Is a Tooth Abscess, Exactly?
A tooth abscess is a pocket of pus caused by a bacterial infection. It usually forms at the tip of the tooth root — we call that a periapical abscess. Sometimes it shows up along the gum line too.
Here’s what happens. Bacteria get inside the tooth, usually through a deep cavity, a crack, or old dental work that’s broken down. Once those bacteria reach the soft tissue inside your tooth (the pulp), they multiply. Your body tries to fight back, and that fight creates pus. The pus builds up pressure. That pressure is what causes the swelling and that intense, pounding pain.
Think of it like a splinter that gets infected — except this one is trapped inside bone and has nowhere to go.
Warning Signs You Might Have an Abscess
Not every toothache is an abscess. But there are some red flags that tell me we’re dealing with an infection and not just a sensitive tooth.
Watch for these:
- Throbbing pain that doesn’t let up, especially at night
- Swelling in your cheek, jaw, or under your chin
- Fever — even a low-grade one
- A bad taste in your mouth (that’s pus draining — I know, not pleasant)
- Pain that shoots to your ear, jaw, or neck on the same side
- Sensitivity to hot and cold that lingers long after the food or drink is gone
- Tender or swollen lymph nodes under your jaw
- A small bump on your gum near the tooth that looks like a pimple
If you’ve got two or three of these at the same time, you’re almost certainly dealing with an abscess. Don’t sit on it.
What to Do at Home Before Your Appointment
Alright, so you’ve called the office. You’ve got an appointment — maybe it’s tomorrow morning, maybe it’s Monday. What do you do in the meantime?
Here’s what actually works:
Over-the-Counter Pain Medication
Take ibuprofen (Advil, Motrin). It does double duty — it reduces pain and brings down swelling. Follow the directions on the bottle. If ibuprofen alone isn’t cutting it, you can alternate it with acetaminophen (Tylenol). Take the ibuprofen, then two hours later take acetaminophen, then two hours later take ibuprofen again, and keep rotating.
That combo is surprisingly effective. I recommend it to patients all the time and most people are shocked at how well it works.
Warm Salt Water Rinse
Mix about half a teaspoon of table salt into a glass of warm water. Swish it gently around the affected area for 30 seconds, then spit. Do this a few times a day. It won’t cure the infection, but it helps draw some of the pus toward the surface and keeps the area cleaner. It can also ease some of the pressure.
Cold Compress
Wrap an ice pack or a bag of frozen peas in a towel and hold it against the outside of your cheek. Twenty minutes on, twenty minutes off. This helps with swelling and can numb some of the pain. Don’t put ice directly on your skin — use that towel as a barrier.
Sleep with Your Head Elevated
Prop yourself up with an extra pillow. When you lay flat, blood rushes to your head and increases pressure at the infection site. Keeping your head up can take the edge off that throbbing feeling, especially at night.
Quick tip: These are temporary measures. They’ll help you manage pain and swelling until you can get treatment, but they are not fixing the problem. The infection is still there.
What NOT to Do
This part matters just as much. I’ve seen patients make things worse by trying the wrong home remedies. Here’s what to avoid:
Don’t Put Aspirin on Your Gum
This is an old myth that won’t die. Placing an aspirin tablet directly on your gum tissue will burn it. Aspirin is acidic. It creates a white, painful chemical burn on your gums on top of the infection you’re already dealing with. Swallow the aspirin normally if you want to take it for pain. Don’t park it next to the tooth.
Don’t Try to Drain It Yourself
I’ve had patients come in who poked at the swelling with a needle or a pin. Please don’t do this. You’re introducing more bacteria into an already infected area. You can push the infection deeper. And you probably won’t actually drain it properly anyway. Leave the drainage to us.
Don’t Ignore It and Hope It Goes Away
I’ll be honest with you — this is the biggest mistake I see. A patient will have swelling, take some antibiotics from an urgent care, feel a little better, and then never follow up. The antibiotics might knock the infection back temporarily. But the source of the infection — the dead or dying tooth — is still there. The infection will come back. And usually it comes back worse.
Don’t Use Heat on a Swollen Face
A heating pad or warm compress on the outside of a swollen cheek can actually make things worse. Heat increases blood flow to the area, which can spread the infection and increase swelling. Stick with cold.
Warning: If you’re having trouble breathing, trouble swallowing, a fever over 101 degrees, or the swelling is spreading to your eye, throat, or the floor of your mouth — go to the emergency room. Don’t wait for a dental appointment. These are signs the infection may be spreading to dangerous areas, and that can become life-threatening.
When It Becomes a True Emergency
Most tooth abscesses are urgent but manageable with a same-day or next-day visit. But some cross the line into genuine medical emergencies.
Go to the ER right away if you have:
- Difficulty swallowing or breathing — this can mean the infection is spreading into your airway
- Swelling that’s closing your eye or spreading down your neck
- A fever over 101F with chills and feeling generally sick
- You can’t open your mouth (called trismus — the infection may be spreading into the muscles)
- Confusion or extreme fatigue along with the other symptoms
I don’t say this to scare you. These situations are rare. But I’ve seen dental infections land people in the hospital, and it’s always the ones who waited too long. An abscess that’s been ignored for weeks has had time to spread. By the time those patients showed up, a simple root canal wasn’t going to cut it anymore.
Don’t be that person.
How We Treat Abscesses at Our Torrance Office
When you come in with an abscess, here’s what a typical visit looks like at Phan Endodontic Partners.
Same-Day Emergency Visits
We keep openings in our schedule specifically for emergencies. If you call us with an abscess — whether you’re in Torrance, Redondo Beach, Palos Verdes, or anywhere in the South Bay — we’ll do our best to get you in that day. This stuff doesn’t wait, and we don’t think you should either.
Diagnosis First
I’ll start with 3D imaging (CBCT scan) so I can see exactly where the infection is and how far it’s spread. A regular X-ray shows you a flat picture. The 3D scan lets me see the full story — how much bone has been affected, whether there are extra canals, and what we’re really working with.
Drainage and Relief
If there’s a visible swelling, I’ll drain it. This gives you almost immediate relief. That pressure that’s been building up? Gone. Most patients say they feel better within minutes of drainage.
Antibiotics When Needed
Not every abscess needs antibiotics. If the infection is contained and I can drain it and treat the tooth right away, antibiotics might not be necessary. But if there’s spreading swelling, fever, or signs the infection is moving beyond the tooth, I’ll prescribe them. I’m pretty careful about not over-prescribing antibiotics — we’ve got enough antibiotic resistance in the world already.
Root Canal Treatment
The actual fix for a tooth abscess is removing the infected tissue inside the tooth. That’s what a root canal does. I clean out the infection, disinfect the canals, and seal the tooth. Once the source of the bacteria is gone, your body can heal the bone and tissue around the root.
In many cases, I can do the drainage and start the root canal in the same appointment. You walk in with a swollen face and you walk out with the problem solved.
When the Tooth Can’t Be Saved
I’ll always tell you the truth. Sometimes a tooth is too far gone. If the infection has destroyed too much tooth structure or bone, extraction might be the better option. I’d rather save the tooth whenever I can — that’s my job — but I won’t push a treatment that isn’t going to work long-term.
Don’t Wait on This
I’ve been practicing in Torrance for years, and the pattern I see over and over is the same. A patient feels a little twinge. They ignore it. It gets worse. They take some pain meds and it calms down for a bit. Then one day their face is swollen and they’re in serious pain.
The earlier you catch an abscess, the simpler the treatment. A tooth that needs a straightforward root canal today could need surgery — or extraction — in a few months if the infection keeps growing.
If you’ve got swelling, throbbing pain, or any of the warning signs I mentioned above, call us. We see same-day emergencies at our Torrance office and we’ll get you out of pain.
Call Phan Endodontic Partners at (310) 378-8342. We’re here for you — even on the tough Fridays.