A Toothache Can Kill You

But the good news is, a visit to your dentist could literally save your life.  😀

BTW – as much as I like using photos to illustrate a point, no worries here, this post is safe to view at work, at home, around the kids, and will NOT upset your stomach at all.  No gory photos!

A Tooth Infection is REALLY Close to Your Brain & Throat

A-Toothache-CAN-Kill-YouAs I mentioned on our Facebook Fan Page earlier this week, it isn’t often that a general “family” dentist gets the opportunity to save a person’s life, but this week that happened here at our south Charlotte family dental office.  A young man came to us through 1-800-DENTIST, and he’d been absolutely miserable for almost a month.  The right side of his face was severely swollen, to the point he couldn’t open his right eye, and he had difficulty opening his mouth enough for us even to take a look and identify the problem tooth.  He could barely even talk, and was clearly exhausted from not being able to sleep well for a long time.

With a good x-ray and brief exam, the problem tooth was identified as an upper right molar (top right back jaw tooth) with a major cavity.  On the x-ray, it looked like the roots were close to the sinus, which explained why he had some really bad sinus pressure on that side, too.  Literally, the tooth abscess had penetrated his sinus.  And if the infection was into his sinus, that meant it was not all that far from his brain.  As most anyone knows, pretty much ANY infection that reaches the brain will put you in the hospital, and even if you survive, there is potential for severe brain damage.

If a lower jaw tooth abscesses that bad, the risk is a little different: the infection can spread through spaces between different tissue levels under the tongue, down the throat, and if it gets bad enough, can force your esophagus (your food goes down that) and trachea (the way air gets to your lungs) closed.  That means you can’t either eat or breathe!

Please Take a Dental Abscess Seriously!

After seeing the young man, we realized we had to act quickly, or he would end up in the hospital within 24 hours (probably a lot less than that).  Antibiotics, unless they are given by an IV or in extremely high doses, can take 12-24 hours before they build up to an effective level in your blood, so they don’t work that fast!  We made time in our schedule and were not only able to remove the tooth, but to drain an incredible amount of the infection away.  He could actually open his eye by the time he left!  But if we hadn’t seen him immediately, the incredible pressure from the infection would have just continued to build, the pain would have worsened, and eventually the infection would have forced its way, through whatever tiny space it could find, into his brain.

The Mouth is the Gateway to the Whole Body

It’s sad that more of the public isn’t made aware of how deadly a tooth abscess can be; people think to themselves, “It’s only a tooth/my gums, after all.”  But the teeth and gums provide a direct path into the rest of your body, and you have some extremely vital organs very close by.  Please don’t kid yourself……if there is major swelling of the face, it is SERIOUS.

A Happy Ending 😀

The good news in this story, is that we’ve seen the young man back each of the last 2 days to follow-up.  While the swelling hasn’t disappeared completely (the antibiotics will eventually take care of that), today he was able to actually smile when he shook my hand, and after 2 nights of awesome sleep, he said that he feels like a new man.

And that, dear friends, is one of the reasons I absolutely LOVE being a dentist!

What Can Be Done for a Tooth Abscess?

So if you have an abscess, here are somethings you can do for some relief (besides the obvious first step of calling a dentist ASAP):

  1. Cold compress – an ice pack of some kind, placed over the area for 15-20 minutes, with at least 30 minutes in between sessions, can provide a lot of relief
  2. Alternate Ibuprofen and Tylenol for better pain relief than either alone.  Take 2-3  ibuprofen, wait 3 hours, take 2 Tylenol Extra Strength, then just keep alternating.
  3. Warm salt water rinses – if there’s any sores or bleeding, the salt water will sooth it.  1 tsp in a normal-sized coffee cup, rinse for 30-60 seconds every hour.
  4. Avoid hard, crunchy, pointy foods (chips, nuts, hard bread)
  5. Avoid foods/drinks that are either really hot or really cold.

Now here are the things your dentist might recommend for treatment:

  1. If the tooth is fixable, and likely to last a long time, a root canal and crown
  2. If the tooth is too broken or decayed to fix, an extraction may be the only choice.

If the tooth has to be extracted, you have 4 basic choices:

  1. Do nothing and leave the space.  While this will have consequences down the road (other teeth moving can mess up your bite and smile), it’s always a choice.
  2. A partial or complete denture.  This is usually the least expensive replacement, but many people don’t like it, because you have to take it out to clean it and it doesn’t look as natural.
  3. As long as there are teeth on either side of the extraction, you can get a dental bridge.  A bridge is basically several crowns that are connected, and the teeth on the side of the space support it just like a bridge over a river.  The upsides are that you don’t have to take it out, it can look very natural, and especially if the teeth supporting the bridge need treatment anyway, you fix several problems at once.  The downside is mostly that you do have to drill on other teeth, and if they’re healthy…..yeah….not a good idea there.
  4. Dental implants.  No doubt about it, a dental implant, supporting either a crown, bridge, or denture, is the best way to replace one or more missing teeth.  Rock solid, they may last the rest of your life.  Of course, it’s also the most expensive in the short term, but long term, it’s definitely the best way to go.


To make an appointment for a Complimentary Consultation:

Request an Appointment Online or call us at 704-364-7069.

We’ll look forward to meeting you soon!

By | 2017-06-09T20:35:21+00:00 July 22nd, 2011|Emergency dental visit|122 Comments

About the Author:

My profession and passion are one and the same: I've been a Charlotte dentist since 1999, and if you're in need of a dental office, we'll gladly welcome you. We offer most of the most modern technology available and a unique and broad combination of services. We know the dentist isn't the most fun place to be, but we try to make it the best possible, and since I truly love my job, we aim to offer the best dental care possible.
  • MB

    Can you get an abscess in a tooth that is crowned, and if so, can it cause the other teeth on the same side to go numb like they have been frozen with novicaine?

  • Steven Nichols

    Yes I Have An Access On The Bottom Left Jaw..Third Tooth Back From My Front Teeth And It’s Only Half A Tooth There But Unfortunately I Have No Insurance And Just Started A New Job So What Do I Do? And Could It Have Caused My Tonsils To Swell?

  • N.U.E Natures Unifying Effort

    My back tooth is broken down to the gum for bout 2 years now..My gum started hurting yesterday while eating.. now my lymph node on that side is swollen.. I scared.. I can deal with the pain..I’m just scared ima get sick really bad because of the infection. I gave know insurance or money to pay right now.. should I puncture the gum to release the outside out before it builds up or travels some where else. Should I go to E.R. and get antibiotics. Will that stop infection.

  • Jessica LaPlante

    I have swollen lymph nodes and occasional pain in throat area- I have an appt in 5 weeks to have all 4 of my wisdom teeth removed. 3 are impacted the 4th one is partially erupted- I am 32 years old. My lymph nodes have been swollen off and on for about 6 months- I have had recurrent tonsillitis is this time frame. My dentist and oral surgeon both agree that the wisdom teeth could be causing these problems. I have been on antibiotics 3 times in 6 months by my primary care dr and it does make the infection clear up some but it always comes right back. Do you have any advice on what I should do in the mean time? Also do you agree that the removal of wisdom teeth will get rid of this issue?

  • Jasmin white

    So I’ve got a cavity on one of my top front teeth. It’s doesn’t hurt everyday but it hurts here and there. The pain isn’t severe though like I can sleep fine and the pain goes away in 30 minutes to an hour. I don’t know if I should be worried about it yet. I’m embarresed to go to my dentist because my teeth are crooked and I have 2 teeth that are nearly fully rotten all my top row of teeth are messed up bad. I want to fix my teeth but I’m extremely scared of the dentist !! I do brush my teeth twice a day and I try to limit sugar in my diet from now on. My cavities are from too much sugar in my diet

    • Jasmin, I definitely understand those fears, and I assure you, all dentists are used to seeing patients in your situation. That’s what we’re here for, is to help, not make you feel badly. If you have pain that lasts from 30-60 minutes, that’s definitely something to be concerned about, so please do call a dentist as soon as you can, ok?

  • Dan

    Hi, I’m Dan. I’m 21 years old and have had an abscess for around 3 years now. It doesn’t hurt, and every once in a while it swells up and I pop it. Sometimes it’s pus, sometimes it’s blood, sometimes both. I’ve experienced no extra swelling, no increase in size to the abscess, and no other abscesses. No numbness anywhere, either. I know I should have it removed, but in how much danger am I right now? I don’t have the money and my insurance won’t cover all of it.

    • Dan, the reason you’ve been able to make it this long is precisely because it pops occasionally. It sounds a bit gross, but it’s much the same principle as a zit; when the skin pore is so clogged that the pus can’t come out, either with pressure or on its own, those are the zits that swell up big and get really painful. The ones that can pop, either on their own or with pressure, are the ones that don’t hurt as much. With dental infections, a lot of the pain comes from the pus building up pressure in the bone and squeezing the nerves, along with the inflammation that comes from infection. When the abscess pops, it releases the pressure and prevents pain. So as long as it can do that, you’re not in severe danger. That’s the good news.
      Of course, the bad news is that it’s just never a good idea to leave a chronic infection in your body, so of course, I strongly encourage you to save the money and get it extracted as soon as possible.

  • Jonathan Gurgua

    Hello, I’m Jonathan Michael. I’m 23 years old & I have one abscess on my rear molar. I went to the ER yesterday around 3:17am because I couldn’t take the pain & the headache anymore.. They gave me ibuprofen & ampicillin but my face still swollen & the swollen spreading towards my bottom lip area.. I thought the antibiotics would stop the swelling. I’m still taking the two medications & my tooth still hurts bad, but not equally bad like last night. I do feel the swollen area numb.

    Was wondering if theirs anyway I can get my molar pull out please. I don’t possess a social security card or id & no insurance. I simply have my birth certificate & a copy of passport & school records.. I do work under the table so I can make payments of whatever y’all charge me. I don’t want no-one to feel sad for me, but this molar really hurts & everywhere I call they need an id or social. Even free dental clinics.. The ER it’s the only option to get more antibiotics, only I don’t know how much longer I can last with this molar wide open. It’s been open for roughly two years & couple cavities on my other teeth . I’m begging for help & theirs no other place that wants to assist me. Please, please, help me.

    • Jonathan, if you’re in Charlotte, give us a call, and we’ll see what we can do, ok?

      • Jonathan Gurgua

        Good evening Charles!

        I was able to obtain an appointment in Lexington, NC university dental campus. My appointment won’t be until May 6. I have 4 more days until my Penicillin pills run out. I’m still taking ibuprofen. It’s been day two since I went to the ER and day two of taking does two pills daily, 3 times a day. I’m still suffering pain in my tooth. My pain from 1 through 10. I said it’s a 2, Like I can feel the pain, only it’s not uncomfortable. Now my issue, it’s that last night the swelling started looking like a ball.. I check my tooth and I saw pus coming out of my tooth. I press the sides of the gum where the infected molar located and more was coming out until blood began to come out as well till stopped. The following day I press the same area and no more pus coming out just a slight blood that looks sluggish . I’m afraid the swelling mite be pus, Could that be the case? I continue taking ibuprofen just not sure if its actually swollen or pus. If there’s a possibility that it can be pus what should I do? I attempted to insert a needle in the swollen area, but not sure if I went deep enough. Since my appointment its until may 6. Do you think I should go to the ER again? Would they be able to extract the pus from my lower right cheek? Or the dentist the only one that can perform it? What would happen if its pus and I just go on taking the penicillin and let the pus sit until my dentist appointment?

        Thank you responding back early.

        Edit: I forgot to mention that the area that looks swollen it doesn’t feel numb anymore.

        • Jonathan, you are correct that the whitish stuff is pus, but the fact that you’re able to press it out is a good thing, even though it probably seems really gross. By pushing it out, you are reducing the amount of infection in the area, which reduces the pressure and the pain. It’s similar to popping a huge zit, basically. Don’t overdo it, though! If there is blood coming out, that means you’ve gotten most of it out that you can, and doing more won’t really help. The swelling may not go down completely, though.

          Rinse the area vigorously with warm salt water: coffee-cup size mug of lukewarm water with a level teaspoon of salt, 1 mouthful 3-4 times per day.

          Keep taking the penicillin, and as long as the swelling doesn’t continue to worsen, you’ll be ok until the 6th.

  • Deborah Kelly Imvu

    Hi, I am a 54 year old female, i do have type 2 diabetes, which i am working very hard to get under control as my numbers have dropped from 7.1 to 6.1. I had all my upper teeth pulled out about 3 years ago. A little over a week ago, i felt a small lump (like a tiny ball) in my upper gum above where my eye tooth would have been. I am real nervous now cause me too, i google things and always think the worst. But i have seen the dentist once last week, i been on amoxicillin 500 mlg 3x a day for 1 week now with no improvement and it hurts really bad, i dont see any facial swelling but u can see it on my gum, its very tender to touch next to my right nostril , and also i feel like i have a headache on the right side of my head. I go back to the dentist tomorrow, i had her call me back today and she wouldn’t give me any information over the phone, which kinda worries me more…i just don’t know what this could be, being i have NO upper teeth and it seems like a gum abccess to me…i’m very scared cause i do know if not treated this infection can go to my brain…but i am wondering if you might know what this could be, i mean i hope and pray it’s not oral gum cancer, the area to me just looks very red and inflamed and swollen…please help….what does this sound like to you?

    • Deborah, that does sound unusual, and I’m glad you’re seeing the dentist about it. There are several things that it could be; while oral cancer is on the list, your description doesn’t easily fit the descriptions for most of them. From the little information given, it does sound like an abscess, so I’m wondering if there was part of a tooth that broke off during the extractions that is now the source. Statistically, that’s a more likely possibility, but it’s hard to say.
      Best thing is to see the dentist and hopefully they can find out for sure.

  • Rob King

    Well I haven’t been to a doctor in probably ten years, I lived on my own since I was 16 so my eating habits have been for the most part quantity over quality, as for my oral hygiene it hasn’t been the best. I often just brushed, mornings and nights, but no mouth wash nor floss. Anyway my back chewer teeth have been having issues, and now I have one that is elevated, and terribly hurting. It’s on my bottom right hand side, first from the wisdom tooth. And the pain is actually under my tongue. I’m pretty sure it’s infected as my ear has a weird feeling. I’m almost positive I need antibiotics and the tooth to be pulled. But I haven’t seen a doctor in so long I’m not sure how to go about getting a dentist as there are so many different ones in my area. What do you recommend I look for in a dentist or dentist office?

    • Rob, one way to try and find one is to look for their Google and Yelp reviews (although you have to take Yelp reviews with a huge grain of salt, because if a business doesn’t spend money with Yelp advertising, they will often filter out the good reviews to put pressure on the business). Don’t necessarily look for perfect 5-star reviews, either – that often means someone is gaming the reviews. If they have mostly solid reviews and a few so-so ones, that’s fine and probably more realistic, because no one is perfect.
      When looking at a dental office website, remember that most of them are fairly generic and cookie-cutter, but if you find one that sounds more personal, that is often a sign that the dentist is involved, and my personal feeling is that is a good thing, because they care about communicating honestly. Just my opinion, though.
      With the circumstances you provided, you probably do need to find an oral surgeon. If the swelling is under your tongue, call NOW. Don’t necessarily worry about finding a perfect match – just see someone NOW.


    “Do nothing and leave the space. While this will have consequences down
    the road (other teeth moving can mess up your bite and smile), it’s
    always a choice.”

    Millions of people never replace a removed tooth and are fine. Stop with the scare tactics to drum up business.

    • “Scare tactics?” No, it’s a simple statement of what CAN happen.

      As a matter of fact, you’re absolutely correct about millions of people missing one or more teeth and living perfectly fine lives. Heck, some people live wonderful lives without ANY teeth. Whenever we are extracting a tooth, we always inform the patient that they don’t have to do anything, but if they’d like to replace it, then the choices are A, B, or C.

      Given the choice, most people prefer to have the tooth replaced. We never push anything, so I resent your accusation that I’m trying to “drum up” business. Heck, I’m so busy I can barely handle all that we have. All we do is offer options, discuss the pros and cons of treating vs not treating, and let our patients decide.

  • Tari Anne

    What the hell do you do if you have not got the money for expensive dental treatments? It is outrageous what it costs! I am Canadian and we don’t get this for free that is for sure.

    • Tari Anne, I absolutely understand that the costs can be high. Unfortunately, there are no easy answers because it’s a complex and multi-faceted problem that has to do with insurance coverage (or not, or how much), how much people get paid, costs of dental education, starting and running a dental practice, etc. I have to pay my employees, my bank loans, school loans, suppliers, landlord……and none of those are cheap either. I’m sorry I don’t have any better answer.

      • Tari Anne

        It is a social problem and should be covered by the same plans as health care here in Canada. Since having dental issues can be so life threatening its ridiculous for it not to be! I truly believe that dental health must not rely on employers benefits as most do not offer it and those that do atr barely worth it. I hear what you are saying and its true. Ill keep taking my advil and hope for a miracle… A decent job or for this situation to fix itself .

  • Archy Moses

    I have very bad teeth I have three teeth that are broken off at the gum line and three broken in half I have most of my teeth are cracked and little pieces break off all the time the dental office that took my state medical shutdown and no one in my area will accept my medical for the past week the right side of my face and neck and even my upper head hurts my gums feel swollen. I don’t own a car and I can’t afford to travel are there any charities that will help. I don’t know what to do I ask some dentists on 1800 dentist and two dentists both told me that teeth are for the privileged and I’m not important enough to help. My real name isn’t archy moses I’m just so embarrassed that I don’t want any o e to know who I am I don’t even leve my home any more I wish some one would be nice enough to give some information that could help. Some times I feel like death is the only thing a loser like me deserves.

    • Archy, I am so incredibly sorry, I completely lost track of this comment that you posted. I hope that you were able to find some help from some source. But no matter what, you’re not a loser deserving of death – you’re a human being of value just for being you. Have faith in yourself!

  • Cindy Newbert

    I’ve had na infected tooth for a few months now… its now were I have puss coming out of my gums… what do I do. . Is it an emergency

    • Cindy – if you have pus coming out of your gums, yes, that is a significant infection and you need to see a dentist or physician as soon as possible.

  • Jen

    I woke up yesterday morning with a horrible toothache that kept me from falling back to sleep. I couldn’t get into the dentist until tomorrow so I tried using home remedies to help until then. I was placing garlic along the gums where the pain and swelling were and it seemed to help at first. I also was rinsing with salt water and leaving a tea bag on the area. Now 24 hrs later, the pain isn’t as bad in the tooth, but my jaw is swollen like a golf ball?! Did I do more harm? I’m afraid it might burst while I’m sleeping.

  • Karly Ann

    Ive had broken/decayed teeth for years and years and i have always popped abscesses myself cleaned it and pulled my own teeth only because i cant afford a dentist. Even the supposed free (not so much) dentists wanted alot of money. I had a chipped front tooth that was bonded and every few years the bond came off and i got it redone (my parents) but after becoming an adult it was my responsibility and when the bond came off again i couldn’t afford to get it redone…..now 10+ years later its cracked off even more and a few days ago i woke up looking like a duck! My top lip was so swollen and stuck out….i had a huge abscess on my upper front tooth gum line. Ive tried ice….didn’t work…..hot salt water….nothing…..any suggestions? I can get antibiotics from the hospital…but cant afford the dentist

  • angela

    I haven’t had dental work done in years…I had both canine teeth drilled and filled at three gum line at 2:15pm, its now 8:45pm, I have a headache and the teeth feel kinda sore. And slightly nauseated? Is that normal? I’ve felt kinda off since I left the office? Is my anxiety Judy getting the best of me?

    • angela

      I also have a serious infection in my upper left back teeth. that has been coming and going for almost four months now. I’ve been on penicillin, amoxicillin, and now augmentin twice. I am seeing an oral surgeon for a consult on Monday today is Thursday. The infection has caused my left side of my face to swell four times now. The pain was excruciating the first time. My primary prescribed a strong narcotic to help along with antibiotic. But the last three times the pain was bearable. But the swelling was insane.

  • Lisa

    Been putting off getting 2 teeth pulled with antibiotics because I can’t afford to go to the dentist cant get medicaid what am I suppose to do if I cant get pulled will possibly end up in hospital! Help do not know what to do!

  • D. N. V.

    I would so love it if you could pass this on to my local ER! Painful tooth after hours, close to weekend. Can’t get into a dentist until Monday-my dentist would have to see me to prescribe anything, I haven’t been recently. Walk-in clinics won’t take me because it is a dental issue. Tell me to go to the ER….ER doctor, takes one look at my teeth, tells me I need a dentist. He was with me for all of 3 seconds. They sent me home as not an Emergency. In the meantime, I am in a huge amount of pain, my eye is pretty swollen, my temple is killing me, my ear aches, and it is starting to make my throat hurt. I was crying for an anti-biotic. No pain pills-I have bad reactions to them. But because meth is a huge problem in our area, and the doctors (not the dentists) think I have bad teeth from it, I get sent home for drug seeking behavior. Yes, I was drug seeking, an antibiotic. It is a crazy world when you go place to place trying to get a script for a $4 anti-biotic. Knowing you have bad teeth and knowing it could possibly kill you down the road, yet no one will help, is a very horrible feeling.

    A question though: I have never asked my dentist what has caused all of my bad teeth, yet he has never treated me like a drug addict. (I do get it a lot elsewhere) I did give the hygienist a brief dental history. Most of my maternal side of the family has had to have dentures by the time they were 30-40. I, myself, am lactose intolerant, so low on calcium. I had 2 kids back to back. When I was pregnant with my last child, I had a black spot develop on my tooth, despite brushing, flossing mouth wash. When part of my tooth came off, my tooth was hollow. Most of my teeth now are hollow, when the outside breaks off, there is nothing there. The outside of my teeth are also very fragile, parts broke off eating a sandwich, fragile. I have never done any illegal drugs-not even experimentally. (Most people I know have at least smoked a joint, but I have done nothing) Any ideas what causes me to have meth mouth without doing meth?

  • Lynne Staley

    I’m wondering something. I’ve had a black hole that has gotten a lot bigger the past year in my very last molar, bottom right. It does not hurt. No bubble in the gum, nothing. I shouldn’t worry unless I develop pain or fever, right? I can’t afford to get it extracted right now. Thanks.

    • Lynne, if it hasn’t started hurting yet, it be still be possible to do a filling on it, which would be way better than getting it extracted. But even if you do choose to get it removed, try not to wait until it actually gets really infected, ok?

  • joei

    Does my dentist need to drill to put in a particle denture?(had to have two front bottom teeth pulled Perio disease)

    • Joel, I’m not exactly sure I understand your question. Can you explain a bit more please?

      • joei

        Thank you for your reply, I am missing my two bottom front teeth I have the option of getting a bridge for 6100.00 or a partial denture when I was in the office I told him I wanted the partial he said for me to come back and he would take a mold then after that to come back and he would have to drill some small holes for the partial to rest? I thought that partials had clips/ brackets? Thank you

        • Ok, thank you for the explanation. And from that, the answer is “probably yes.” Your dentist is talking about using the drill to create small “rest seats” in the chewing surfaces of a few teeth. When the metal framework for the partial denture is then placed, there are small metal extensions that will “rest” into those indentations and be held in place, keeping the partial denture stable. They aren’t always needed, but most of the time. No worries, though – they are very small indentations, not really holes. More like divots, or little scooped out areas.

          Hope that clears things up, but feel free to ask again if it’s still not clear.

          • joei

            Thank you, you answered my question, I just did not want “holes” drilled in healthy teeth, I finally got my gum disease under control and I do not want to create more problems.

            • Glad I could put your mind at ease! You probably won’t even need any anesthetic unless your teeth are super sensitive.
              And good for you for getting the gum disease under control; don’t ever let up, though, because it can come roaring back if you slack off too long. Stay on top of it, though, and you’ll be fine.

  • nikki

    Hi.. I was wondering I had a root canal like 12 years ago. Lately I’ll get a small abscess in upper part of gum . no pain in that tooth but if I bite down I feel pressure in tooth. Is that possible?

    • Nikki, it is definitely possible for the root-canal treated tooth to become reinfected. Did you have a new filling or crown placed on the tooth after the root canal was completed? Far too often, people don’t get the tooth properly restored after root canals, and the temporary fillings don’t last long, allowing re-infection by leaking. Another possibility has to do with the tooth cracking, which also allows bacteria back in. Since the nerve is gone, you usually won’t feel any hot or cold sensitivity, but if you feel pressure, that likely means the infection is building up at the tip of the root. You should definitely see a dentist soon. Hopefully, it can be retreated so you can keep the tooth a good long time.

  • LozC

    Hi Dr Payet,
    3 days ago I went to the dentist with an awful toothache and was told the lower left 6th tooth was decayed and infected and the dentist performed the first part of a root canal and prescribed painkillers and antibiotics which I have been taking as told. Since then the whole left side of my tongue and bottom lips has ulcered, I have earache in both ears, swollen lymph nodes in my neck and white spots on my tonsils. Could this be linked to this root canal or the infection or just very bad luck? I am nervous to have the 2nd part of the root canal done whilst I am still in so much pain from my throat and ears. What’s your advice? Thanks.

  • Parmila

    Hi Dr Payet.. My mum has a dental abscess and the dentist wont touch it until the swelling goes down. She went to the doctor and got some amoxicillin. The third day on the amoxicillin she woke up with a swollen face on the side of the bad tooth. Her pain is not bad, she is taking ibuprofen. Its been about five or six hours since she woke up and the face swelling is the same.. should she go to ER or wait and see what happens? How long would it take for the antibiotics to kick in?

    • Parmila, by the 3rd day, the antibiotics should already be working pretty well, so if the swelling just got a lot worse, your mom really needs to go back to the dentist right away and get treatment started. If the tooth is to be extracted, that’s the BEST way to get rid of the infection; if she’s going to have a root canal, they can at least START it to get rid of the source of infection in the tooth, put some medication in it, and finish in a couple weeks. There’s no good reason to wait at this point. The ER really won’t be able to help, but the dentist needs to start treatment immediately.

      Hope that helps.

  • April Peterson Crawford

    My husband has a severe dental abscess on his side top tooth. It broke off down into the gum line a while ago and last week he was having pain but no swelling. Friday he started Bactrum ds and Saturday morning his face started swelling up so we went to the er. The doc did nothing and sent him home. Yesterday being Sunday and day 3 of the Bactrum my husband woke up and his face was so swollen that his eye was almost swollen shut and he developed chest pains so I called 911 and they took him back to the same hospital he was at the day before. The hospital did give him a round of antibiotics threw the iv this time and sent him home with 300mg of Clindamycin however they did no x-ray to see just how far up and how deep the infection goes. Now today his face is even bigger and his eye is now completely swelled shut along with his top lip being swollen on the side the infection is on is and not able to even open his mouth like that. I am very scared at this point and we have no insurance. This is now day 4 of the antibiotics and it still doesn’t look like it has a drain point but his cheek on the side of his nose is very hard. Do you suggest trying a different er or waiting even longer to see what the antibiotic does? Right now I’m putting ice on his face, having him rinse with lukewarm salt water, and alternating pain meds and motrin. Please, please help me…I’m extremely scared he’ll die from this. He has no fever but breaks out in terrible sweats and now complains it feels like it’s burning.

    • Oh my that sounds awful! I can’t believe they didn’t admit him to the hospital at the last visit, but April, at this point, it sure sounds like he desperately needs surgery to remove the tooth and drain the infection. I missed your comment yesterday, so I hope he’s OK, but if you haven’t gotten him back to the hospital, take him NOW and MAKE them admit him. What you’re describing absolutely sounds life-threatening and VERY SERIOUS.

  • Stephanie

    Hi dr. Payet, do you know of any really good dentists around the Athens or Augusta area in Georgia? I need some assistance I feel like I have an abscess developing. I had one recently on my top front tooth to the right but now I think I have one on the left side. Those front teeth are crowned also.

    • Stephanie, I can’t think of any off the top of my head. I’m sorry! If one pops to mind, I’ll definitely let you know.

  • maci wyatt

    My 1 1/2 year daughter has almost gotten all of her molars in, today she woke up with a very swollen jaw. We figured she might have an abscessed tooth but none in her mouth show to be inflamed or decayed. Is there any way that one of the molars that haven’t broke through could be abscessed inside the gum? Just wanting to know, and if so what would be the likely solution?

    • Maci – interesting question. I missed it yesterday, so I’m curious if the situation has changed at all? A couple thoughts, although, of course, my first recommendation is to call a dentist right away:
      1) One possibility is indeed that there is still a tooth waiting to erupt. Pretty unlikely, though.
      2) There is a cavity on a tooth that you just can’t see. Even on baby teeth, if the cavity starts on the side, it may get very deep before it breaks.

  • christine

    My fiance had 4 teeth extracted yesterday due to bad infection in his face. They drained some of the infection but today his face swelled back up and hes in pain again. He believes theres still infection because he feels a knot in his face. He also thinks there is a piece of tooth in there because he can feel something sharp. Hes been on antibiotics for 4 days and is continuing to take them. He has an absess in one of the sockets that was under the bad tooth. Should we be alarmed?

    • Christine, if the infection was THAT bad, it can take several days for the antibiotics to fully kick in and get it under control, so unless the swelling keeps getting bigger, I wouldn’t be too alarmed yet.

      Some of the swelling may also be from the extractions themselves. Have your fiance put ice packs on his face for 20 minutes at a time, about once per hour, and do that until tomorrow. Starting tomorrow, he can use heat packs instead (it’s kind of like treating a muscle injury).

      What pain meds is he taking? Has he started doing very gentle salt water rinses? If not, put 1 level teaspoon of salt in a coffee cup and warm it slightly (just lukewarm, NOT hot!) and very carefully and gently rinse for 30 seconds every couple hours.

      Lastly, unless the dentist was really slack, it’s probably NOT a piece of tooth that your fiance is feeling; it’s more likely a sharp ridge of bone. While those can irritate the tongue, they’re not a problem and will eventually smooth off on their own.

      Good luck!

  • Christopher Bubb

    For the past month I’ve been experiencing something with the gums in the lower right quadrant of my mouth that is seriously confounding me. In my Internet research I have managed to convince myself that it has been everything from periodontitis to an abscess to just a cyst to oral cancer. I really do know my best recourse is to see a dentist and I plan to hopefully make an appointment for next week or the week after (it may not be the most opportune time because I’m starting a new job next week, but I have to do what I have to do, I guess).

    About a month ago, while brushing my teeth, I noticed a very dull pain while brushing my teeth in that area – around the canine tooth in my right lower quadrant and the adjacent molar. It wasn’t a continuous pain, only while I was brushing my teeth. There was a little bit of bleeding from the gum, but I have often been very aggressive with my brush strokes while brushing my teeth, which my previous dentists will attest to, so I chalked it up to that. Then about a week later I noticed that my gum along the length of my two molars in that quadrant (I had my wisdom teeth out years ago) seemed swollen and lumpy, yet painful only to the touch or when brushing.

    In the past couple of weeks, the swelling on the gums has subsided a bit, but is still there and I have tasted what I assume to be pus (not certain it is) in my mouth. I switched to an electric toothbrush and have had no further major problems with bleeding from my gums, but still feel twinges of pain when I brush in that area on occasion (not every time). On top of that, the canine tooth in that lower right quadrant feels slightly loose. It’s the only tooth that feels any kind of mobility and it’s only slightly loose, not like it’s about to fall out. However, the swelling in my gum begins with the adjacent molar, not that tooth, which has me rather confused. There is also now a bit of swelling in my cheek on the right side, not a lot of pain per se but mostly pressure and occasional shooting pains up to around my ear, which I assume could be either because of an abscess, recovery from the Bell’s Palsy I suffered nearly two years ago and from which I am still recovering, TMJ or maybe a sinus problem or ear infection.

    I’m thinking this might possibly have resulted from bruxism or grinding my teeth, as I have a tooth in the upper right quadrant of my mouth parallel to this problem area that has of late become extremely sensitive to hot and cold, so it’s possible I may have ground my teeth too hard or something and injured both teeth. I do know that grinding can knock permanent teeth loose.

    As I said before, I’ve been through just about every possible scenario in my mind as to what could be causing this. I thought periodontitis, but when I examine my teeth in the mirror, the gums don’t seem to look like it – they don’t seem to be receding and they don’t look red or diseased to me, and only that one tooth is loose which, again, I suspect may be the result of grinding. I thought maybe a tooth or gingival abscess, but I haven’t been experiencing severe or unrelenting pain, and I’m not sure an abscess could stretch along the entire length of the gum line for two teeth (or a cyst for that matter). (I’ve had more loss of sleep from worrying about what could be wrong with me than from pain.) I really hope it’s not oral cancer – I don’t smoke or chew tobacco, but my parents, of whom I am frequently in the company, do smoke. Can secondhand smoke lead to oral cancer?

    A little background. I am 34, obese, have type 2 diabetes (and take meds for it, but not insulin) which I am really struggling to control though I am taking steps to be more physically active, and am still suffering with the effects of an attack of Bell’s Palsy a little over two years ago, also on the right side of my face. I know that there can be a metallic taste in the mouth as the taste buds heal on the affected side. I did fall off the wagon a little for a time in regards to oral hygiene, but have gotten much better at brushing my teeth twice a day and using an electric toothbrush. Historically I’ve always thought my oral hygiene was good but I know diabetics have an increased risk of issues too.

    Anyone have a clue, based on my combination of symptoms, as to what this is? The symptoms themselves haven’t been bad enough to seriously disrupt my quality of life, but worrying about them has been. I will of course see a dentist for this as soon as I can.

    • Christopher – wow, that has to be one of the most thorough and detailed comments that I have EVER received in 5 years of blogging – I’m impressed!

      At the same time, I am hesitant to suggest anything beyond your initial correct guess – definitely see a dentist. Given that the issue does seem to be focused on your gums, going to see a periodontist might well be even better. If you tell me approximately where you live, I might be able to connect you with someone, as I know a lot of dentists around the country (I’m assuming you’re in the USA). The various symptoms you describe could easily fit one or more distinct problems or, as you guessed, might be a combination of problems.

      And yes, I completely understand the results of too much Googling, as I’ve done it myself. If you search long enough, you’ll find someone online who’s convinced that the symptoms of a common cold are that of a brain tumor that’s about to kill you any second now.

      Whatever you find out, it would be great if you’d follow up and let us know? I’m very curious, because while I don’t honestly think it’s oral cancer (just based on statistics), it could be a range of things.

      • Christopher Bubb

        Looks like I will have to wait till next week to make an appointment – I tried but the dentists who might possibly take my medical insurance seem to all be closed for the New Year’s holiday. But I am planning on following up on this as soon as I can – hopefully find a dentist with later afternoon/early evening hours. This doesn’t seem like an emergency so I probably won’t go to urgent care unless things get alarmingly worse in the next few days. Unburdening myself about this, though, has made me feel a lot better. The stress was probably making it worse. And no more Googling! Thanks for listening and I definitely will see my dentist.

        • Christopher, yeah – most dentists indeed will be closed around this time, but if you can make it until Monday, you should be fine. It’s a very intriguing problem, but doesn’t seem like anything life-threatening. Still, if it does get worse quickly, don’t hesitate to go to urgent care.

          • Christopher Bubb

            Well, I saw a dentist this afternoon and he said it was only a mild case of gingivitis and nothing to be alarmed about. So that takes a huge load off my mind. I hadn’t seen in a dentist in a long while due to not having dental insurance, but I made a follow-up appointment for July. So that makes me feel a lot better. He sent me away with some Crest Pro-Health for treating gum irritation and a new toothbrush and floss.

            • Christopher, so glad to hear that! Good luck with everything, and if anything else comes up, don’t hesitate to ask. 🙂

  • Evelyn McKnight

    First, I apologize for.any typoes on this stupid phone… It’s my fiances, and the only option to internet access at this.point. I’m diabled, waiting for court hearing to determine my disability status for.the.past 5 years. My fiance has a lousy job that barely pays him anything. I can’t drive.because of disability, he can’t afford any vehicle currently. The state is suppose to provide assistance for transportation, but the last three times I called for appointments, no one showed up or they blocked my numbers… Very rude people… I was going to ann arbor by train for the school’s dental help, which was doing such great work, but we recently we’re kicked out, was homeless for about a month and a half, so we had to stop taking me to get the rest of.my dental work done. My family on both sides has bad dental issues, and I’m also allergic to any form of alcohol, so mothwashes in my area are out of the question, and the prescribed toothpaste is running out. The teeth are so bad, that brushing doesn’t even get the gunk off, i have to floss it off, scrape it or whatever i can befor e AND after brushing. It’s rediculious with having no immune system to fight off.the bacteria that shows up in a matter of minutes, thanks to my mother’s side… And the alignment, thanks to my father’s side is useless to get braces for, which four of my brothers and sisters are.a testament to… One dentist I’ve seen a.few.years ago when i first got medicaid, literally insulted.me and wanted to charge me over $6k for work i found out later was pointless… To say the least i.told them to go screw themselves, they shouldn’t treat thier patiences like that…

    Anyway, the main issue is, one tooth the student fixed might still be infected, it.still has random pain, or or something constantly stuck between the tooth, (upper right, just between canine and molar), this tooth was broken in half for several years with no issues down tot the gum, and now it’s sensitive to everything. We are currently living in an area we can barely afford, no transportation to any place.close, the dental school i was going to is too far away and costs too much to get out to, granted it’s just $3 copay whoch is a blessing, had about $50k work done for about $400 in all including transportation costs, and thats like four.visits… They really did a lot for me, but i dont have any way to contue my treatment.. And unfortunately i have the lower left back molar broekn open toalmost the root for the past nine years, damn tv dinners.and thier chicken always chipping mybteeth so often, but like i said, we can’t afford.much, so we get cheap food to.feed us… That is constantly hard to clean out, and i was given the option to see an oral surgeon for removal, and havine problems.with the upper teeth growing down and not able to stop, or leave it in unfixable because my insurance won’t cover the root canal to fix.it… I don’t know what to do, it doesn’t hurt yet, only if and when I’m trying to clean the food out of.it.constantly, it’s not a dead tooth either, it still responds to that cold chemicle testing stuff, in fact,.I’ve shocked a.few dentists.that all my teeth that were.chipped, or broken tot the lulp we’re very much alive, viable, and not in much pain for years. I’m still terrified.to chew.on anything becuase how easy they’ve chipped just from rinsing in the past… No one can seem to find out why my teeth are.so horrible. I really want nice teeth before.me and fiance get married by next fall, but I’m beginning to feel this is impossible after 20 years of fighting dentists to just get them to fix my teeth instead of portraying me as the bad guy. At least the student i had was trying to find a link in my teeth and any common deseases that might be causing the lack on immune system to keep my teeth strong. What do you suggeat I can do?

    • Evelyn McKnight

      Update, the upper right canine, and i guess tge premolar right behind it are tge problems. The premolar hurts, but if i place a few layers of floss between the canine and insisor, it relieves a lot of pressure for some reason.,also today, i could eat or sleep, made ham and bean soup with left over ingredients, took one bite, without touching the area of pain, it shoots up pain immediately, i litterally can not eat! All the placrs we called in the area aren’t opened, my dentist isn’t answer ing her phone, these were botg just recently worked on about two months ago, and peroxide rinse with warm water and a small amount of salt aggrivated it to the point of not only tears, but literally screaming! Fiance was rushing with 911 and they refused to help, for the love of… HELP ME!

      • Evelyn McKnight

        That was suppose to be “Couldn’t eat or sleep”, i hate this keypad…

        • Evelyn McKnight

          The only place that accepts my insurance is about a mile and a half away, and they won’t see me until monday. They’re closed right now, and I have no way to eat anything, we don’t own a blender, we don’t have any soft or room temp foods, even if we did, it would be stuck in the back left molar where I can’t pull it out… I’m exhausted, in lots of pain, and no one will do anything around here… I haven’t eaten in almost 72 hours, 911 won’t respond, and I have no idea if I can even last until tomorrow… My allergy to alcohol, citric acid, and so much other crap is limiting me on any home remedies for pain, and I’m terrified to keep taking my 800mg IBUPROFEN. The floss idea, I took out last night in hopes of it going back to normal, I just put some in, it’s no longer relieving any pain, and it’s getting worse each minute. I’m in dire need of help here, and I feel you skipped right over my post and didn’t care!

  • Huey Huynh


    I’m from Sydney Australia, male 31.
    i had 4 wisdom teeth and third left lower molar surgically removed 11 days ago.
    3 weeks prior to surgery I had a headache, fever, and bodyaches. I didn’t know what was wrong with me, nor did I know you could get body/headaches from and impacted molar.

    After a few 2nd opinions, my Gp told me it might be from the tooth, I didnt have a private health fund so I just dealt with it for 3weeks till I could gather up $5000 to do the surgery under general anaesthetic.
    Right after the surgery/antibiotics I started feeling better, and the fever completely disappeared after 2days.
    My concern is that the fever/headache has returned just today, am I over reacting, do I just have a normal headache, or has this infection travelled to my brain?

    Note: I am on my 3rd cycle of amoxicillin and the sockets have healed well apart from very minor swelling on the guns where the sutches are.

    Kind regards

  • Cindy

    I’ve had bad teeth for years. Most of them are broke off at the gum. I haven’t had any pain from my teeth for a long time, I know I need dentures but can’t afford them yet. Last night when I went to bed, everything was normal. I woke up at 3:30am and the whole right side of my face was numb. I have no pain but not sure about why my face was numb I kind of related it to having to be from my teeth. I rinsed my mouth out with warm water and I brushed what’s left of the teeth on that side along with brushing my gums. I still have no pain or swelling except for a little in my face. When I did brush and rinse I could taste the infection. As I’ve been up moving around I’m starting to get some feeling back in my face. I’m just making sure that this can happen from my teeth even though I have no swelling or pain from my teeth. If so, am I going to need to get an antibiotic? I’ve been saving for dentures just not there yet. I’m confused by this because of no pre warning signs of any kind. So I’m just asking if this is possible to happen without any pain or anything. Thank you.

    • Cindy, it sounds a little bit like Bell’s Palsy, although I don’t have enough information to say for sure. Here’s a link for you to check out – if it is, an antibiotic probably won’t help much. http://www.webmd.com/brain/tc/bells-palsy-topic-overview

      If half of your face is numb, though, you absolutely need to see either a doctor or physician as soon as possible to have it checked out. Don’t take chances, ok?

  • Nancy Heuser

    Dr Payet, My name is Nancy and I have a giant phobia of dentists (no offence, but having a dentist drill my teeth without Novocaine didn’t help), Now I’ve gone in for the check-up part of the problem and they had given me a list of Oral surgeons and after calling all 6 of them, NONE take my medical assistance. Now, I’ve lost so many teeth, leaving the roots within my gum, and my two canine teeth are broken in half. I now only have 9 teeth on top and two and a half missing on my bottom. I’ve done a round of anti-biotics and some pain medication but it didn’t really help. That was all within 6 months. Now, my lower right hand wisdom tooth is decayed to the point that there is only half of the tooth there. I am in so much pain that I have had a migraine for two days, a week before this I lost my voice, and as of right now, I have the migraine and just last night my entire right side of my face went completely numb, including my tongue. I went into the ER had a ct scan and was told that there’s fluid in my sinus cavities along with the migraine. They have me on Prednisone, and vicoprofin. I’m not feeling any better and the pain is so intense that I want to just let my head explode just to take away the pain. I’m wondering if perhaps it’s one of the many roots that I hold in my gums, or if it’s the half of a wisdom tooth and if it couldn’t possibly be an abscess that’s gotten thru to possibly my brain?? I plan on calling my dentist to make an appointment for next week…I’m just wondering if there’s something that I can do to help me feel better in the meantime or what it is I should do. Please help me, I’m scared and in so much pain. BTW I’m in the capitol area of Pennsylvania and need help..please reply asap..Thanks in advance..

    • Nancy, I tried replying to you yesterday, but apparently I hit a wrong button and it all got deleted, so hopefully today I can remember what I wrote!

      First, I would suggest calling multiple ER’s in your area. Not all ERs are equipped to deal with dental emergencies, but some do have oral surgeons on staff. You just have to find the right one (assuming there is more than 1 in your area).
      Second, if you can’t find one of those – see if there is something like an Affordable Dentures clinic near you. Their business model assumes that a lot of people can’t afford things, so they often (not always, but often) are set up for Medicaid or DMO plans that aren’t accepted other places.
      If that’s not available, try Googling something like “emergency dental clinic Medicaid” or variations on that. There will usually be something like this in most big cities that will do work on a sliding scale or have super-flexible payment plans.

      My guess is that the wisdom tooth is your big problem, as broken off roots don’t usually seem to cause such horrible infections. Occasionally, but really not very often.

      Please do let me know if you’re able to find someone to help. If you can tell me a little more precisely where you are, maybe I can ask around my network of colleagues and find someone who can help.

      • Nallely Paz

        Im sorry im totatly off topic but im like freaking out and some advice will be nice ! My dentist said I needed a root canal but did not explain .I’m currently 7 months pregnant and I’m wondering if my teeth became sensitive because of that? It only hurts when I bite down or chew chewy foods. Its no sensitive to cold or hot and does not hurt at night. My pain was stronger 2,days ago and I was given penicillin and I think that helping a lot! I currently do not feel pressure on my tooth but still bothers me when I chew. I went to get a second opinion my another dentist and he said I does not look like I need a root canal but I did need a oclussual adjustment . the tooth that hurt was hittiing my the top teeth first than any other my others teeth. This is due to a root canal my prior dentist did , he did the filling for the root canal too high and was giving me an uneven bite. Once he adjusted my bite I could finally close my mouth without pain. However, I’m scared this might now solve the problem ? I really hope it does ! My xray didn’t show any sign of a need of a root canal its tooth #30 . what do you think?:/ if my bite adjustment was the only problem how long would it take so I could finally chew on my right side again?

        • Nallely, it sounds like the 2nd dentist might have found the problem. If the bite being too high was the problem, you should have almost complete relief within 24-48 hours. If there’s a little soreness remaining at that point, you might need just a little bit more adjustment to finish the job.

          Give it a few more days and see how it does, and please do let me know either way, ok?

  • jacob

    i’ve had an abscess for 2-3 years now, during that process a second one formed. each abscess is on my gums, one at the top one on the bottom. i went to the doctors about it a couple years ago and they told me to go to the dentists to get a root canal but i havent gone. every few weeks one of them will swell up and ill pop it, its actually disgusting. my face hasn’t swelled up once but the abscess on the top gum, right above one of my front teeth was swelled and i could not pop it, my top lip and area around the abscess on the outside of my skin felt numb, especially right under one of my nostrils. how serious is this? can it kill me?

    • Jacob – if your skin is going numb even on the outside of your face, that’s pretty serious. PLEASE get to a dentist right away. You need immediate treatment and probably some antibiotics.

    • jacob, if you’re actually getting numbness in the area due to pressure (the nerves are getting so squeezed by the pressure, they can’t transmit sensation to your brain), then yes, that is very serious. Probably not yet at the point of killing you, but it’s not something you want to ignore – PLEASE go see a dentist and get it treated.

  • Krystal Letitride Russi

    My friend swallowed the puss from abcess he looks terrible what can he do he wont go to Dr or dentist

    • Krystal, fortunately, just swallowing the pus will not hurt your friend, although you’re right, it’s pretty gross. At some point, however, your friend had better go see a dentist or oral surgeon and get it taken care of, of things could get a whole lot worse.



    • BorisBulldog

      The all caps fooled me, I thought you had something important to say!

  • patty

    i have medicaid but know one will see me because they don’t take medicaid or are not taking new i have 3 teeth that need pulled an problem need surgery to have them taken out but am just really scared to see a demist what should i do

  • I just came across this post while searching for info on “Tooth Pain”.This is a really good post here.Has alot of information.I sure never knew that an infected tooth could go to your brain & kill you!! Dr.Payet sounds like a really caring dentist.Some of the comments I read were very rude & untrue that some wrote to this caring doctor.Whatever it is that those people do for a living,I’m sure wouldn’t be doing for free like they want the dentists & doctors to do!!There are programs that will help low income ones to pay for medical costs.You all were able to find & read this post so I know you’re able to look & find a program that will help you pay medical costs.Everyone Take Care of not only your teeth but all your heath.Keep up the Wonderful Great Work that YOU do Dr.Payet

  • pamela

    I am 21 at 19 I was told I had a calcium deffiencency and would need denture, which is fine by me. Since then all of my filling have fallen out. I have almost 20 holes in my teeth and am sure I have at least three abscessed. The past couple months I’ve noticed my eyes trying to swell. I have a fever everyday. Its gotten to the point I can’t sleep without taking double aleve and ibuprofen. I can’t sleep until I am literally exhausted. My lymph nodes are swollen to the point it hurts to talk. I can’t keep focused anymore and not to mention weak. I feel as if my head is being crammed between semi’s and then it feels as if I’ve been shot with a shotgun. Im so tired of this pain. My mother is a hypochondriac. And is telling me that I’m not long off from dying. I don’t qualify for medical assistance and don’t have the money to pay outta pocket. Is there something I can do?!? Please help me. I’m about to have someone knock me out and pull them all but I know I need a mold for dentures so I’m trying my best.

    • Pamela, I am so very sorry to hear what you’re going through, and I”m sure it’s awful. I also really wish I had a solution for you, but the best advice I can give is something like Affordable Dentures. Also, look up the Missions of Mercy (here’s a link to the North Carolina one, I think it has some links to other states too . Depending on where you are and if they’re having one soon, that might help. If you reply and tell me where you are (City/State at least), maybe I can look something else up for you.

      Oh, one other possibility – check to see if there are any dental schools near you. The dental students are strictly supervised, so you’ll get good care, and it’s usually at a HUGE discount compared to a private dental office.

      Lastly, if your face is swelling that much, go to the ER. Seriously, infections that bad can kill you, and the ER docs can at least prescribe some antibiotics for you, or worst case admit you for treatment. Yes, I know there’s a cost to it, but it’s better than dying.

      Good luck!

  • ross hawkins

    Hello, I hope you can help me .I am from the UK and have recently have toothache on my crown which is fitted with a post.My dentist took a x-ray and told me there is a infection to which he has prescribed me am amoxycillan .After finishing these antibiotics the pain has come back and am not sure what action I can take next as I don’t want to lose the tooth .Thankyou

  • Tammy

    I have a infection in my lower right side and one on my upper left side. My last dental visit was on the 17th, after already taking one round of antibiotics. This time they put me on amoxicillin and Flagyl. I am almost done taking the meds again and the infection is not gone. I still have face swelling and the pain is unbearable at times. They can’t pull the teeth until the infection is gone and it doesn’t seem the infection is going any where anytime soon so my question is, what do I do next or what should the dentist try next to fight this infection?
    The way they talked, this was their last resort to fight this infection. I am worried the infection will never go away and I will be in pain all the time. It is to the point, I want to rip the tooth out myself.
    Any advice would be greatly welcomed, thank you for your time.

    • Tammy, there is no rule stating that the infection has to be gone before the tooth can be removed. In fact, often the best way to get rid of the infection is simply to get rid of the tooth that’s causing it; RARELY do I make a patient wait.

      I’m curious – have you seen a general “family” dentist, or was this an oral surgeon? If it was not an oral surgeon, I would highly recommend you see one, given how you’re describing it. Some family dentists aren’t quite as familiar with how to treat these cases. HOWEVER…..bear in mind that I haven’t seen you, so this advice is only general in nature – your dentist may have a very good reason for how it’s being handled that I don’t know.

      When in doubt, however – it never hurts to get a second opinion, but it does need to be a second opinion in person, not online. 😉

  • Daren

    Utterly ridiculous that people complain that Dentists and Doctors make money.. First of all, this may not be the case for this particular dentist, but a lot of them sacrifice years of their lives by attending college in order to make more money.. If not for that why would anyone go through the rigors of medical school and take on the associated costs just to make the same amount the burger flipper at McD’s makes?

    People need to learn how to accept the fact that hard work pays off, as does taking care of yourself. When I was 16 a good friend of mine was putting lotion on and I asked why she bothered. She told me ” you only get one body and that’s it, so you have to take care of it”.. That was her choice and it was mine ever since. My teeth have been screwed up by an AWEFUL dentist and some of us have problems we can’t really control. My problems all stemmed from very bad allergies and sinus pressure that caused me to eventually crack two molars. I was treated with a root canal and a crown on the two teeth and after an unfortunate experience with another dentist the crown was knocked loose and the other tooth was chipped at the tip of the root, which caused my infection. Unfortunately this dentist hurt me so badly that I didn’t go to anyone for 2 yeas. Now I have to get both pulled and have implants. Do I blame my new dentist for what will eventually be $8,000 out of pocket? Absolutely not. I understand he’s doing his job and has bills to pay.. People in this country who always seek to place blame on everyone but themselves is the reason for so many problems we face today.

    Dr Payet. I applaud you and thank you for your work in helping people to understand and showing such compassion. My sister-in-law Dr. Mchelle Woodward DDS was very similar in this regards and gave a lot of her time and work away for free. Still, though, people didn’t appreciate the work she did. It brings tears to my eyes to think of all those ingrates that she helped in the past. Time wasted and lost as she has, since, passed away at the young age of 39.

    Please don’t be discouraged by negativity. There are plenty of us who know and understand the work our medical professionals do to take care of us and keep us comfortable. I don’t mind you lining your pockets in the mean time. After-all, if Had simply purchased a mouth guard for $20.00 or so I wouldn’t be getting ready to fork of $8k on implants.

    Have yourself a great day!

    • Jane Smith

      Wow. It’s really great that you live in la la land. It’s great you’re sister-in-law was a dentist. But the sad truth is, many, many dentists (excluding Dr. Payet of course!) and doctors make tons of money in their profession. I don’t knock their abilities in any way. I am simply stating the fact that many of us, such as myself, have been completely and utterly screwed by “Obama Care” (haha the biggest joke ever) and cannot get proper insurance. Most dentists don’t accept Medicaid, and most don’t want to deal with the many complicated issues that arise from failure to get to a dentist because of lack of insurance! Thus dental problems escalate.

      After almost dying of a tooth infection, I am completely aware of the fault in our system, and how it fails millions of Americans everyday. This is why people are dying of preventable care!

      “People in this country who always seek to place blame on everyone but themselves is the reason for so many problems we face today.”
      But the elite policies at the top couldn’t POSSIBLY have anything to do with our lack of dental care!
      Go ahead, live in your fantasy world, where shit plants flowers and life is Little House on the Prairie. And maybe one day you will wake up and realize THE SYSTEM IS TO BLAME FOR THE MANY PROBLEMS WE FACE TODAY! Deaths due to lack of medical care in Canada, Cuba, New Zealand, Australia? ZERO. Deaths due to lack of medical care in America? Increased by more than 40% in the last 10 years. 60,000 wow that’s evil incarnate
      But go ahead and blame the victims…
      Let me guess…
      You’re a Christian Republican who thinks poor people are lazy and stupid…
      Maybe someday you will wake up from the fantasy dream life you live in and join humanity!

  • alex rosas-garza

    Dr.Charles I’ve had an abscess infection a year or more ago had a swollen face on my right side of my face went to the hospital they cut the bubble in by my gums and swelling went down they said I need to get it pulled right away I wasn’t working then so didn’t have money no insurance so I left it alone and a month from now it came back tooth pain the I got meds went down still light tooth pain but I have headaches feel weak and feel like throwing up I don’t know what to do I’m scared I’m cutting it to close I’ve had a panic attack thinking about it is that possible? What should I do? Hope to get a responed very soon please and thank you if you wonna talk to me faster here’s my number 209-271-9763 save my life helping me on what to do with my situation please

  • Andy

    Dr payet.
    A fantastic reply, and it seems to have ended that topic and shut them up once and for all good for you
    For standing up for yourself and that of the dentist industry.
    I have a tooth abcess right up above my co Sid canine and I had it root cand like ten years ago and drained cotton wool left inside and a tem filling to go back a week later to have it shaped strengthened with a pin filled and crowned !
    But because of my fear not of the dentist or their drilling or injections ect but because I suffer major panic attacks as a result of such a wonderful childhood lol but I’m a big burly strong beast f a an and every time I go to dentist that damn position in that chair like upside down makes me dizzy then I have a panic attack !
    And my god it embarrass me no end , that’s why I don’t go to the dentist.
    Now I’m 49 have abeses up down left right ect lol and infections and pain to die for broken teeth all over the show and I know now I have one choice left !!! Damn dentures !!
    And I also know that I’ve got to go and have it done like next week as I’m in trouble with the pain and infections !! Big time !!
    So here’s a lil message to you folk who are scared to go !!
    Scared of the dentist !!
    Suffer panic attacks ect !!
    Just try to find the courage , no infect find the courage and just do it , and here’s why ??
    Because the longer you leave it ,as I have done my god the worse it gets !!
    And in the end you’ve got to get it done anyway !! Theirs no other way !!
    Difference is !! Now I will have to have loads of horrid stuff done ?
    All my teeth pulled ?
    And end up with dentures lol
    So you will never win by being scared or not going !!
    The end result is the same !! Just worse a lot worse and you lose all your teeth !! End of !!
    And I think dentists are a godsend !! If we never had gents like you going to dental school for what is it like 7 years or so ?
    And all the debt and stress and studying ect you ave to go through ? Then the loan to open build fit out and kit your surgery and that’s before you spend like the next 3 to 5 years building a customer base just to start paying your debt back ect !!
    Without people like you who made those sacrifices to get where you ave ! And my god don’t you ave to make some sacrifices !! He’ll yea !!
    Well without you wonderful intelligent people !!
    Dentists ? I salute you and respect you all of you !! You are wonderful and I hope you all get to own a mansion and drive the Lamborghini ect because you most certainly do DESERVE TO.

  • Ted

    Doc is right. I worked for a medical group for years, seen it all. People generally want it free because they are in pain today now and think their doc just goes home with a big check. Md’s are in short supply because the training costs are so high, and there is a dangerous tidal wave of society that wants it free simply because you do not want to pay, or look for the plethora of free care already avail. How any people have you heard complain that their dental bill was way too high, but they have 2 snomobiles, or motorcycles, or accessories on their car, or spend 30% of their entire income on a car they really cant afford, or spend money left and right on constant mcdonalds visitsm or pizza, beer, lottery tix? People generally can quite easily pay most of these kinds of costs, tooth root canals etc but do not “want” to or let it interfere with their pleasure spending. Before you hate me, these were my views when i lived dirt poor from age 18-30, meaning lived over a guys garage once for $250/month. This dentist on this blog is under no obligation to spend 15 years of his life sacrificing to make it thru dental svhool, accumulate $500,000 of very real debt and then work for free just because people have need,. Sorry folks. Show some respect. He is spending his own personal time to try to help people for free on this web as it is. Good luck

  • alaina

    Dr. I just haved a quick auestion for you. I have an abcess in tooth #6. It has already had a root can.al but is absecessed again. I am told I wsill have to pay $885 up front since it hasn’t been two years And I just don’t have that. Then they proceed to tell me tooth #6 goes straight to the braIn. I’m not sure why they needed to tell me that but now I am having a foul smell coming from the hole in the tooth and massive migranes and vomiting. Is there a chance my absecess has made it too far up and causing these problems. I’m just really in a lot of pain and really scared! Thank you so. for listening to me an I look forward to your answer.

    • Oh my Alaina, that sounds really bad.

      First of all though, let me correct one thing – NONE of your teeth go straight to your brain. If someone told you that, they might have been trying to scare you with the seriousness of the situation, but no, none of your teeth have any kind of direct connection. HOWEVER…….given enough time, an infection CAN slowly work its way through different tissue layers and spaces to eventually reach the brain, but not many people let it get that far.

      Now, if you’re having migraines, that alone can be caused by the infection, and throwing up can be caused just by migraines, so they might be connected indirectly. HOWEVER…..IF the infection HAS gotten close to your brain, those could also be symptoms.

      So what does that mean? At the very least, you need an antibiotic right away. If those symptoms keep worsening, please go to the ER for evaluation, ok? This really can be serious, so don’t take chances.

  • ken berg

    wow, in dentist school they should have a class that taught you empathy. Having an Infection that severe unfortunately makes you cranky. That response was very turbulent and tribal. Showing a caring heart to what they are going through shows true
    relationship skills…. which reflects you have issues with your job… if you have to vent here about seeing it through your eyes…. you need to use your insurance to go see a therapist… or definitely see an Anger Management counselor immediately…

  • Helen

    Hello, my dad was recently admitted to the ICU for sepsis like symptoms and dehydration. He was transported from a nursing home. He is semi responsive and is on heavy antibiotics. While my dads mouth was open, I noticed a tremendous amount of tooth decay and bleeding from his gums. My step mom mentioned the nursing home does not clean his teeth daily a nd that many times he will pocket unchecked food in his mouth. His tongue also appears coated..is it possible that a tooth abcess is the root of these problems..lack of appetite due to severe gum and mouth pain?? My dad is unable to communicate due to Parkinson’s Disease.

    • Helen, I am so sorry to hear about that, and yes, it’s absolutely possible. I have heard similar horror stories from other people, where elderly parents in nursing homes don’t get the oral care they need even from those who are supposed to be providing it. Of course, it can often be extremely difficult to help when dealing with patients who have Alzheimers, Parkinsons, or other forms of dementia, as they can be very uncooperative and combative even. Still, it is very important.
      Hopefully they’ll be able to stabilize him at the ICU; you should absolutely bring this to the attending doctors’ and nurses’ attention, and they may be able to guide you to some good resources. Come to think of it, since I don’t have any to give you personally, I will do some research this week and see what I can put together, as you surely are not the only person dealing with this tragic situation.

  • martha

    Hello Dr. Payet I wanted to ask you a question.
    About a year ago I had a terrible toothache that made the bottom of my face swollen due to my bottom tooth that was infected. I got treated and I was so scared to take it out that eventually I never did… I regret it cause now I’m scared of the possibilities. At the moment I’m waiting to get the job I need to get money for my dentist appointment, do you think I can wait a little longer or should I go get it pulled out ASAP?

    • Martha, give me a moment to consult my crystal ball………hmmmmmm. (Sorry – just trying for a little humor there, probably a bad idea with your situation.)

      Anyway, I wish I could give you a good answer, but the real answer is, “I don’t know.” I’ve seen people who had broken teeth for YEARS before the abscess “blew up” on them and got horrible; I’ve also seen people for regular 6 month check-ups where everything looked fine, and a week later a huge piece of their tooth broke off with no warning. What that means is simply that there’s no good way to predict when, or even IF, something will happen. I’ve seen people with cracks in teeth that I was sure would break soon, and 10 years later, they still love pointing out to me, “Hey doc, remember you told me I’d better get a crown on that tooth? Hahahahaha, it’s still fine, see!”

      The best advice that I can give you is this: Get it done as soon as reasonably possible.

  • Bob

    Wow. You sound utterly heartless. I would never see you, no matter how much pain I was in. In fact, I’m going to report you to the ADA. Hope your little bitchfest was worth it.

    • Bob, I’m sorry you feel that way, and I guess I can understand it. That doesn’t change the fact that the system kinda sucks from my side, too, but few people actually bother to understand how things work on our side of the fence. Very few people can even BEGIN to imagine the kind of debt that we carry, and most people are too scared to do it.
      In the end, though, I absolutely love my job, and to be honest (not arrogant), I’m damn good at what I do. I regularly discuss my cases with colleagues all over the world, and I’m held in pretty high regard. There are probably less than 20 dentists in all of Charlotte (currently about 900) that know how to do all the things I do. That’s not arrogance – it’s fact. If you actually ask my patients, you’d probably change your opinion very quickly, and if you met me in person, I’m sure of it. I often joke about how awesome I am to put people at ease, but if you get to know me, you’d know that I’m actually a pretty humble guy who’s ALWAYS trying to get better at my job and ALWAYS try to take care of the patients who trust me to fix them. I have a very strong moral and ethical code by which I live, and money is NOT my reason for being a dentist. You have no idea how many patients I’ve turned down for treatment because I didn’t believe it was right; no idea how many times I managed to do a filling instead of a crown for a patient and save them hundreds of dollars, even when I could have done a crown and no one would have known differently. I could do $20,000 veneer cases, but I usually talk them into doing braces and some whitening for $4,000 instead, because it’s better for them.
      Think what you want, but to judge me simply because I got on my soapbox a bit and defended myself from some heartless and rude comments? Well, I won’t lose any sleep over that.

  • Heidi

    I don’t think it was harsh, it’s reality. I have been put my entire life & have raised Terri boys on my own. They qualify for state insurance, I don’t. My dentist is more than willing to take monthly payments in $25.00 increments. I brush 3 times a day, floss twice a day and rinse at least once a day and still have horrible teeth. I blame it on thefact that I just do not make regular appointments as I should. I got off track. You should not blame your own short comings on someone else. It isn’t someone else fault if you are poor. If you are unsatisfied with your living situation change it. Don’t get pissy with the guy that’s trying to help you.

    • Heidi, thank you so much, and I hope that things do get better for your in all areas. However, I am curious if we could figure out why you’re still getting so many cavities, because with everything you’re doing right, there must be something going on. I’m sorry that I didn’t answer up until now (missed it and then all the holidays, etc), but if you use our Contact Form, please don’t hesitate to send me an email, and I’ll be glad to try and help figure it out.

  • Bob

    I’m just amazed that somebody would allow themselves to get that bad before seeking help or doing something to stop it.

    It would be no different if a person had a cut on their hand and never washed it or treated it, and it got all infected and swollen. I can only assume this young man never or rarely brushed his teeth or used any sort of antiseptic mouth rinse.

    The teeth and gums are just like most other parts of our body. As long as you keep sores and injuries from becoming worse with infection, the body can heal itself pretty well. You just have to keep the injury clean.

  • brian brogan

    i came across this article and just started reading it and i never knew that an abscessed tooth can cause that many problems. im really afraid to go to the dentist cause i have bad teeth and im afraid of what the dentist might say about it. i have two molar’s on my top row of teeth one on each side that are severely damaged. the right molar on the top is so damaged that it is flush with my gum line and the one on the left has a hole in the side and crack going straight thru the middle half way across it. and my second posterior tooth on the right side has a hole from a popcorn kernel that cracked it. it scares me cause all my friends say that an abscessed tooth can go to the brain and kill you but i dont know if thats possible but it could be. i work as a general contractor and have to pay for my own insurance. its the drills and everything that scare me and after reading this article about the kid that could barely open his eye makes me wonder if thats whats causing my eye problems in my left eye.

    • Bob

      Check out dental schools in your area. They may have a program where you “volunteer” to allow a dental student to use you as a learning tool. It could cost nothing, or just some administrative fee and material costs.

      It is much better care than you’ll get through a state aid agency or some dilapidated free clinic in the bad part of town. These are students in their final year of study, and these dental schools always have the latest and greatest showcase dental facilities and tools to attract high paying students and justify the tuition.

      • Bob, that’s actually an excellent idea. Of course, there is usually still some cost associated with being treated at the schools, and the biggest downside is often that the appointments take a very long time. However, dental schools do help provide treatment to those who can’t afford private care, and the care is generally quite good, as the professors check everything quite rigorously.

  • I have a serious abscess on my bottom jaw under my teeth so bad that I have to get all of my bottom teeth cut out. The infection is so bad that the abscess is all thru my bottom gum. I hope the best for everyone

  • Jillian Jacklin

    This is a great story. I had no idea, entirely how bad abscess teeth can be. I have had to go through two root canals so far this year. (I have dental insurance but only with a 1000 dollar coverage limit) My dentist still needs to finish my root canal on my left incisor. The infection is still there though, even after 10 days of antibiotics. I am still in pain, not so intense where I am crying and losing sleep. It’s mostly pressure and numbness; but it hurts very badly with I bump my face or brush my teeth. (pretty much every time I touch it) My dentist did call me in Clindamycin (since it’s stronger) But I feel so awful still, basically can you truly clear out a dental infection with a root canal and how long does it take for it to heal? I read some conflicting information on this, that makes me feel that I should have the tooth pulled and get a false tooth. What’s your opinion on this? Thank you.

  • shawnea kile

    I have a question my brother is in so much pain. He has a tooth infection….hes hallucinating….he hasnt sleep all night cause of the pain hes in. We dont know what to do he doesnt have insurance so its just money out of our pockets we dont have as we are all on disablity. What can we do?

    • Wow, I am so sorry to hear about that! If his pain is THAT bad, he MUST go to the ER IMMEDIATELY. With infection so severe it’s causing hallucinations, he may have infection nearing the brain and it could kill him. Forget about the money – just take him to the ER or you may be taking him to the undertaker. 🙁

  • Patricia

    Im 25 with a toothache my left eye was swollen no my bottom jaw hurts like crazy its been going on for a couple of days when i touch my bottom jaw i fell a little knot on a scale frim 1-10 its a ten

    • Patricia, that sounds really bad with that much swelling and pain. I would strongly recommend you get to the ER or a dentist, as that kind of infection is very serious!

  • Yes, but my 22 year old son is in terrible pain. He has not found a job yet. He has no insurance. I am so worried. What do people do in this situation?

    • Mary, if the pain is that bad, then he may have to at least get to the ER. Most ER’s aren’t set up to provide any dental treatment, but perhaps some antibiotics at least if there is severe infection. Alternately, he may need to apply for Medicaid and find an office that accepts it. If there’s any way you can assist him, that would be another option. Regardless, though, he needs to see someone promptly, as failure to do so can have truly life-threatening consequences. Good luck!

  • Julie McKay

    Thank you so much. Because of the information you provided, I brought my husband to the hospital and he has just come out of recovery. An abscess can be life threatening and I know this now first hand. I owe you and my wonderful new dentist (Dr. Landry – Harvey, LA) for saving his life! Sincerely, J. McKay

    • Julie, I’m sure sorry to hear about your husband’s experience, but am so glad that he’s recovering and will make it. It’s wonderful to hear that I was able to help in some small way, so thank you for writing!

  • Dr. Silva Arejian, DDS

    Nice content. Thank you for sharing your wonderful thoughts with us, I bookmarked your site for my future references.

  • This is such a great reminder! We can never hear too many times how important prevention and healthy behaviors are when it comes to oral health. Read more about taking care of yourself and your teeth at http://www.dentalinsurance.org.

  • Thanks for the helpful information!!

    • jacqui morris

      hi this advert should be in every dental surgery.
      my son had abcess in upper left 5th which went through his sinus up through left frontal lobe and skull.im delighted to say he surved after 9hrs brain surgery & 3wks on life support,surgeons removed part of left frontal lobe and has 5inches of skull missing unable to have titanium plate as his epilepsy is fragile and his brain swells,he now has 24/7 care/
      kind regards mum.

      • well if ppl cud afford to go to yhe dentist..I’m a songle mother work 2 jobs an attend school..my face is so swollen my eyes almost shut an I can’t hear outta my right ear…but without 400 bucks…they basically said die….the system sucks..an that credit care demied me for a 500 dollar debt from 12 yrs ago…u ppl don’t care….make ur thousands a month while we steive to try an live..teeth or no teeth…smdh

        • Tonya, I’m very sorry to hear about your experience, and I genuinely hope that you can find someone near you to help. Have you looked into Medicaid or some type of state assistance? Some offices will take those, and perhaps that would help?
          You know, I actually agree with you that the system sucks; it totally sucks that it costs $200-400,000 to attend dental school; it totally sucks that it costs another $250,000 – $500,000 to actually build an office; and then it sucks that I have to pay all the bills, pay my employees, and we don’t get paid until after all those bills are paid every month for 10-15 years; it sucks that I have to pay $10-30,000 every year to keep attending quality Continuing Education courses so I stay current on how to provide the best care for my patients – and that comes out of MY pocket.
          And then it REALLY sucks when people blame us by saying things like, “…u ppl don’t care…”
          Do many dentists make a good living? Sure they do. You know why? Check out this little article I wrote recently: Think the Dentist is Expensive? Then Brush & Floss! The reason we make money, sadly, is that people don’t take care of their teeth. Is that my fault? Nope.

          Look, I don’t want to sound callous or uncaring. But really, it sucks when people don’t take responsibility for their own health, and then blame us.

          • Conswalla

            Wow! Your response is quite harsh. Sad.

            • Conswalla, you’re right, maybe I was a little harsh, but I hope you can understand it a little from my point-of-view, too. After all, how many times a day do you think we have to hear, “No offense, doc, but I HATE coming to the dentist.” After awhile, it kinda gets to me and actually hurts my feelings.
              I take a lot of pride in my job; if you look around my site, all the cases you see here were done by me, and you can probably tell that I try very hard to do high-quality work. And yeah…….last year I actually spent $30,000 on advanced continuing education, plus another $65,000 on new equipment to help take care of people. But then people think it’s ok to say, “u ppl don’t care.” Really? I could have skipped all that and taken that money for myself and my family, but no, I invested it to become a better dentist, with great equipment, to take care of my patients. I don’t care? Really? Heck, if anything, I care too much sometimes!
              In addition, it is so frustrating when people get mad at me. In all seriousness, I did not cause the cavities, the abscesses, the broken teeth, the gum disease…..but when I provide solutions to fix those problems, people get mad that we charge for it?

              I do genuinely feel badly for the lady with the bad abscess, and hopefully she can find a way to get it taken care of. I donate my time at the NC Mission of Mercy dental clinics in December, and know that those happen in other places, too – maybe that would work for her.

              It’s just hurtful when people accuse me of not caring, of being a greedy b******d, and worse, when they have zero idea how much we put into what we do and how much it costs us.

              • Debbie Ritenour

                It wasnt harsh at all! Thank you for taking the time to explain and respond to all these people! The information is wonderful and I thank you!