Updated: Apr 26
In order to permanently get rid of a swollen face from a tooth infection, you must treat the source of the infection in addition to the facial swelling. This usually requires a combination of draining the abscess, taking antibiotics, and also getting either a root canal or tooth extraction. If you try to do just one of them without the other two, the swelling will just come right back after a few days and you'll be back where you started.
What this also implies is that all home remedies will do absolutely nothing to reduce facial swelling from a tooth infection. At most, it will slow down the spread of the infection and possibly offer some temporary pain relief. You should see an emergency dentist as soon as possible.
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How to drain an abscess
Small tooth abscesses can be drained at home. In fact, they tend to pop by itself accidentally a lot of times if it gets scratched with hard food.
Large abscess with facial swelling cannot be drained at home because it requires making an incision directly into the abscess. It is as unpleasant as it sounds and that is why you need to be numb for the procedure. Therefore it is next to impossible for you to do it at home so you must see a dentist to drain the infection.
This is how your dentist will drain a tooth infection with a swollen face:
Apply numbing gel. The gel will prepare the site for the injection by making it more comfortable. Without it, the dental numbing needle will hurt more.
Administer local anesthetic. You will require quite a bit of local anesthesia to numb the area. The anesthetic of choice is usually either Lidocaine or Articaine. The amount of anesthesia will be more than what you would need for a typical cavity filling. The reason is because sometimes it is difficult for you to get numb with all that swelling.
Incision with scalpel. With a scalpel, your dentist will make an incision directly into the abscess through the gums and down to the bone. The size of the incision will depend on the size of the abscess. The large the tooth infection, the bigger the cut will need to be.
Break loculations. Using a hemostat, go into the abscess with the instrument closed but open it on the way out. Keep repeating until you pop or break up all of the loculations of abscesses within the swelling.
Apply pressure. Use your finger to apply digital pressure to squeeze out all of the infection. You'll notice a mix of blood and pus. The blood will be red while the pus will be white. They should ooze right out if your face is as swollen as you say.
Irrigate. Flush out the inside of the abscess. Some clinicians will prefer to use a saline solution to irrigate it out. Plain water or an antibiotic rinse can be used as well. As long as its some sort of fluid that will help wash out the inside of the abscess.
Repeat steps 4-6. Your dentist most likely will not be able to drain the abscess completely in one go and therefore must repeat steps 4-6 a few times in order to get the swelling down completely.
Place a drain or leave it open. Once your dentist determines that the abscess is completely drained, they may opt to place a drain in the abscess. The drain is a plastic tube that is stitched into the incision so that it allows the infection to continually drain throughout the next 2-3 days. The drain prevents the wound from completely closing. This is used whenever the infection is really bad and you are worried that it may swell back up in the middle of the night when the patient goes home. The drain will need to be removed in about 2 days, which means a follow up appointment with your dentist.
However, if the swelling is not very severe and your dentist feels like they've confidently drained most of it, they may just leave the wound open and let it drain naturally.
After you leave the dentist office, you are NOT done because there are some at home instructions which you need to follow.
Massage your face. You must periodically massage your face because it helps the abscess continually drain throughout the day. This means you will get a lot of blood and some pus in your mouth.
Use a mouth rinse. If your dentist prescribed you a mouth rinse, you should use it. Otherwise you should rinse with salt water since it is simple, inexpensive, and effective. Making a salt water rinse is very easy because all you need is 4 oz of water and a teaspoon of salt. Gargle and swish with it as much as possible throughout the next few days until the wound completely closes.
Cold compress. Make sure you use a cold compress on the affected side of your face. Alternating, fifteen minutes on and fifteen minutes off will help reduce the swelling in your face.
Last but not least, don't forget to take your antibiotics which is the next step. It will assist in the healing and also prevent it from coming back. Yes, it can come back!
Reduce facial swelling by taking antibiotics
Even with draining the abscess, your swollen face may not go away completely without a course of antibiotics. The drainage will physically remove a lot of the swelling but it may not clear out all of the bacteria and that is why you need antibiotics. The medication will help get rid of any residual bacteria and infection that the drainage procedure may have missed.
The most common antibiotic to take for facial swelling from a tooth infection would be amoxicillin. The instructions are as follows:
Take 1 tablet of 500 mg amoxicillin every 8 hours.
Take the pill with food to minimize GI issues.
Repeat for the next 7 days.
You should notice your face get less swollen with each passing day of taking the antibiotics. If your face returns to normal before you finish all of the antibiotics, you should still finish the entire course. The reasoning is that you want to make sure all of the bacteria and infection are gone 100%.
What happens if you take antibiotics but don't drain the abscess?
If you decide to take antibiotics without draining the abscess, there is a chance that the swelling may not go down but it depends on how long you've had the swelling. There is a specific time cut off for when antibiotics can work without any draining..
Taking antibiotics within 48 hours of the swelling starting. If you manage to get antibiotics into your system before the 48 hour mark is up, you have a good chance of being able to bring your swollen face.
Taking antibiotics after 48 hours of the swelling starting. If you take antibiotics after the 48 hour mark, it may not reduce the swelling. What typically happens in these cases is you start taking the antibiotic but notice that the tooth abscess is still swollen after 3 days.
The second scenario happens quite frequently because most patients don't quite recall exactly when the swelling started. If you tell your dentist that it just started last night, they may just prescribe you antibiotics but only to find out that it has no effect a few days later. When that happens, you'll have to return to the dentist office and have the drainage procedure started.
Root canal or Extraction
The abscess drainage and antibiotics will certainly help bring the facial swelling down but they won't get rid of the source of the tooth infection. As the name implies, the source of the infection stems from the tooth itself and the only way to treat the tooth is either take out the nerve via a root canal or remove the entire tooth.
Normally after the swelling comes down from the drainage, you will return to your dentist about 2 days later to have either one of these procedures done.
A root canal involves separating the nerve from the tooth and cleaning out the entire inside of the tooth. The tooth itself does not get removed from the mouth but the nerve does. The infection usually stems from an unhealthy nerve that slowly turns into an abscess. It is the infected nerve that continues to produce pus to make the abscess swell.
What this means is that even if you get the swelling down but you leave the infected nerve untreated, the swelling will just reappear after a few days. The reason is because the untreated nerve just produces more swelling. It is a cycle that needs to be broken and a root canal can do just that.
What to expect for a root canal:
Apply topical anesthetic. This is the pre-numbing gel that prepares the injection site.
Dental numbing shot. This is the actual numbing for the tooth with the anesthetic of choice being Lidocaine or Articaine.
Remove any tooth decay. Before you can even remove the nerve, you must remove any tooth decay that may be in the tooth. This is part of the root canal process because the entire tooth needs to be absolutely clean on the inside.
Remove the infected nerve. After the cavities are removed, the nerve can be taken out of the tooth. The inside of the tooth will be flushed out multiple times to ensure that all bacteria are dead.
Place medication inside the tooth. If you had severe facial swelling, your dentist will most likely need to place antibiotics within your tooth to let it kill any residual infections. There are times where the abscess is so bad that you need to repeat this step 2-3x. That of course makes the root canal procedure take more time and more visits but it is necessary to ensure that the infection is completely gone.
Return about 1-2 weeks later to fill the canal. Once the tooth infection is 100% healed, your dentist will be able to fill in the canals.
With that, the root canal part is completed but you still need to return for the core build up and crown. The reason you need the crown is because the blood supply travels with the nerve.
Unfortunately when you take the nerve out of the tooth, the blood supply goes with it. This means that the tooth will no longer receive any more nutrients and that makes it start to get brittle over time. If you happen to bite into something hard the wrong way, you can possibly fracture the tooth. A fractured tooth will need to be extracted, which means that you just wasted all that time doing the root canal!
The lesson is to try to get the crown as soon as possible after you complete root canal treatment. Otherwise you'll be wasting your money if you crack it in half.
An alternative to a root canal would be a tooth extraction, which is when the entire tooth gets removed from the mouth. Of course this is a much more drastic and invasive procedure since you'll be short one tooth after the procedure. This treatment is usually not the recommended one if the tooth can be restored with good prognosis.
However, if the tooth has a very big cavity or the infection was just too severe, you may have no choice but to have the tooth removed.
Here is what you can expect for a tooth extraction at the dentist:
Pre-numbing gel. You definitely need some numbing gel to get the injection site comfortable. There is no reason to not use it because it can only help.
Injection. Next will come at least two separate dental numbing shots. Usually there is more than one nerve going to your tooth and both of them will need to be anesthetized.
Release the gums. Your dentist will go all around your tooth by releasing the gums with a sharp instrument. They can also use a scalpel to release the ligaments that are holding your tooth in place.
Start elevating the tooth. A tool called an elevator will be placed deep into the gums and will be used to leverage the tooth loose.
Deliver with forceps. Once the tooth is loose enough from the elevating, it can be delivered out of your mouth with forceps.
Irrigate. Next your dentist will flush out the extraction socket to remove any debris or bone particles that may have been separated.
Stitches. Sutures may or may not be needed, depending on whether or not your dentist had to cut into the gums to lap a flap. If they did, they will need to be responsible and stitch it back up.
Prior to getting treatment with your dentist, all home remedies will do NOTHING to make your face less swollen from a tooth infection. The reason is because it does not treat the source of where the swelling is coming from, which is usually the tooth itself. What typically happens is that the patient tries a variety of home remedies but the swelling continues to get bigger and bigger. The source of the infection continually produces more swelling and since the at home remedies do nothing to treat it, it grows unimpeded.
However, after receiving dental treatment for the tooth infection, home remedies are helpful in bringing down the swelling on your face and help alleviate pain.
Salt water rinse. If the abscess needed to be drained, you may be oozing blood for the next few days in your mouth. The best way to keep it clean and to rinse out all of that blood is by using a salt water rinse. It is gentle, effective, and inexpensive.
Cold compress. Get an ice pack and alternate 15 minutes on and 15 minutes off of the affected side of your face. Repeat as many times as needed. The compression from the ice will help to reduce your swollen face and also numb the area from the cold.
Pain medication. Definitely take your pain medications after the procedure because you do have an open wound after the drainage procedure. Without any painkillers, it would be fairly uncomfortable unless you have a high pain tolerance. Taking them will just make the healing process a lot more comfortable.
These are the three home care remedies that we would recommend after finishing your dental treatment.Auto-Detect
Having a swollen face from a tooth infection can be pretty traumatic experience so we're sure you don't want to go through that again. Here are some tips on how to prevent it from happening again or at the very least catch the infections early so they don't require invasive treatment.
Good oral hygiene. Brush for at least twice a day for 2 minutes each. Floss before you go to bed and try to use a mouthwash.
Cavity reversing toothpaste. Use either a fluoride toothpaste or a hydroxyapatite one because those are the only two that have cavity reversing potential. All other types of toothpastes do not have the cavity stopping and reversing potential such as Xylitol, herbal, and charcoal.
Minimize sugar intake. Make sure you try to decrease the amount of sugars and carbohydrates you eat. The reason is because bacteria require sugar in order to form cavities! If you starve the bacteria, they won't be able to work.
Routine dental visits. Always prudent to go in for your dental check up visits so that your dentist can examine you and take x-rays to see if any problems are brewing. Even if you don't like being examined, you should at least think about how clean your teeth feel after the cleaning. Perhaps that can serve as encouragement for going to the dentist.
Minimize acidic foods and drinks. Its not just sweet treats that can promote cavities, anything that will decrease the pH in your mouth has the potential to start cavities. The reason is because a cavity will start once the pH in your mouth drops to below 5.5, which is considered the critical level.
Don't delay dental treatment. Last but not least, do not procrastinate on an identified dental problem. If your dentist tells you, there is an irreversible cavity on your tooth, please do not procrastinate on the treatment. Tooth decay will grow and progressive through their stages when left untreated. All major problems such as facial swelling from a tooth abscess usually starts as a small cavity. If you delay treatment it will end up being more expensive and also more time consuming.
If you have a tooth infection that made your face swell up, you should skip the home remedies and go straight to your dentist. Prior to getting dental treatment, home remedies will maybe marginally alleviate the pain but do nothing to treat the source of the swelling.
The only way to get rid of a swollen face and cure the tooth infection is by undergoing a combination of treatment: abscess drainage, taking antibiotics, and getting either a root canal or tooth extraction. When we say a combination, we mean that you need all three of them in order to successfully get rid of the infection. If you try to do just one without the other two, the swelling will return within a few days.
Yes, the condition is that serious and requires that much treatment. Please do not delay treatment if your face is swollen, go to your dentist immediately or as soon as possible.
Author: Written by Dr David Chen, a dentist in long island city that provides emergency dental services.