Toothache and Dental Abscess First Aid: Pain Relief, Warning Signs and When to Go to the ER

Quick answer: for a toothache, rinse with warm water, floss gently to remove trapped food, hold a cold compress on the cheek and take an over-the-counter pain reliever as directed on the label; the American Dental Association’s 2024 guideline favors ibuprofen or naproxen, alone or with acetaminophen, for short-term dental pain in adults who can take them. Do not put aspirin on the gum, which can burn tissue, and do not give benzocaine gels to children under 2. Call a dentist as soon as possible. Go to the emergency room or call 911 if you have facial or neck swelling with fever, trouble breathing or swallowing, swelling that spreads toward the eye or jaw or feel very ill, since a dental infection can spread.

A toothache always seems to strike at the worst time: on a weekend, during a holiday or in the middle of a storm when the roads are closed. Most tooth pain is not dangerous in the short term, and simple first aid can make you more comfortable until you see a dentist. A small number of dental problems, especially spreading infections, need emergency care right away. Knowing the difference helps you act calmly and safely. This guide is part of our emergency first aid guide.

Guidance in this article comes from the American Dental Association (ADA), including its 2024 clinical practice guideline on managing acute dental pain, the U.S. Food and Drug Administration (FDA), Mayo Clinic and MedlinePlus. It is general information, not a substitute for dental or medical care. Follow pain reliever labels and ask a pharmacist or doctor if you have health conditions or take other medications.

Common Causes of Tooth Pain

• Tooth decay (cavities) that reaches deeper layers of the tooth
• Cracked or broken teeth
• Lost or loose fillings and crowns
• Gum disease or food trapped between teeth and gums
• Dental abscess, a pocket of pus caused by bacterial infection
• Wisdom teeth that are erupting or impacted
• Sinus infections, which can cause aching in the upper back teeth
• Teeth grinding, often at night

Pain that is sensitive to cold and fades quickly is often less serious than pain that throbs, lingers after hot or cold, wakes you at night or comes with swelling.

First Aid for a Toothache

1. Rinse your mouth with warm water to clean the area.
2. Floss gently around the painful tooth to remove food that may be trapped.
3. Apply a cold compress to the outside of the cheek for about 15 to 20 minutes at a time to reduce pain and swelling.
4. Take an over-the-counter pain reliever as directed on the label, if it is safe for you.
5. Keep your head raised when resting, which may reduce throbbing.
6. Avoid very hot, cold, sweet or hard foods that trigger pain.
7. Call your dentist for advice and an appointment.

A warm saltwater rinse, about half a teaspoon of salt in a cup of warm water, may soothe irritated gums. Swish and spit; do not swallow.

Pain Relievers

The ADA’s 2024 guideline on acute dental pain in adults and adolescents 12 and older recommends nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, alone or combined with acetaminophen, as first-line options for many patients. The guideline recommends against opioids as a first choice. NSAIDs are not safe for everyone, including some people with kidney disease, stomach ulcers, bleeding risks or certain heart conditions, and during parts of pregnancy. Acetaminophen can harm the liver in high doses. Read labels carefully, and ask a pharmacist if you are unsure.

What Not to Do

• Do not place aspirin on the gum or tooth. It can cause a chemical burn.
• Do not use benzocaine gels for children under 2. The FDA warns that benzocaine can cause a rare but serious blood condition called methemoglobinemia, and it should not be used for teething.
• Do not apply heat to a swollen face, which may encourage infection to spread.
• Do not try to pop or drain an abscess yourself.
• Do not take leftover antibiotics. They may be the wrong drug or dose and do not replace dental treatment.

Clove Oil

Clove oil contains eugenol, which dentists have long used in some dental materials. Some people dab a tiny amount, diluted, on a cotton swab near a painful tooth for temporary relief. It can irritate gums and is not safe for young children. If you use it, apply a very small amount and avoid swallowing it.

Dental Abscess: What It Is and Why It Matters

A dental abscess is a collection of pus caused by a bacterial infection. It can form at the tip of a tooth root, often from deep decay or a crack, or in the gums beside a tooth. Signs may include:

• Severe, throbbing pain that may spread to the ear, jaw or neck
• Pain when chewing or biting
• Sensitivity to hot and cold
• Swelling in the gum, face or cheek
• A pimple-like bump on the gum that may drain
• A foul taste or bad breath
• Fever and feeling unwell
• Swollen lymph nodes under the jaw

An abscess will not go away on its own. Even if it drains and the pain eases, the infection remains and can spread. Treatment typically includes draining the abscess, a root canal or extracting the tooth, sometimes with antibiotics. Call a dentist promptly.

When an Infection Becomes an Emergency

Mayo Clinic and other medical sources warn that dental infections can spread to the jaw, neck, face and, rarely, deeper spaces or the bloodstream. Go to the emergency room or call 911 if you have:

• Swelling in the face, under the jaw or in the neck, especially with fever
• Trouble breathing or swallowing
• Swelling that pushes the tongue up or makes it hard to open your mouth
• Swelling spreading toward the eye
• High fever, chills or a racing heart
• Confusion or feeling very ill

These symptoms can signal a serious spreading infection. Do not wait for a dental appointment.

Broken Teeth, Lost Fillings and Crowns

Broken or Cracked Tooth

• Rinse your mouth with warm water.
• Save any large pieces in a clean container.
• Apply a cold compress to reduce swelling.
• Cover sharp edges with dental wax or sugar-free gum to protect your tongue and cheek.
• See a dentist as soon as possible.

If a tooth is knocked out completely, time matters. Our guide to knocked-out tooth first aid explains how to handle and store it. A tooth injury from a fall or blow may also involve a head injury; see our guide to head injury and concussion warning signs.

Lost Filling

Pharmacies sell temporary filling material that can cover the hole until you see a dentist. Keep the area clean and avoid chewing on that side.

Loose or Lost Crown

If a crown comes off, keep it safe. Some people temporarily reseat a crown with over-the-counter dental cement, following package directions. Do not use household glue. See a dentist soon.

How to Tell Urgent From Routine

Not every toothache needs the same level of care. Sorting your symptoms can help you decide where to go.

Situation	Where to go
Mild sensitivity to cold that fades quickly	Routine dental appointment
Lost filling or crown without severe pain	Dentist within a few days
Broken tooth with sharp edges or pain	Dentist as soon as possible, often same or next day
Throbbing pain, swelling of the gum or a bump on the gum	Dentist the same day if possible
Knocked-out permanent tooth	Dentist or emergency care right away
Facial or neck swelling with fever	Emergency room
Trouble breathing or swallowing	Call 911

Questions a Dentist May Ask

Being ready with answers can speed up care over the phone:

• When did the pain start, and is it constant or does it come and go?
• Is it triggered by hot, cold, sweets or chewing?
• Is there swelling, and where?
• Do you have a fever?
• Did you have an injury?
• What medications have you taken, and when?
• Do you have allergies or medical conditions?

Urgent Care vs. the Emergency Room

Urgent care clinics and emergency rooms usually cannot fix teeth. They can treat pain, check for spreading infection and prescribe medication, but you will still need a dentist for drainage, a root canal or extraction. Go to an ER for the serious warning signs listed above, and call a dentist or urgent dental clinic for other problems. Many dental offices have an after-hours line, and some areas have emergency dental clinics or dental school clinics with lower costs.

Keeping Comfortable While You Wait

Waiting a day or two for an appointment can be hard. Eat soft, room-temperature foods such as yogurt, eggs and soup, and chew on the other side. Drink plenty of water, and keep brushing gently, including the sore area, to keep it clean. Sleep with an extra pillow. Track your symptoms and pain reliever doses on your phone or a notepad so you can report them to the dentist and avoid taking too much.

Wisdom Tooth Pain

Erupting or partially trapped wisdom teeth can cause pain and swelling in the gum behind the last molars. Rinse with warm salt water, keep the area clean and use cold compresses. A dentist should check swelling, bad taste or fever, which may signal infection.

When Jaw Pain Is Not a Tooth Problem

Pain in the jaw, teeth or gums is sometimes a sign of something outside the mouth. The American Heart Association lists pain or discomfort in the jaw, neck, back or arms as possible heart attack symptoms, especially when it comes with chest discomfort, shortness of breath, nausea, cold sweat or lightheadedness. Women are somewhat more likely than men to have these less typical symptoms. If jaw pain appears suddenly with any of these signs, call 911 rather than waiting for a dentist. Our guide to heart attack warning signs explains what to do while help is on the way.

Sinus infections, jaw joint (TMJ) problems and nerve conditions can also cause pain that feels like a toothache. A dentist or doctor can help sort out the cause.

Toothaches in Children

Children may have tooth pain from cavities, new teeth coming in or injuries. Use children’s pain relievers dosed by weight according to the label, and call your child’s dentist. Do not use benzocaine for babies and toddlers. Watch for facial swelling and fever, which need prompt care.

Dental Emergencies During Disasters

Storms, power outages and travel can make dental care hard to reach. To prepare:

• Keep your dentist’s emergency number saved in your phone.
• Find a backup option, such as an urgent dental clinic or dental school clinic.
• Keep up with checkups, since many emergencies start as untreated problems.
• Pack a small dental kit in your emergency supplies.

Dental Emergency Kit

• Pain relievers you can safely take
• Dental floss and a travel toothbrush
• Temporary filling material
• Dental wax
• Small container with a lid for broken pieces or a knocked-out tooth
• Gauze
• Instant cold pack
• Salt packets for rinses

Our checklist for a first aid kit for a small apartment shows how to fit these into a compact space.

Preventing Dental Emergencies

• Brush twice a day with fluoride toothpaste and floss daily.
• Limit sugary snacks and drinks.
• Wear a mouthguard for contact sports and a night guard if you grind your teeth.
• Avoid chewing ice, hard candy and pens.
• Get regular dental checkups so problems are caught early.

Frequently Asked Questions

What can I do for a toothache at night?

Rinse with warm water, floss gently, use a cold compress, take a pain reliever that is safe for you and keep your head raised. Call a dentist in the morning.

Is a dental abscess an emergency?

It needs prompt dental care. Go to the ER if you have facial or neck swelling with fever, trouble breathing or swallowing or feel very ill.

Will antibiotics cure a tooth abscess?

Antibiotics may help control infection but do not fix the source. Drainage, a root canal or extraction is usually needed.

Can I put aspirin on a sore tooth?

No. Placing aspirin on the gum can burn tissue. Swallow pain relievers as directed instead.

Can a toothache go away on its own?

Pain may come and go, but the cause usually remains. See a dentist even if pain fades.

When should I go to the ER for tooth pain?

Go for swelling of the face or neck with fever, trouble breathing or swallowing, spreading swelling or feeling very ill.