Tooth Abscesses in Children: Causes and Recommendations

The appearance of tooth abscesses in children isn't something to be taken lightly. We'll tell you what causes them and how to act.
Tooth Abscesses in Children: Causes and Recommendations

Last update: 29 October, 2022

Infections in little one’s teeth and molars can lead to the development of tooth abscesses in children. This is a collection of pus inside the bone, in the gum, or even in other areas of the mouth or face.

The timely treatment of this problem is very important, as in addition to the discomfort it causes in children, it can spread the infection to other parts of the body.

In this article, we’ll tell you why tooth abscess appears in children and how to recognize them. You’ll also know how to prevent it and how to act in case it occurs. Find out more here.

What are tooth abscesses?

Tooth abscesses in children are an accumulation of pus caused by a bacterial infection. This collection of putrefied material is located in a kind of pocket that presses the tissues to come out.

They can be located in different places of the oral cavity, although the most frequent abscesses are periapical (at the ends of the dental roots) and periodontal (on the gums, on the sides of the root zone).

But as we’ve already mentioned, abscesses can affect other more distant places, inside and outside the mouth. Therefore, they can reach the soft tissues of the floor of the mouth, the neck, and the cheeks. And in these cases, the risk of complications is very high, so urgent action must be taken.

Sometimes, dental abscesses in children can make their way to the outside through a fistula. This is a kind of channel created by the body to connect a purulent cavity with a more superficial area and thus evacuate its contents. At first sight, it looks like a kind of pimple on the oral mucosa or on the skin.

A tooth abscess on a child's gums.
Dental abscesses can create fistulas, which are channels through which the pus tries to drain naturally and spontaneously.

The causes of dental abscess in children

The cause of a dental abscess in children is a bacterial infection inside a tooth. These germs can reach the inside of the tooth through a cavity or a fracture.

Untreated cavities are the most common origin of the problem because the same bacteria that destroy the hard tissues of the tooth reach the pulp, the deepest area of the tooth. As a result, the nerve dies and the infectious process develops.

The putrefied content of the infection itself within the tooth element accumulates at the ends of the roots or in the periodontal area. And little by little, the abscess is formed.

Strong blows to the teeth or large repairs can also lead to pulp death and subsequent infection.

Symptoms of tooth abscesses in children

To help children alleviate their discomfort, it’s essential to know the manifestations of tooth abscesses. Here are the most common ones:

  • Pain in the affected tooth: The pressure exerted by the pus on the surrounding tissues generates stabbing or throbbing pain. The child may report that the tooth feels like it is “throbbing”.
  • Sensitivity: There’s discomfort when biting and exerting pressure on the affected tooth. Also, with hot and cold foods and drinks.
  • Pain that extends to the cheek, ear, jaw, and neck on the affected side.
  • A loose tooth.
  • Red, swollen gums or with a small protruding lump. Touching and pressing on them is uncomfortable or hurts.
  • A fistula over the gum.
  • A bitter taste in the mouth.
  • Bad breath.
  • Swelling of the neck, under the jaw, or cheeks. These areas may become red, hot, and tender.
  • Swollen and tender lymph nodes under the jaw and neck.
  • Fever.
  • Difficulty breathing or swallowing.
  • Pain relief if the abscess ruptures or a pus-draining fistula develops.


Tooth abscesses in children require dental treatment because, many times, the body itself manages to drain the contents of the purulent cavity to the outside. While this reduces symptoms, it doesn’t mean that the problem is resolved.

Infection within the tooth, bone, and gums continues and an untreated infection can spread to the jaw, floor of the mouth, and other areas of the head and neck. Depending on the severity of the condition, it can also be life-threatening.

If the infant develops a fever, nausea, or vomiting, or there’s difficulty swallowing, speaking, or breathing, it’s important to get urgent medical attention. Also, if the abscess reaches the neck or eyelids, or the pain worsens. In these cases, hospitalization may be necessary to avoid more serious complications.

Treatment of dental abscess in children

When children have a dental abscess, it’s very important to take them to a pediatric dentist as soon as possible. The professional will evaluate the situation in order to carry out the best treatment, according to the needs of the case.

The use of antibiotics to treat the infection is necessary and is generally accompanied by an anti-inflammatory treatment to reduce discomfort and promote recovery.

Depending on whether the problem’s located in a baby tooth or in a permanent tooth, the treatment alternatives will vary. Also, these will depend on the degree of involvement of other tissues, the possibility of causing serious complications, or the remaining time the tooth has left in the mouth.

In general terms, the aim is to keep the tooth in the mouth and drain the abscess to eliminate the infectious focus. This is almost always done through a perforation inside the tooth itself. Then, the canals are cleaned and disinfected and a root canal is performed to solve the problem.

In some more complex or dangerous cases, when the infection has spread, the extraction of the tooth may be the best solution. Once the problem is solved, the corresponding rehabilitation should be performed to maintain oral health, function, and esthetics.

There are very few cases of children who require a surgical intervention to drain the abscess through the skin or mucous membranes. This technique consists of making an incision over the swollen area to help remove the pus. And then, inside the cavity, it will be necessary to treat or remove the problematic tooth.

A dentist performing work on a little girl's mouth.
Treatments for tooth abscesses in children include draining the pus and fixing the damaged tooth.

Home remedies

There are some household practices that can help children with tooth abscesses feel better. These home remedies in no way replace dental treatment. They’re simply measures to relieve the little ones until the problem is solved:

  • Apply cold compresses or cloths intermittently, no more than 20 minutes at a time, to the swollen face to reduce swelling.
  • Make mouthwashes with warm water and salt, but without the child swallowing it.
  • Keep the mouth sanitized. Brush the affected tooth gently. In cases of teeth with large cavities of caries, try to eliminate all the residues that have accumulated inside.
  • Administer the medication prescribed by the dentist in the correct way. It shouldn’t be suspended if the child already feels better because the antibiotic should complete the whole cycle to avoid pharmacological resistance.
  • Avoid very cold or hot food.
  • Never try to drain or treat the child’s abscess by yourself at home. This is very dangerous. The best solution in these cases is always to seek professional help.

How to prevent tooth abscess in children

The best way to avoid the discomfort and risks associated with tooth abscesses in children is to prevent their occurrence. And in this task, parents play a fundamental role.

The fewer bacteria proliferate in your children’s mouths, the less chance of cavities and infections they’ll have. For this, it’s essential to maintain healthy habits such as a healthy diet and proper oral hygiene.

Taking your child to the pediatric dentist regularly also helps prevent this problem. The professional is an ally for parents in keeping their children’s mouths healthy.

And if despite the care, you suspect that your child may have a dental abscess, don’t waste time. Seek professional attention immediately to prevent the infection from spreading and becoming an emergency.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

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This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.