Emergency dental treatments
Incision and drainage of a dental abscess: how we relieve the pressure
A small cut into a swollen gum lets the pus out, and the pain usually drops within minutes. It is the quickest way to make an abscess safe while we deal with the tooth that caused it.
Clinically reviewed by Dr Ibraheem Ijaz, Principal Dentist · GDC 301711 · Last reviewed April 2026
Why draining an abscess works when painkillers do not
An abscess is a pocket of pus trapped in tissue that cannot stretch. As the body sends white cells to fight the bacteria, the pocket grows, and the pressure inside it climbs. It is the pressure, not the pus itself, that hurts, which is why an abscess throbs with your heartbeat and why lying down makes it worse. Painkillers dull the signal but do nothing about the pressure. Antibiotics struggle to reach the middle of an abscess because it has no blood supply. Making a small opening and letting the pus out solves the actual problem, and the relief is often immediate.
Incision and drainage, usually shortened to I&D, is the surgical name for that opening. In dentistry it is nearly always a minor procedure done in the chair under local anaesthetic, taking ten minutes or so. It settles the emergency. It does not fix the tooth, and we are careful to say that at the time.
When we drain rather than extract or root fill straight away
Most abscesses are drained through the tooth itself, either by opening the root canal or by taking the tooth out, and no cut in the gum is needed. We add a separate incision when pus has collected in the soft tissue and has nowhere else to go: a tense, shiny lump on the gum, a swelling that has spread into the cheek or under the jaw, or an abscess between the gum and the tooth. If you have a swollen face with a visible bulge, drainage is likely to be part of the same-day treatment.
Sometimes drainage is deliberately done first and the definitive treatment a few days later. A large, hot swelling makes local anaesthetic less effective, and it is safer and kinder to drain, let the tissues settle for two to three days, then extract or root fill under proper numbness. A gum abscess caused by a deep pocket rather than a dead nerve may need only drainage and cleaning of the pocket, without any treatment to the tooth.
Incision and drainage step by step
Examination and X-ray.
Anaesthetic around, not into, the abscess.
The incision.
Encouraging drainage.
Dealing with the tooth.
Fees for draining an abscess
Drainage is a short procedure and is priced accordingly; the bigger cost is whichever treatment removes the cause. Both are agreed before we start. Our fees page lists everything, and finance is available for the follow-on treatment.
| Treatment | Fee (from) |
|---|---|
| Emergency examination including X-rays | £30 |
| Incision and drainage | Quoted in writing at the examination |
| Emergency root canal, stage one, if the tooth is to be kept | from £200 |
| Extraction, if the tooth cannot be saved | £120–£260 |
| Out-of-hours (after 6pm weekdays, weekends) | Additional charge |
Aftercare in the first 24 hours and the first week
The first day. Expect the opening to ooze for several hours. Warm salt-water rinses, a teaspoon of salt in a cup of warm water, held over the area every few hours from that evening, keep the drain open and clean. Do not press or squeeze the swelling. Take paracetamol and ibuprofen as directed on the packet, and eat soft, cool food. Do not smoke. If a rubber drain was placed, leave it alone; we remove it at a review in 24 to 48 hours.
Days two to seven. The swelling should visibly shrink each day and the throbbing should not return. Keep up the salt-water rinses after meals and before bed. Brush the teeth around the area gently. Call us the same day if the swelling starts to grow again, if you develop a fever or feel generally unwell, if the skin over the swelling goes red and tight, or if the opening closes and the lump refills. Those are signs that the pus is re-collecting or that the infection is spreading, and they need to be seen, not waited out.
Dealing with the cause once the swelling has gone
Pus is a symptom. It came from somewhere: usually a dead nerve inside a tooth, sometimes a deep gum pocket, occasionally a fragment of root or an impacted wisdom tooth. Drain the abscess and leave the cause, and it will refill, typically within a couple of weeks, because the bacteria that produced it are still there. The choice for a dead tooth is root canal treatment, which keeps the tooth, or extraction, which does not. We give you the fees for both and a recommendation based on how much tooth is left and how the roots look on the X-ray.
When it is more than a dental problem
A swelling confined to the gum or the cheek is a dental problem and we treat it. Some swellings have moved beyond that. Go straight to A&E, or call 999, if the swelling is closing your eye, has crossed under your chin to the other side, is making it hard to swallow your own saliva, open your mouth or breathe, or if you have a high temperature with a racing pulse. These are signs of infection tracking into the spaces of the neck, which can threaten the airway within hours and needs hospital drainage and intravenous antibiotics. The Northern General Hospital on Herries Road has the nearest maxillofacial unit. Outside our 8am to 8pm hours, NHS 111 can direct you.
Questions, answered
Common questions
Does incision and drainage hurt?
We numb the area first, but infected tissue is harder to anaesthetise fully, so you may feel a brief moment of pressure as the cut is made. It is over in seconds and the relief that follows is usually far greater than the discomfort.
Will draining the abscess cure it?
No. Drainage removes the pus and the pain, but the tooth or gum pocket that caused it still has to be treated, or the abscess comes back. Root canal or extraction usually follows within days.
Can I pop a dental abscess myself?
Please do not. A needle or fingernail at home introduces new bacteria, rarely reaches the pocket properly, and can push infection deeper into the face. A dentist can drain it cleanly the same day for a modest fee.
Do I need antibiotics after drainage?
Usually not, if the pus is out and the cause is being treated. We prescribe them only when the infection has spread into the face or neck, or you have a fever or feel unwell.
How long does the swelling take to go down?
Most of it goes within 24 hours of drainage and the rest over two to four days. Swelling that grows again after drainage needs to be seen the same day.
Why did the abscess come back?
Because the source was not removed. A dead nerve or a deep gum pocket keeps producing bacteria until it is root filled, cleaned out or extracted. Drainage alone is temporary.
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