Seek immediate emergency care if swelling extends below the jawline into the neck, if you have difficulty breathing or swallowing, if you cannot open your mouth more than one finger-width, if you have a fever above 102 degrees, or if the swelling is rapidly worsening. These signs suggest fascial space infection that can compromise the airway.

If you can breathe and swallow normally, call us at (503) 822-0096 first. We can provide definitive diagnosis and treatment — something the ER typically cannot do for dental problems. If you have airway concerns, severe systemic symptoms, or it is after hours with worsening symptoms, go to the ER first and then contact us for follow-up.

When the pulp of a tooth dies completely, the pain from the tooth itself may stop — but the infection continues spreading into the bone and soft tissues. The swelling is caused by the infection, not the tooth nerve directly. This painless-but-swollen presentation is actually more concerning because patients tend to delay treatment.

Temporarily and incompletely. Antibiotics reduce bacterial load in vascularized tissue but cannot reach bacteria inside a dead tooth or within an enclosed abscess. The pain will return — often worse — once the antibiotic course ends. Definitive treatment requires addressing the source: root canal therapy, extraction, or surgical drainage.

Take 600 milligrams of ibuprofen (Advil) and 500 milligrams of acetaminophen (Tylenol) together — this combination is more effective than either alone and is supported by published research. Apply a cold pack to the outside of your face in 20-minute intervals. Do not apply aspirin directly to the gum. Call (503) 822-0096 so we can prepare for your arrival.

For abscess drainage, most patients experience dramatic pain relief within minutes of the procedure. For root canal therapy, pain resolves as soon as the infected pulp is removed. For emergency extractions, the source of pain is physically gone. We aim to eliminate — not merely mask — the cause of your pain at the first visit.

Yes, and it is particularly valuable for severe pain cases. Inflamed tissue has a lower pH that can interfere with local anesthetic effectiveness. IV sedation provides systemic pain and anxiety management regardless of local tissue conditions, ensuring you are comfortable throughout the procedure.

A CBCT scan provides a three-dimensional view of the infection, showing exactly which tooth is the source, how far the bone destruction extends, whether the infection has entered the maxillary sinus or fascial spaces, and the proximity to nerves and other critical structures. A regular X-ray compresses this information into a flat, two-dimensional image where overlapping structures obscure critical findings.

Absolutely. Upper tooth infections can cause referred pain to the temple, eye, and ear because the trigeminal nerve supplies sensation to all of these areas. Many patients visit ENTs or eye doctors for headaches or ear pain that is actually dental in origin. If conventional treatment has not resolved your head or facial pain, a dental evaluation should be your next step.

Yes. Intermittent dental pain often indicates a cracked tooth or early pulpitis — conditions that are progressive. Pain that comes and goes is not pain that is getting better; it is pain from a problem that has not yet reached its worst stage. Early treatment while the problem is still intermittent is always less invasive than waiting for constant, severe pain.

We use a combination of local anesthetic techniques tailored to the specific tooth and procedure. For lower molars, this may include an inferior alveolar nerve block supplemented with a long buccal nerve block and intraseptal injection. IV sedation is available when local anesthesia alone is insufficient. We do not begin treatment until you are completely numb and comfortable.

Rarely. Current evidence shows that ibuprofen combined with acetaminophen is more effective than opioids for dental pain, with fewer side effects. We follow evidence-based prescribing guidelines and reserve opioids for cases where non-opioid alternatives have failed. When opioids are prescribed, it is for a limited duration with a specific clinical justification.

Dental treatment during pregnancy is safe and recommended — the American College of Obstetricians and Gynecologists specifically states that needed dental care should not be delayed during pregnancy. Local anesthesia with lidocaine is pregnancy-safe. Necessary extractions and root canals are ideally performed in the second trimester, but emergencies are treated at any stage. We coordinate with your OB when indicated.

The emergency examination and CBCT imaging typically cost $150 to $350. Treatment costs depend on what is needed — drainage, root canal therapy, or extraction each have different fees. We provide a complete cost breakdown after diagnosis and before any treatment begins. Most dental insurance covers emergency visits. CareCredit financing is available.

The pain itself is not life-threatening, but the infection causing it can be. Untreated dental infections can spread to fascial spaces, compromise the airway, or enter the bloodstream. Deaths from odontogenic infections, while rare in the developed world, still occur — almost exclusively in patients who delayed treatment. This is why we take every swelling and severe pain case seriously and treat it the same day.