Persistent throbbing pain that wakes you at night, facial or gum swelling, a pimple-like bump on the gum that drains pus, a foul taste in the mouth, fever, or pain when biting down on a specific tooth. If swelling is spreading toward the eye, under the jaw, or into the neck, call (503) 822-0096 immediately — this is urgent.

Antibiotics reduce bacterial load in tissues with blood supply, but they cannot sterilize the inside of a dead tooth or penetrate the thick wall of an abscess cavity. The source — the infected pulp or the pocket of pus — must be physically eliminated through root canal treatment, extraction, or surgical drainage.

A minor surgical procedure where Dr. Gvozden numbs the swollen area, makes a small incision into the abscess, and allows the pus to drain. A small rubber drain may be placed for 24 to 48 hours to keep the pathway open. The procedure provides rapid pain relief and prevents further spread of the infection.

Yes. Untreated dental infections can spread along fascial planes into the neck, chest, and mediastinum. Bacteria can also enter the bloodstream, causing bacteremia. In rare cases, dental infections have led to brain abscesses, cavernous sinus thrombosis, and endocarditis. These complications are preventable with timely treatment.

If you can breathe normally, swallow without difficulty, and do not have a high fever, call us first at (503) 822-0096 — we can provide definitive treatment the same day. If you have difficulty breathing, cannot swallow, or your fever is above 102 degrees, go to the ER immediately and then follow up with us for source treatment.

Our CBCT 3D scanner produces a three-dimensional image of your jaws in under 15 seconds. This reveals periapical radiolucencies (bone loss at the root tip), internal resorption, root fractures, and the exact pathway of infection spread through bone — information that two-dimensional X-rays frequently miss.

Extracting the infected tooth is often the treatment for the infection. Removing the source allows the body and antibiotics to clear remaining bacteria from surrounding tissues. Current evidence supports extraction even in the presence of active infection when adequate antibiotic coverage is provided.

When clinically indicated — particularly for infections that have failed previous antibiotic therapy or involve immunocompromised patients — we obtain a culture and sensitivity specimen during drainage. This identifies the exact bacterial species and which antibiotics will be effective against them.

As soon as possible. Simple periapical infections can progress to fascial space involvement within 24 to 72 hours. We maintain emergency slots every day specifically for infection cases. The longer treatment is delayed, the more extensive the infection becomes and the more complex the treatment required.

Frequently. The roots of upper premolars and molars often project into or very near the maxillary sinus floor. An abscess on these teeth can erode through the thin bone into the sinus, causing odontogenic sinusitis — a condition that will not respond to typical ENT sinus treatments until the dental source is addressed.

First-line empiric treatment is typically amoxicillin-clavulanate (Augmentin) for its broad aerobic and anaerobic coverage. Clindamycin is used for penicillin-allergic patients. Metronidazole may be added for severe anaerobic infections. We select antibiotics based on infection severity, patient allergies, and culture data when available — not as a one-size-fits-all prescription.

Yes. IV sedation is available for incision and drainage, emergency extractions, and any procedure where the infection has made local anesthesia less effective. Inflamed, acidic tissue can resist local anesthesia — sedation ensures you are comfortable regardless.

Not necessarily, and this can actually be a dangerous sign. When an abscess ruptures internally, pressure on the nerve decreases and pain subsides — but the infection is now spreading into soft tissues. Persistent or increasing swelling after pain decreases warrants immediate evaluation.

Most patients experience significant pain relief within 24 hours of drainage. Swelling typically resolves over three to seven days. If extraction was performed, socket healing takes one to two weeks. Complete bone healing at the infection site may take three to six months, which we monitor with follow-up imaging.

Most dental infections originate from untreated cavities, cracked teeth, or failed previous root canals. Regular dental checkups that catch decay early, treating cracked teeth before bacteria reach the pulp, and addressing gum disease are the most effective prevention strategies. If you have a toothache that lasts more than two days, do not wait — call (503) 822-0096.