Dental Swelling and Infection: A Guide for East Palo Alto Patients

Swelling in the face or gum is one of the dental problems that should never be left to see what happens. For patients in East Palo Alto, this article explains what usually causes dental swelling, how to tell when it has become dangerous, what you can do at home in the meantime, and how the infection is treated once you are seen.

What causes dental swelling

Most dental swelling comes from an infection. The common sources are:

• An abscess at the root tip. When deep decay or a crack lets bacteria reach the nerve inside a tooth, the infection can travel out through the root into the bone and surrounding tissue.
• A gum abscess. Bacteria trapped in a deep pocket between the gum and tooth, often linked to gum disease, can form a painful swelling.
• A partly erupted wisdom tooth. Gum tissue over a lower wisdom tooth can trap food and become inflamed.

Less often, swelling follows an injury or a reaction to something else. Assessment tells us which it is.

Warning signs that mean the emergency room

Dental infections can spread into the spaces of the face and neck. Go to an emergency room or call 911 if you have:

• Difficulty breathing or swallowing
• Swelling under the tongue or in the floor of the mouth
• Swelling spreading toward the eye or down the neck
• A high fever, chills or feeling very unwell
• Difficulty opening the mouth

These signs mean the infection needs urgent medical care. The tooth will still need treatment afterwards, and we can help with that once you are stable.

When to call us the same day

Swelling that stays around one tooth or one area of gum, without the signs above, still needs to be seen promptly. The sooner in the day you phone, the easier it is to find you a time. The same applies to a throbbing toothache that wakes you at night, a bad taste in the mouth, or a small bump on the gum that releases fluid.

What you can do at home in the meantime

• Rinse gently with warm salt water
• Take an over-the-counter pain reliever as directed on the label, if it is safe for you
• Use a cold compress on the outside of the face in short intervals
• Keep your head raised when lying down
• Stay well hydrated

Avoid heat on the face, which can encourage swelling to spread, and do not try to drain the area yourself.

Why antibiotics are only part of the answer

People often hope a course of antibiotics will make the problem go away. Antibiotics can help when an infection is spreading or you have signs like fever, but they cannot reach the source inside a tooth or a deep gum pocket. Without treating that source, the infection tends to return. Current dental guidance favours treating the cause directly and using antibiotics selectively.

How the infection is treated

At the visit we examine the area, take images and identify where the infection is coming from. Depending on what we find, treatment may involve:

• Draining the abscess to release pressure, which often brings rapid relief
• Starting root canal treatment to clean out the infected nerve and save the tooth; see root canal myths for what that involves
• Cleaning a gum pocket thoroughly when the source is gum disease; our article on deep cleaning explains the process
• Removing the tooth when it cannot be saved

We explain what we see and your options before starting treatment. Nitrous oxide is available if you feel anxious.

Insurance and HPSM

East Palo Alto is in San Mateo County, and many residents have Medi-Cal dental through the Health Plan of San Mateo. We accept HPSM Medi-Cal dental, as well as the major PPO dental plans. We do not accept dental HMO plans. If you are an HPSM member, mention it when you call so we can check coverage while arranging your visit. More detail is on our HPSM page.

Preventing the next infection

Most dental abscesses start as a small problem that went unnoticed: a cavity, a cracked filling or early gum disease. Regular checkups and attention to early signs of gum disease help catch these before they become painful.

Reaching us

Eclat Dental Studio is in Mountain View on Showers Drive, reached from East Palo Alto via Highway 101 or El Camino Real. If you have dental swelling without red-flag signs, call (650) 917-8348 and we will see you as soon as we can.