If you have swelling of the gums, face or cheek related to tooth pain, you may have an infection. Tooth decay, gum disease or cracked teeth are common causes of toothaches — and the source of most dental infections.
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While a persistent toothache indicates the need to see a dentist, infections require an urgent evaluation, as tooth or gum infections can quickly become serious and spread throughout the body.
To complement your dentist's treatment plan, there are also some home strategies, such as cold compresses, salt water rinses and over-the-counter medications that can ease your pain and swelling.
Step 1: Call Your Dentist
If your toothache is accompanied by pain, fever or swelling of your gums, face or cheek, schedule an urgent appointment with a dentist. Don't delay, as these symptoms may be related to an infection or an abscess — a collection of pus caused by a bacterial infection.
Without treatment, dental infections can spread to the jaw bone, teeth and surrounding tissues, and could even lead to a life-threatening blood infection called sepsis.
Step 2: Apply Ice
As a complement to medical treatment, cold therapy can help ease swelling. Applying an ice pack to your swollen check decreases inflammation, and temporarily narrows blood vessels, minimizing fluid buildup. Do not apply ice directly to your skin, as doing so can cause pain and tissue damage.
Instead, place a towel in between your skin and the ice pack, use a reusable ice pack that has cloth backing, or wrap a bag of crushed ice cubes in a thin towel before applying to your cheek. Leave in place up to 20 minutes, then rest for at least 20 minutes before reapplying. Repeat hourly or as needed to improve symptoms.
Step 3: Rinse and Clean
A traditional dental remedy — rinsing with warm salt water — is commonly recommended to ease swelling. Exposing mouth tissues to a solution that is saltier than body fluids is theorized to pull excess water from gums and other exposed tissues, dehydrating these tissues and decreasing swelling.
Just how well this helps cheek swelling is unclear, but rinsing with salt water may have other benefits. It's a safe way to clean the mouth, and this rinse may reduce bacteria levels — as most bacteria do not thrive in a salty environment.
The usual approach, repeated several times daily, is to mix 1/2 teaspoon of salt into 8 ounces of warm, clean water and swish for up to 2 minutes before spitting out. Also continue to brush and floss as directed by your dentist to remove any trapped food particles that may be contributing to your toothache and swelling
Step 4: Relieve Pain
Over-the-counter (OTC) anti-inflammatory medications, such as ibuprofen (Advil) or acetaminophen (Tylenol), are often recommended as a way to relieve swelling and pain due to a toothache. When you speak with your dentist or doctor, ask about the dosing schedule that is recommended for you.
If you have any health conditions or take prescription medications, seek your doctor's advice on pain management before you use these pain relievers. In some cases, your doctor may recommend a rinse, topical agent or prescription medication for pain relief.
Reviewed by Kay Peck, MPH RD