Toothache and dental abscess: when it is urgent and where to get help

Toothache can start as a dull ache and turn into something that needs prompt attention, so it helps to know the warning signs before you need them. This guide sets out what the NHS and Northern Ireland health bodies say about the causes, the signs of an abscess and the routes to urgent help. It gives general information only and cannot diagnose what is wrong with your tooth.

Common causes of toothache

The NHS lists several causes of toothache: tooth decay, a dental abscess, a cracked or damaged tooth, a loose or broken filling, infection (especially around wisdom teeth), problems with braces, gum disease, teeth grinding and sensitive teeth.

Because the causes differ, the treatment differs too. A dentist has to examine the tooth to find out which one applies. If a filling has come out, the guide on temporary fillings and what to do if one falls out explains the usual steps.

The NHS says to see a dentist if toothache lasts more than 2 days or does not respond to painkillers. It also lists these reasons to book: a fever, pain when biting, red gums, a bad taste, or swelling in the face or jaw.

Signs of a dental abscess

The NHS describes a dental abscess as causing intense toothache or pain in the gums. Other signs it lists include redness inside the mouth, sensitivity to hot or cold food, a bad taste in the mouth, difficulty eating, swelling in the face, swollen glands on each side of the neck and a raised temperature.

Only a dentist can confirm an abscess. The NHS says the dentist will drain the pus, and that root canal treatment or removal of the tooth may follow under local anaesthetic. It adds that you may be given painkillers and may be prescribed antibiotics afterwards. Read about root canal treatment if a dentist raises it.

When toothache is an emergency

Some symptoms need urgent help rather than a routine appointment. The NHS says to go to A&E if you have toothache and the area around your eye or your neck is swollen, or if swelling in your mouth or neck is making it difficult to breathe, swallow or speak.

For a dental abscess, the NHS says to call 999 or go to A&E if you:

• are finding it hard to breathe, speak or swallow
• have a swollen or painful eye, or suddenly start having problems with your eyesight
• have a lot of swelling in your mouth
• are finding it hard to open your mouth

The NHS also says not to drive yourself to A&E. The NHS advises asking someone to drive you, or calling 999 and asking for an ambulance.

Out-of-hours dental help in Northern Ireland

The NHS pages quoted above refer to NHS 111, which is the England service. This guide did not find an equivalent dental route through 111 in Northern Ireland on the official pages checked, so it does not suggest one, and a dentist can tell you what applies. Use the Northern Ireland routes below, and check the official pages for the latest details, because services and opening hours change.

During working hours, nidirect says emergency dental treatment may be accessed from local dental practices, Monday to Friday. It adds that treatment may require payment and that you might be directed to an emergency department instead.

For out-of-hours problems, the Business Services Organisation (HSC Northern Ireland) tells patients to phone their own dental practice first. For Saturdays, Sundays and Bank Holidays, it lists an Emergency Dental Clinic line on (028) 2566 3510, open 8.00am to 12 noon according to that page, checked 6 October 2026.

The same page says a dentist triages each call, and treatment is given only when clinically necessary. The reasons it lists are dental swelling (spreading infection), trauma to teeth from an external force, uncontrolled bleeding after an extraction, and severe dental pain not controlled by over-the-counter medications.

It warns that demand is high and you may have to travel outside your area. It also says not to attend any site without an arranged appointment, and that normal General Dental Service charges are payable. Phone numbers and hours can change, so confirm them on the official page. For more on this route, see our emergency dentist listings.

What not to do

The NHS gives these cautions for toothache and abscess:

• Do not go to a GP surgery for an abscess, because a GP cannot give dental treatment.
• Do not take more than the dose stated on the painkiller packet. The NHS says this will not make them work better and carries serious health risks.
• Avoid very hot, very cold or sweet food and drink, and do not smoke, because the NHS says smoking can make some dental problems worse.
• Do not give children salt-water rinses, because the NHS says they could swallow it.

While you wait for treatment, the NHS suggests over-the-counter pain relief, soft foods and a soft toothbrush. Follow the packet instructions and ask a pharmacist which pain relief suits you. This guide cannot give dosing advice.

If the problem began with a knock, nidirect has separate first-aid wording for a broken or knocked-out tooth. Our guide to a cracked or chipped tooth links to it.

Next step

If you need a dentist soon, start with your own practice, or browse practices that list emergency dental appointments in Belfast. Always phone ahead and confirm availability, as listings do not show current appointments.