Could My Baby Have a Dental Abscess?
The short answer
A dental abscess is a pocket of pus caused by a bacterial infection, usually from an untreated cavity. Signs include a visible bump or boil on the gum near a tooth, swelling of the face or cheek, pain (especially when chewing), fever, and foul taste in the mouth. A dental abscess needs prompt treatment by a dentist because the infection can spread. Treatment may include antibiotics, drainage, and addressing the underlying tooth problem.
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By Age
What to expect by age
Dental abscesses do not occur in babies without teeth. However, gum cysts (Epstein pearls or Bohn nodules) can appear on newborn gums and may look concerning but are completely harmless and resolve on their own. If you notice any unusual growth or swelling on your newborn's gums, have your pediatrician examine it.
With teeth just starting to emerge, abscesses are extremely rare. Any unusual swelling on the gums at this age is more likely related to teething (eruption cyst) or a benign cyst. An eruption cyst appears as a bluish swelling over an erupting tooth and resolves on its own.
As more teeth erupt, dental trauma (falls while learning to walk or stand) can damage a tooth, which may later develop an abscess. If your baby bumps a tooth and it becomes discolored weeks later, this may indicate the nerve has been damaged. Watch for gum swelling above the discolored tooth.
Dental abscesses become possible, especially if cavities develop. Signs include a pimple-like bump on the gum, facial swelling on one side, refusal to eat (especially hard foods), drooling, fever, and irritability. If you see a bump on the gum that releases pus, or facial swelling, contact your dentist promptly.
Children with early childhood cavities are at risk for dental abscesses. The primary teeth most commonly affected are the upper front teeth and the molars. Treatment may include antibiotics, drainage, pulp therapy (baby tooth root canal), or extraction of the affected tooth. Untreated abscesses can affect the developing permanent teeth underneath.
What Should You Do?
When to take action
- Mild gum swelling around an erupting tooth that resolves as the tooth comes in
- A small bluish cyst over an erupting tooth (eruption cyst) that resolves on its own
- Your baby chews on things and drools during normal teething
- You notice a small bump or boil on the gum near a tooth
- A previously injured tooth has become discolored and the gum above it is swollen
- Your child has persistent tooth pain or avoids chewing on one side
- Your child has facial swelling (especially around the eye or under the jaw), fever with dental symptoms, or difficulty swallowing or breathing
- A gum abscess is draining pus and your child appears ill or has high fever
Sources
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Trust your instincts. If something feels wrong, reach out to your pediatrician.
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Related Medical Concerns
Tooth Abscess in Babies
A tooth abscess is a bacterial infection that causes a pocket of pus to form around a tooth. In babies and toddlers, it usually results from untreated tooth decay. Signs include a visible swelling or bump on the gum (sometimes called a gum boil), facial swelling, fever, irritability, and refusal to eat. A dental abscess is a medical urgency that requires prompt evaluation and treatment by a dentist, as the infection can spread.
Early Childhood Cavities (ECC)
Early childhood caries (ECC) is one of the most common chronic diseases in young children, affecting about 23% of children under age 6 in the United States. ECC is caused by bacteria, primarily Streptococcus mutans, that produce acid when exposed to sugars. Baby teeth are especially vulnerable because their enamel is thinner. Early detection and treatment are critical because untreated cavities can cause pain, infection, and damage to developing permanent teeth.
My Baby's Tooth Was Knocked Out or Loosened by a Fall
If a baby tooth is knocked out, do NOT try to replant it (unlike permanent teeth). Apply gentle pressure with gauze to stop bleeding. If a tooth is loosened or displaced, see a dentist within 24 hours. If a tooth is pushed up into the gum (intruded), see a dentist promptly as this can affect the permanent tooth developing underneath. Save any tooth fragments for the dentist to examine.
Baby Chipped or Knocked Out a Tooth
Dental injuries are common in toddlers who are learning to walk and run. A chipped baby tooth usually just needs smoothing by a dentist. A knocked-out baby tooth should NOT be reimplanted (unlike permanent teeth), as reimplanting can damage the developing permanent tooth underneath. A tooth that has been pushed up into the gum (intruded) needs dental evaluation but often re-erupts on its own. The most important step is controlling bleeding and watching for infection.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.