The Stages of a Gum Abscess

Hand written by Dr David Chen, an actively practicing dentist and avid writer. #doctorswrite

There are three stages to a gum abscess and they can be differentiated from one another based on the severity of the swelling. The infection originates from the gums and begins as localized swelling affecting a single tooth. However when it is left untreated, it starts to progress and spread.

Gum abscess stages
Gum abscess stages – progressions

Gum abscess stages:

  1. Localized gum swelling around one tooth.
  2. Generalized gum swelling around multiple teeth.
  3. Gum swelling with facial swelling.

The progression of this dental abscess involves greater swelling with each subsequent stage. Consequently the treatment for it also becomes more complex and costly.

Stage 1 – Localized swelling

The first stage of a gum abscess is localized gum swelling around the affected tooth. The infection is limited to a single tooth because it is the beginning of the abscess. Essentially it starts with one tooth.

Signs and symptoms:

  • Swollen gums but limited to a single tooth
  • Red and poofy looking
  • Bleeds easily upon touching or brushing
  • Constant mild dull pain

The abscess is fairly mild and small in size at this stage but when left untreated, it will start growing and involving more teeth.

Stage 2 – Generalized swelling

The second stage of a gum abscess is generalized swelling which affects multiple teeth. The infection has spread from the affected tooth to the adjacent teeth. The size of the abscess is significantly larger than the first stage.

Signs and symptoms:

  • Swollen gums around multiple teeth that are adjacent
  • Very red and poofy looking gingiva
  • Bleeds very easily upon touching or brushing
  • Constant moderate dull pain

The longer you leave this stage of the abscess untreated, the more the swelling will spread. At first it may only affect 2-3 teeth but it can grow to involve the entire quadrant of teeth.

Stage 3 – Facial swelling

The third stage of a gum abscess is facial swelling in addition to generalized gum swelling. The abscess has spread beyond just the gums and the teeth at this stage because it now affects your face.

Signs and symptoms:

  • Gums swollen around multiple teeth
  • Very red and poofy looking gingiva
  • Bleeds very easily upon touching or brushing
  • Severe pain
  • Face is swollen and looks disfiguring

This condition can look incredibly disfiguring because the face can be swollen to the size of a golf ball or bigger. Typically once patients have this, it becomes a dental emergency where they’ll drop everything that they’re doing to get it treated.


The treatment for each stage of a gum abscess will differ since the extent and severity of the infection are different. Of course the more advanced the disease is, the more complex and expensive the treatment will be.

Treatments for a gum abscess:

  • Scaling and root planing. Commonly known as a deep cleaning, the root surfaces below the gum line will be cleaned. That is in addition to what is above the gum line.
  • Gingival curettage. Instead of cleaning the teeth, the insides of the gums will be scraped to remove granulation tissue and infection.
  • Incision and drainage. For severe swelling, full drainage of the abscess is needed. An incision into the swelling followed by manually draining it.
  • Antibiotics. Oral antibiotics in pill form along with a rinse may be prescribed. Their purpose is to help clear out the infection and reduce the chances of recurrence.

Which treatment do I need?

The more severe your condition is, the more involved the treatment will be. We’ve created a decision tree as a guide so you have an approximate idea of what to expect.

Gum abscess stages - Treatment
Treatment modalities

In the case for gum infections, you may find it interesting that more treatments are added on as the condition advances. The procedure doesn’t simply change as you move from one stage to the next, it simply gets added on to the list.

Treatment for each stage of a gum infection:

  • Stage 1 – scaling and root planing, gingival curettage
  • Stage 2 – scaling and root planing, gingival curettage, incision and drainage
  • Stage 3 – scaling and root planing, gingival curettage, incision and drainage, antibiotics

What you can take away from this is that you should get it treated as soon as possible. Less procedures will be involved which also means it’ll be less expensive.


A gum abscess will progress through three distinct stages if left untreated. With each stage the infection grows bigger and the swelling worsens. Treatment for each stage also becomes more complex and costly.

You should see your dentist as soon as you suspect a gum infection. Your wallet will thank you.


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The purpose of the content at afterva is to encourage you to seek in person care with a doctor. It's not nor was it ever meant to be a substitute for medical advice. Every situation is unique and impossible to diagnose without a clinical exam.

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