Q. What has to be done for hole in tooth with pain and swelling?

Answered by
Dr. Deepti Jakhmola
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 23, 2022

Hello doctor,

My mother is 45 years old. She got a hole in teeth and she is complaining of a toothache for three days and from yesterday, she developed swelling on the right half of the face. Is this any sort of emergency?



Welcome to

After going through your query and image sent by you (attachment removed to protect patient identity), this seems to be a case of severe infection inside the right tooth. Tooth decay has resulted in infection in the innermost part of the tooth called pulp that contains nerves and blood vessels.

The Probable causes:

Deep dental caries.

Investigations to be done:

Intraoral periapical radiograph (X- ray).

Differential diagnosis:

Acute periapical abscess or buccal space infection.

Probable diagnosis:

Acute exacerbation of chronic periapical abscess.

Treatment plan:

1. Treatment can be planned after analyzing the X-ray.
2. To reduce pain and swelling, antibiotics and anti-inflammatory drugs can be given for 3 to 5 days.
3. If infection beneath the root is not in excess, then root canal treatment can be done.
4. In case of excessive pus and infection, pus drainage followed by extraction should be done.
5. Immediate extraction is not advisable.

Preventive measures:

1. No hot fomentation should be done.
2. The face should not be covered.
3. No massage should be done.
4. Biting from the affected side should be avoided.

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