Should I go to the emergency department, or to the dentist in the morning?

If there is any finding to do with breathing, swallowing or your voice, nothing is waited for; call 112. Even without those findings, swelling that reaches the tongue and the floor of the mouth should be assessed the same day. Even with swelling that stays in the lip and does not progress, the cause still needs looking into, because it is likely to come back.

How do I tell it apart from swelling due to a dental abscess?

The timing and what comes with it point the way. Swelling from an abscess usually begins with a painful tooth, grows over days, the skin reddens and warms, and a temperature may be seen. In sudden swelling there is most often no painful tooth, the swelling arrives within hours, and it gives more of a feeling of tightness. The definite distinction is made by an examination; if you are in any doubt, do not hold off on being assessed.

The same swelling happened before and went on its own, should I still have it looked at?

Yes. An attack that settles on its own does not show that the next one will be mild, and it does not make looking into the cause unnecessary. With attacks that keep coming back, the link with medicines, foods and materials you come into contact with is looked at; noting the dates of the attacks makes that easier. This history also needs to be known before any dental procedure is carried out.

Sudden swelling of the lip and tongue: what to do

What does this mean?

Sudden swelling happens when fluid inside the blood vessels leaks into the surrounding tissue in a short time. The lips, the eyelids and the tongue are the areas that hold this fluid most readily, which is why the swelling becomes visible within minutes or a few hours. The swollen area feels tight, most often does not itch, and does not leave a dent when you press on it.

The telling details are the speed and what comes with it. In sudden swelling there is usually no redness, heat, temperature or throbbing toothache; the swelling arrives overnight. Swelling from an infection that comes from a tooth, on the other hand, grows over days, hurts when touched, the skin reddens and warms, and a temperature and feeling unwell most often go with it. Even though the two pictures swell the same place, their paths are completely separate.

There is also a difference between swelling that stays in the lip and swelling that spreads to the tongue, to the floor of the mouth or to the throat. The tongue being pushed up and back, the voice changing, saliva that cannot be swallowed and a noise you can hear as you breathe all show that the airway has begun to narrow. Once these findings appear, waiting is not the right thing to do; how fast the swelling will progress cannot be predicted in advance.

Behind sudden swelling of the lip and tongue there can be allergic mechanisms, non-allergic ones, or a dental infection spreading fast; the distinction is made by how quickly the swelling develops and by whether pain and a temperature are there.

Likely causes

Angioedema Dental Abscess Facial cellulitis

What helps at home?

Write down the medicines you have recently started, what you ate that day and your last dental procedure; this information is directly useful at the emergency department.
Do not warm the swollen area, rub it or try to empty it; none of that reduces the swelling and it can make things worse.
If you have had a similar attack before and have been given an emergency medicine, follow the instructions you were given for it; even if you have used the medicine, do not put off asking for help.
Do not stay on your own; if the swelling progresses you may struggle to speak, so it matters that someone is with you.

When not to wait

If you are struggling to breathe, or there is a whistling sound as you breathe
If your tongue has swollen so much that it does not fit in your mouth, or you cannot swallow your saliva
If your voice has changed, or sounds hoarse or weak
If the swelling is growing and spreading within minutes
If a rash, tummy pain, a temperature or feeling faint comes with the swelling

Frequently asked questions

Should I go to the emergency department, or to the dentist in the morning?: If there is any finding to do with breathing, swallowing or your voice, nothing is waited for; call 112. Even without those findings, swelling that reaches the tongue and the floor of the mouth should be assessed the same day. Even with swelling that stays in the lip and does not progress, the cause still needs looking into, because it is likely to come back.
How do I tell it apart from swelling due to a dental abscess?: The timing and what comes with it point the way. Swelling from an abscess usually begins with a painful tooth, grows over days, the skin reddens and warms, and a temperature may be seen. In sudden swelling there is most often no painful tooth, the swelling arrives within hours, and it gives more of a feeling of tightness. The definite distinction is made by an examination; if you are in any doubt, do not hold off on being assessed.
The same swelling happened before and went on its own, should I still have it looked at?: Yes. An attack that settles on its own does not show that the next one will be mild, and it does not make looking into the cause unnecessary. With attacks that keep coming back, the link with medicines, foods and materials you come into contact with is looked at; noting the dates of the attacks makes that easier. This history also needs to be known before any dental procedure is carried out.

This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.

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