Management of acute dental infections requires an understanding of microbiology, anatomy, pharmacology, wound healing, and oral surgery. Recognizing early signs of inflammation and differentiating them from characteristics of an infection facilitates timely intervention and avoids further complications. This article addresses various aspects of the diagnosis and treatment of acute oral infections. Suggestions are made to help differentiate between swelling associated with an infection and edema related to inflammation of nonpathogenic origin. In addition, discussion focuses on how to distinguish between an abscess and cellulitis, when to culture, and which antibiotics to select to resolve an infection. Protocols for managing an infection with and without fluctuance are reviewed. Finally, the consequences of spreading cellulitis are discussed, and signs indicating the need for referral of a patient are delineated.