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Periodontal Abscess: Causes, Diagnosis & Complete Treatment

First of all, let’s look at this critical medical term “periodontal abscess” to make it easier for a standard propeller to row through the stream. The medical terminology looks tough while reading it, but having a little understanding makes it’s smooth. After comprehending the term, it becomes convenient for every person to know whether they are also facing the ailment.  Its significance can be revealed from the fact that the wrong conception may lead you to diagnose improperly. And this bitter reality may cause the practitioner to put someone’s worthy life in danger. Hence it’s essential for every professional and common man to have a concept about the disorder they thought they might be vulnerable to that disorder.

DEFINITION

The term “peri” refers to “in the surrounding or encircling any major entity or organ.” For example, a thin layer covering the heart consists of the word peri; similarly, peritoneum means around the abdominal cavity.  On the other hand, the term “odontal” refers to any structure surrounding the tooth. As the term dental signals towards teeth, in the same manner, odontal means outside the tooth. Hence our mind clicks towards “gums.” As gums are the nearest tissues surrounding the teeth?

Now let me elaborate that what does the word gum means? Most of us know that it is a type of connective tissue that is firm and covers the base of the tooth and arches of both mandible and maxilla. It is also known as “gingiva.” “Abscess” is the phenomenon in which there is a dreadful accumulation of pus; it may occur in any part of the body. The area has undergone abscess formation has faced microbial invasion due to which WBC’s fight with them and create white debris. The area affected with an abscess is inflamed and hyperactive.

Précising the long talk PERIODONTAL ABSCESS” has defined as:

“The pathological or destructive condition in which an abscess is formed in or on the gums leading to pain, inflammation, and pus accumulation is termed as PERIODONTAL ABSCESS.” A tiny red ball containing the pus and protruding from the gum reveals the condition on visual observation.

According to anatomical position, this abscess is also called a parietal and lateral spot, as it often originates on the lateral aspect of gum. It does not create from the tooth pulp.

Periodontal Abscess

TYPES OF PERIODONTAL ABSCESS

The periodontal abscess is categorized depending upon many bases. This type of spot communicates with its vicinity either through the gingival sac or other periodontal tissue. The oral cavity affected with periodontal abscess presented at the clinic must be adequately observed. It’s significant to diagnose and interpret the various types of periodontal abscess.

Lateral periodontal abscess

According to anatomical position, this abscess is also called a parietal and lateral spot, as it often originates on the lateral aspect of gum. It does not create from the tooth pulp. According to the anatomical description of the oral cavity, healthy gum’s gross appearance consists of pink colour, tough and engraved in nature. When the gum suffers from “lateral periodontal abscess,” then the gum’s outer or exposed side becomes inflamed, fleshy, and reddish.

Acute periodontal abscess

The periodontal abscess is locally affecting the oral cavity, characterized by purulent inflammation of the periodontal tissue. In medical terminology, the term “ACUTE” refers to any ailment or disorder that suddenly gets the worst form. The sudden onset of periodontal abscess causes the complications of gingivitis to prevail. Pain, inflammation, exudation, and sensitivity on palpation are common signs of an acute periodontal abscess.

It’s a ritual that acute cases in the medical profession need to be treated earlier; otherwise, the prognosis becomes poor in no time. Hence the periodontal abscess is marked as the third most usual dental emergence because it is swift.

Periodontal abscess vs. Periapical abscess

Before these two disorders, we must have a little notion about these terms in our minds. Hence I have already elaborated about a periodontal abscess. Now it’s the turn to known about the periapical bump. In dentistry, the apex is known as the tip of the root of the tooth embedded in the gum. When a purulent suppuration originates from the tooth’s peak, it is called the “PERIAPICAL ABSCESS.”

Features Periodontal abscess Periapical abscess
Anatomical position It affects the periodontal pockets, furcations, and vertical osseous line. It affects the apex of the tooth embedded in the tooth.
etiology It may occur due to bacterial invasion at the gum pockets. It may occur due to tooth decay or cavities.
Parts of the oral cavity affected It mostly affects the jaw bones It affects the soft pulp of the teeth.

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Gingival abscess vs. periodontal abscess

The gingival and periodontal abscess can be compared depending on their similarities and differences.

Gingival abscess Periodontal abscess
It is a type of purulent, localized infection that only affects the gum tissues. In periodontal abscess, the abscess occupies the tissues lying between the gum and the tooth.
Ligaments and other structures remain intact. In this type of abscess, deep gum pockets, jawbones, and surrounding tissues are severely traumatized.

 

Periodontal abscess and antibiotic:

Antibiotics or antibacterial drugs are medicine used to treat bacterial invasion. Hence periodontal abscess is also originated from bacterial attack, so antibiotics play a pivotal role in treating a periodontal abscess. The most common conditions in which antibiotics are employed include acute ones such as pyrexia, deliberate facial swelling, and Some of the most important antibiotics used to treat the gum or periodontal abscess contains:

  • Amoxicillin, clindamycin- this formula of antibiotics are most effective against anaerobic bacteria.
  • Metronidazole- also known as Flagyl, its mechanism of action comprises of antiprotozoal and antibiotic effect. It can be administrated through oral, intravenous, and topical routes.
  • The use of antibiotics is recommended after proper microbiologic analysis of aspirated pus.

Periodontal Abscess

Periodontal abscess causes

Etiological factors of any ailment are compulsory to be known. It will help in the diagnosis and treatment of that particular disorder. The causes of periodontal abscess are mostly originating from some primary disease. Let me elaborate on some of the core causes of periodontal abscess:

  • Blockage of deep periodontal pockets
  • Periodontitis is a primary disorder that causes a period of bone destruction. It ultimately leads to the formation of a periodontal abscess.
  • Microbiological invasion, particularly a gram harmful anaerobic bacteria. Following are the most common bacteria causing periodontal abscesses:
  1. Porphyromonas gingivalis-its prevalence ranges from 50% to 100%.
  2. Prevotella intermedia
  3. Prevotella melaninogenica
  4. Fusobacterium nucleatum
  5. Tannerella forsythia
  6. Treponema species
  7. Campylobacter species
  8. Capnocytophaga species
  9. Aggregatibacter actinomycetemcomitansor gram-negative enteric rods.

The marginal closure of the peri-gingival pocket could also lead to an extension of abscess formation in encircling tissues. It may lead to plaque formation, and consequently, the dental tissue deteriorates and causes severe pain.

Regional risk factors comprise a protruded tooth, hollowness on the root, cracked or broken tooth, or external root absorption, which can all put the patient to the development of periodontal pockets, that are then at risk of abscesses.

Periodontal abscess symptoms

Signs and symptoms of any disorder are apparent or felt anomalies that depict that patient suffers from a particular illness. Those signs and symptoms that a patient can only felt are termed as subjective symptoms. On the other hand, the symptoms observed with the naked eye by others are termed as objective symptoms. In the case of a periodontal abscess, the patient suffers from both types of subjective and objective symptoms. As bump means the accumulation of pus hence a prominent lump in the periodontal tissue can be seen. Other objective and subjective symptoms consist of:

  • Pyrexia OR fever
  • It is radiating pain from the inflamed gum to the neck, ear, eyes, and jaw.
  • Inflamed sub-mandibular lymph nodes
  • Swelling of cheeks and face and jawline
  • Erythematous gums or reddish gums due to clogged blood
  • Malaise
  • Halitosis
  • Foul taste
  • Pain and tenderness on gum palpation either by masticating or grinding
  • Tooth extrusion.

Periodontal abscess diagnosis

The phenomenon of identifying the disease with the help of signs and symptoms, laboratory tests, history, and physical analysis is known as a diagnosis. When we discuss the diagnosis of a periodontal abscess, the first step is history and physical examination. History taking task is crucial to recognize that whether the patient has periodontal treatment previously or not. While asking the patient about his/her body parameters, a practitioner must ask for diabetes. Hence diabetes has been recognized as one of the predisposing factors in causing periodontal abscess. Now, if we talk about the physical examination in diagnosing a periodontal abscess, then symptoms told by the patient and those encountered by observing is a pivotal one.

Radiographs of periodontal tissue also give a clear image of the extent of the severity of this disorder. The hard tissues, especially the periodontal ligament and horizontal or vertical bone, are viewed. In advanced cases of periodontal abscess, the alveolar bone may be lost. In laboratory analysis, the pus sample collected on palpation from the spot is probed under the dark field microscope to know whether it is a periapical abscess or periodontal abscess. Hence the microflora is varied in both disorders.

Periodontal Abscess

Periodontal abscess home remedies treatment

OHH!! The home remedies, my personal favourites one, are the most accessible treatment for every next person to do it by him/herself. No doubt, home remedies are the convenient one but let me tell you that they are time-consuming and don’t give ultimate results. However, trying the home remedies does play a role in relieving pain if no dental appointment has been booked after having a periodontal abscess.

Let’s have a look of few home remedies which will help to treat periodontal abscess as well as another type of gum-related issues:

  1. Maintaining good oral hygiene will going to prevent you from any abscess formation. The microflora of the oral cavity can be prevented from harmful bacteria by having gargles of saltwater. A glass of warm water with a saturated amount of salt will heal abscessed gum and help relieve pain.
  2. Following kitchen ingredients will also help to relieve pain and to make you feel better:

Fenugreek tea, garlic, baking soda, thyme essential oil, and hydrogen peroxide application will help alleviate gums’ pain.

Periodontal abscess treatment

Analgesics, local anaesthetics are the drug of choice for treating a periodontal abscess. In chronic and acute conditions, root canal treatment is also preferable. It involves the removal of abscess material before its sealing. Tooth extraction may also be preferred. However, the use of antibiotics is also preferred, but it may disturb the metabolism; hence it is recommended for short term use. Amoxicillin, Metronidazole, tetracycline are most usually recommended systemic antibiotics for abscess treatment.

Questions:

How do you treat a periodontal abscess?

The periodontal abscess is treated either by draining them and then taking oral medications like local anaesthetics, antibiotics, and painkillers, including ibuprofen or paracetamol.

Will a periodontal abscess go away?

Yes, patients can get relief from a periodontal abscess, and this oral problem can be corrected by taking proper management and treatment. Good oral hygiene will go to prevent you from the formation of periodontal abscess and in getting rid of it.

What does a periodontal abscess feel like?

You might feel pus-like foul taste while eating, pain, inflammation, swishing sensation on palpation, and severe malaise or irritation.

Is a gum abscess an emergency?

Yes, a gum abscess is the third most common oral emergency. Immediately after encountering the symptoms of a gum abscess, you must contact your dentist.

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