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Acute periodontal abscess

Pain of a gum abscess

Summary

An acute periodontal abscess (gum abscess) is an infection around a tooth usually caused by an acute flare up of existing gum disease. Periodontal means around the tooth and this means that the disease affects the supporting structures of the tooth - ie the gums, periodontal ligament (pdl) and alveolar bone.  Acute means that the infection is in its ‘acute phase’ which refers to the types of response your immune system is making to the infection. Basically it means it is likely to be very painful and swollen this swelling may extend to the face or jaw and there can also be an associated fever. 

Features 

  • Pain - well localised to a tooth, made worse by any pressure on the tooth
  • Tenderness and/or swelling in the gum around the root of the tooth
  • Looseness of the tooth - likely to have been loose before the infection also
  • Bleeding from the gums around the tooth
  • Swollen tender lymph glands - this is a sign that the infection is increasing
  • Facial swelling - in more severe case there can be significant swelling and an associated fever if left unchecked this infection can become a medical emergency.

Home care advice

A true abscess is difficult to treat yourself at home but there are a few

A periodontal abscess in its early stages may be managed with pain killers and hygiene measures and sometimes the immune system will keep the abscess under control. However if it gets more serious then it is likely to need professional attention. Any uncontrolled swelling especially when heading towards the neck and throat needs to be URGENTLY treated at an A&E department as there is the danger of life threatening conditions such as Ludwig's Angina.

  • Painkillers such as ibuprofen and paracetamol can be taken together to combat the pain. Always read the label and follow the instructions for use.
  • Hot salty rinses to clean the area and encourage any drainage of pus that maybe occurring
  • Keep hydrated and rested to maintain a good immune response
  • Use of an antimicrobial gel such as Chlorhexidine Gluconate 1% may help fight the infection
  • If above does not work then contact a dentist as you will need oral antibiotics - Any swelling which increases or does not respond to local measures will require a prescription for an antibiotic such as Amoxycillin (IF NO ALLERGY), Clarithromycin or Metronidazole.
  • IV Antibiotics - in a hospital environment if swelling keeps spreading as mentioned above.

Once lockdown is lifted the tooth will definitely need treatment from a dentist and probably referral to a specialist Periodontist (gum specialist)

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Written by Andrew Bain BDS MJDF (RCS Eng)
Apr 27, 2020