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Chronic periapical abscess

Summary

A periapical abscess is is a localised accumulation of pus around the end or the root of the tooth. The source of the infection is a necrotic (dead) pulp inside the tooth or a failing root canal treatment.

As opposed to an Acute Periapical Abscess which causes a lot of pain and swelling, a chronic abscess:

  • Generally painless although may be uncomfortable to bite on
  • Pus may be present and leaking into the mouth either from the gum margin or a sinus in the mucosa covering the end of the root.
  • Tooth may feel ‘spongey’ to bite on.
  • A chronic abscess can turn into an acute abscess at any point.

Home care advice

A chronic abscess will need treatment from a dentist after lockdown but as the symptoms are mild it should not cause an emergency during lockdown.

It is important to avoid it becoming an acute abscess so local measure to keep it clean should be taken:

  • Hot salty rinses to clean the area and encourage any drainage of pus that maybe occurring
  • Use of an antimicrobial gel such as Chlorhexidine Gluconate 1% may help fight the infection
  • Keep hydrated and rested to maintain a good immune response

If the abscess worsens and become acute see here for more details

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Treatment

  • Thorough cleaning of the mouth and improvement of oral hygiene
  • Deep cleaning of the area by a dentist or periodontist  +/- surgery
  • May also need a root canal treatment
  • Review
Written by Andrew Bain BDS MJDF (RCS Eng)
May 2, 2020