Drainage of abscess through pocket is usually the first treatment that is given to the patient. It is followed by scaling of the tooth surface, compression and debridement of the soft tissue wall and irrigation with antibiotic solutions. If a foreign body is present in the pocket, it should be removed.
What is the treatment for periodontal abscess?
Treatment of periodontal abscess is done in two steps, First and foremost is the management of the acute lesion. Later on, appropriate treatment of the original and/or residual lesion is done once the acute situation has been controlled. Drainage of abscess through pocket is usually the first treatment that is given to the patient.
What is a lateral periodontal abscess?
A lateral periodontal abscess is a result of rapidly-growing bacteria within a periodontal pocket. A periodontal pocket forms in the presence of periodontal disease, as the gums become infected and pull away from the surface of the teeth.
When to go to the ER for a periodontal abscess?
Go to the emergency room (ER) if the periodontal abscess is associated with: 1 Fever (more than 38°C). 2 Severe facial swelling. 3 Severe pain that can’t be controlled by OTC painkillers. 4 Tenderness or swelling of the lymph nodes in your neck. 5 Difficulty breathing or swallowing.
What are combined periodontal/endodontic abscesses?
Combined periodontal/ endodontic abscesses: In this case, the localized, circumscribed abscess which either originates from dental pulp or the periodontal tissues surrounds the root apex and/or the apical periodontium of the involved tooth.
What is the first line of treatment for periapical abscess?
Amoxicillin is still the first-line drug of choice but with 34% of Prevotella species resistant to amoxicillin, the alternatives of amoxicillin/clavulanate, clindamycin, and metronidazole need to be considered.
What is the first stage of periodontal therapy?
Emergency treatment is the first priority for any dental patient in need of it. This includes extracting or root canal treating infected or abscessed teeth, treatment of periodontal abscesses, or beginning root canal treatment of Endo-Perio Lesions. This may include antimicrobial therapy.
What antibiotic is used for periodontal abscess?
Antibiotics like Penicillin, Metronidazole, Tetracyclines and Clindamycin are the drugs of choice. Periodontium' is the general term that describes the tissues that surround and support the tooth structure. The periodontal tissues include the gums, the cementum, the periodontal ligament and the alveolar bone.
How do dentists treat periodontal abscess?
Treatment for a gum abscess involves draining the abscess and removing any debris in your periodontal pocket. Your dentist may suggest a deep cleaning procedure called scaling and root planning. This procedure removes plaque and tartar from above and beneath the gum line.
What are the different phases of periodontal therapy?
Principally the comprehensive periodontal therapy can be divided into four main phases: phase I. initial or cause related therapy, phase II. surgical therapy, phase III. periodontal reconstruction, and phase IV.
What is Phase II periodontal therapy?
The Periodontal Surgical Therapy phase involves surgical access to the root surfaces to provide further detailed cleaning, and then there are various additional surgical techniques, which may be employed in an attempt to achieve some regeneration of the lost periodontal attachment of the teeth.
How do I manage a patient with periodontal abscess?
In most cases, your dentist will give you antibiotics to stop the infection. He or she may need to cut open (lance) the abscess so that the infection can drain. This should relieve your pain. You may also need more dental treatment, such as tooth removal or oral surgery to fix bone damage caused by the abscess.
Why is amoxicillin in periapical and metronidazole in periodontal disease?
The findings demonstrated that in patients with advanced periodontal disease, systemic administration of metronidazole plus amoxicillin resulted in (i) an improvement of the periodontal conditions, (ii) elimination/suppression of putative periodontal pathogens such as A. actinomycetemcomitans, P. gingivalis, P.
What are 5 typical antibiotics used in dentistry?
What Are The Antibiotics Used In Dentistry?Amoxicillin.Azithromycin.Cephalexin.Clindamycin.Penicillin.
How do you treat a gum abscess?
TreatmentOpen up (incise) and drain the abscess. The dentist will make a small cut into the abscess, allowing the pus to drain out, and then wash the area with salt water (saline). ... Perform a root canal. This can help eliminate the infection and save your tooth. ... Pull the affected tooth. ... Prescribe antibiotics.
Is a periodontal abscess an emergency?
Periodontal abscesses are a common and painful dental emergency resulting from bacterial accumulation or foreign body impaction in periodontal pockets. They affect both patients with or without active periodontal disease and require prompt management acute and long-term management.
What is the best antibiotic for gum infection?
Amoxicillin is usually the first choice for tooth infection treatment. If your tooth infection is more serious, your dentist may prescribe a combination of amoxicillin and another drug called Clavulanate....Penicillins are a group of antibiotics including:Penicillin.Amoxicillin.Amoxicillin/potassium clavulanate.
What is a periodontal abscess?
Periodontal abscess is a localized acute bacterial infection confined to the tissues of the periodontium and not arising from the tooth pulp. It is an acute destructive process in the periodontium resulting in localized collections of pus, communicating with the oral cavity through the gingival sulcus or other periodontal sites. It is the third most frequent dental emergency, representing 7-14% of all dental emergencies and affecting 6-7% of all patients 1. It is formed as a result of rapidly growing bacteria within a periodontal pocket, resulting in abscess formation. It is a frequent periodontal condition in which periodontal tissues may be rapidly destroyed. Periodontal abscesses may result in complications, due to bacteremia, that may cause infection in distant locations 2-3.
What is the first treatment for an abscess?
Drainage of abscess through pocket is usually the first treatment that is given to the patient. It is followed by scaling of the tooth surface, compression and debridement of the soft tissue wall and irrigation with antibiotic solutions. If a foreign body is present in the pocket, it should be removed.
What is the redness of the gingiva?
The gingiva appears red, swollen and tender 5-6. In the early stages, there is no fluctuation or pus discharge, but as the disease progresses, the pus and discharge from the gingival crevice become evident. Lymph node enlargement may be evident as the duration of infection prolongs.
What is it called when you have a tooth abscess?
When the abscess develops during a short period of time, within days or a week, it is called as an acute periodontal abscess. There is sudden onset of pain on biting and a deep throbbing pain in the involved tooth. The gingiva appears red, swollen and tender 5-6.
How long does it take to get a dental abscess recalled?
Systemic antibiotic and anti-inflammatory treatment is started and the patient is recalled for re-assessment within 24-48 hours. Systemic antibiotic treatment for the dental abscess prevents any bacterial spread and serious complications 27-29.
How long does it take for gingivectomy to return to normal?
As stated above, systemic antibiotic and anti-inflammatory treatment is started. Gingiva returns to normal within 6 to 8 weeks. In some cases, however, where the vertical bone loss and deep pockets are present, gingivectomy or periodontal flap procedures are recommended 9.
Can you test for periodontal abscess before starting antimicrobial therapy?
Culture sensitivity testing of microorganisms involved in periodontal abscess before starting antimicrobial therapy is not feasible in many cases because it is an acute condition requiring immediate treatment and also obtaining a clean bacterial sample for culture is difficult.
What is the treatment for a large periodontal abscess?
However, this is a temporary solution and you will need further treatment. Scaling and root planing: it is also known as non-surgical periodontal therapy.
What is the best pain reliever for periodontal abscess?
You may need over-the-counter (OTC) painkillers to control the pain until you can see your dentist. OTC painkillers include ibuprofen, paracetamol, and aspirin.
What is the difference between periapical and periodontal abscess?
A tooth with a periodontal abscess will be more tender to horizontal percussion (perpendicular to the long axis of the tooth). A tooth with a periapical abscess will be more tender to vertical percussion (with the long axis of the tooth).
What are the risk factors for gum abscess?
Several factors may increase the risk of tooth abscess, include: Poor oral hygiene : plaque is the primary cause of gum disease.
What is the term for a tooth abscess?
If this inflammation is left untreated, it may cause pain and the formation of an abscess (pericoronal abscess). The periodontal abscess is a type of tooth abscess. The other types are periapical, gingival, and pericoronal abscess.
What is pericoronitis in dentistry?
A pericoronal abscess occurs within the gingiva that covers a partially erupted or impacted tooth. Poor oral hygiene can lead to the accumulation of bacteria around the gum tissue that covers a partially erupted or impacted tooth, causing inflammation (pericoronitis). If this inflammation is left untreated, it may cause pain and the formation of an abscess (pericoronal abscess).
What is the term for a tooth abscess that spreads through the periodontal ligament?
This is known as combined Endo-Perio lesion.
What is an abscess in the periodontal?
Periodontal Abscess. Localized, purulent infection within the tissues adjacent to the periodontal pocket that may lead to the destruction of periodontal ligament and alveolar bone.
Can an abscess be incision?
In addition, incision of the abscess may be necessary. If the abscessed tooth does show advanced attachment loss and its prognosis is poor, extraction should be the recommended course of action. A referral to the periodontist is usually recommended for stage-two treatment.
Periodontal Abscess
Presentation
- More Likely to Occur Periodontitis-related abscess: 1. as an acute exacerbation of untreated chronic periodontitis 2. as the consequence of the treatment of chronic periodontitis Nonperiodontitis-related abscess: 1. due to foreign body impaction 2. due to alterations in the integrity of the root leading to bacteria colonization Signs 1. In the presence of a superficial abs…
Investigation
- Inquire about any history of chronic periodontitis and the nature of any recent dental/periodontal interventions.
- Determine the existence of a periodontal pocket (Fig. 1).
- Confirm the presence of purulent exudate.
- Obtain radiographic evidence of bone loss. However, the lack of evident bone loss does not n…
- Inquire about any history of chronic periodontitis and the nature of any recent dental/periodontal interventions.
- Determine the existence of a periodontal pocket (Fig. 1).
- Confirm the presence of purulent exudate.
- Obtain radiographic evidence of bone loss. However, the lack of evident bone loss does not necessarily eliminate the existence of a periodontal abscess.
Diagnosis
- Based on clinical observations/investigation, a diagnosis of periodontal abscess is determined. Differential Diagnosis 1. Periapical abscess 2. Lateral periodontal cyst 3. Periodontic-endodontic lesion In case of recurrent abscesses, the following differentials should be considered: 1. Osteomyelitis 2. Squamous cell carcinoma 3. Eosynophilic granuloma
Treatment
- Two-Staged Approach 1. Management of the acute lesion Systemic antibiotics should be prescribed only when systemic involvement is evident. 1.1. Establish drainage via pocket lumen through subgingival instrumentation of the root surface. In addition, incision of the abscess may be necessary. 1.2. If the abscessed tooth does show advanced attachment ...