A periodontal abscess is a localized collection of pus within the tissues of the periodontium ( Tissues that surround the tooth). This periodontal abscess is a pocket of pus in the tissues of the gum. It is a one type of dental abscess. It occurs alongside a tooth, classified primarily by location and considered an acute bacterial infection.
The prevalence of periodontal abscess is relatively high and it affects the prognosis and future of the tooth. Periodontal abscesses can happen usually for patients, having an existing periodontitis but can also occur in the absence of periodontitis. The cause of the development of periodontal abscess is the marginal closure of a periodontal pocket, or the pocket lumen (space) might be too tight to drain the pus. Also, changes in the composition of subgingival microflora ( bacteria), alteration of bacterial virulence or host defenses, can be the reasons as well.
Periodontal abscess symptoms
A periodontal abscess normally appears as a complication of advanced periodontal disease. A periodontal pocket contains dental plaque, bacteria and calculus. An inflammation takes place when bacteria attack the soft tissue of the periodontal pocket, forming a puss-filled abscess when the body attempts to isolate the infection from spreading. When pus forms, the pressure increases, with increasing pain, until it spontaneously drains and relieves the pain. When pus drains into the mouth, a bad taste and smell are perceived. Usually drainage occurs via the periodontal pocket, or else the infection may spread to deeper tissues or might cause a purulent odontogenic infection. There may be systemic upset, with an onset of malaise and fever.
Periodontal abscesses usually present a painful situation for the patient. It should be treated immediately to relieve pain and resolve the infection. If left untreated, it may spread and lead to severe, irreversible periodontal attachment loss (Gum and Bone loss).
Periodontal abscess Treatment
Periodontal abscess treatment may include drainage through an incision or through the pocket orifice, and root planning is required as well as the use of antimicrobial agents when necessary.
Although an abscess may result in considerable bone loss attachment during its acute phase, this lesion has very high potential for repair after the proper treatment is performed. Although little periodontal support might remain , treatment of the acutely affected tooth should be performed, because regeneration of lost periodontal attachment may happen.
If systemic signs or symptoms are present, antibiotics could be prescribed, and it is desirable that the patient is given a systemic antibiotic to treat the acute infection. Penicillin is frequently used for this type treatment.
Postoperative care is important for the success of the procedure, so the patient should be seen after few days of initial treatment in order to check that everything is resolved. After the abscess has healed up, a full examination of the patient is appropriate around the 1-2 weeks frame, so proper diagnosis can be done and accordingly, a long term treatment plan needs to to be made.