Abscesses of the periodontium

Abscesses of the periodontium are localized, purulent infections that affect the periodontium, the supporting structures of the teeth. These abscesses can lead to the destruction of the periodontal ligament and alveolar bone, causing significant dental and oral health issues. There are primarily three types of periodontal abscesses: gingival, periodontal, and pericoronal.

Types

Gingival Abscess

A gingival abscess involves only the gum tissue, without affecting the deeper periodontal structures. It is often caused by the entrapment of food or other debris in the space between the tooth and the gum.

Periodontal Abscess

A periodontal abscess occurs deeper than the gingival abscess, affecting the periodontal ligament and alveolar bone. It is usually a complication of advanced periodontal disease, where bacteria invade the spaces between the gums and teeth, leading to infection and abscess formation.

Pericoronal Abscess

A pericoronal abscess (also known as a pericoronitis) occurs around the crown of a partially erupted tooth, most commonly the wisdom tooth. It is caused by the accumulation of bacteria and debris beneath the operculum, a flap of gum covering the partially erupted tooth.

Symptoms

Common symptoms of abscesses of the periodontium include:

• Pain, which can be severe and throbbing
• Swelling in the affected area
• Redness of the gums
• Discharge of pus
• Bad taste in the mouth
• Fever and general malaise in more severe cases

Diagnosis

Diagnosis of periodontal abscesses typically involves a thorough dental examination, which may include:

• Visual inspection of the gums and teeth
• Palpation of the affected area to assess for tenderness and swelling
• Dental X-rays to determine the extent of bone loss around the affected tooth
• Periodontal probing to measure the depth of periodontal pockets

Treatment

Treatment aims to drain the abscess, control the infection, and address the underlying periodontal disease. It may include:

• Incision and drainage of the abscess
• Scaling and root planing to clean the periodontal pockets and remove tartar
• Antibiotics to control the infection
• In severe cases, tooth extraction or surgical intervention may be necessary

Prevention

Preventive measures against abscesses of the periodontium include:

• Regular dental check-ups and cleanings
• Good oral hygiene practices, including brushing and flossing
• Avoiding tobacco and managing underlying health conditions that may contribute to periodontal disease

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