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Periodontal abscesses are one most common dental emergency seen in the dental office. The term periodontal refers to tissue and bone surrounding or encasing a tooth. Periodontal abscesses are a sequela to Periodontal disease. This condition is directly related to the supporting structure of the teeth, the bone and the ligaments (commonly referred to as the periodontium). A periodontal abscess is the result of extension of inflammation and infection into the supporting structure of the teeth and the subsequent destruction of the periodontium. As the supporting structure is destroyed pockets are formed that provide an area for the accumulation of food, plaque, calculus (tartar) and bacteria. Ultimately a infection pursues, and an abscess is born.

Symptoms of a Periodontal Abscess

Unlike a toothache periodontal disease is usually painless in its early stages. It begins as an inflammation of the tissue round the neck of the tooth commonly referred to as
Gingivitis and becomes Periodontitis as the supporting structure is destroyed.
Most patients requiring emergency treatment are in the acute phase of periodontal disease.

1. A periodontal abscess is characterized by swelling of the gums (gingiva) adjacent to a tooth or teeth.
2. The painful swollen area often arises overnight.
3. In the early stages, the pain is a continuous throbbing and burning sensation.
4. Usually does not prevent sleeping or eating.
5. The adjacent tooth is usually not sensitive to touch, but mobility may be present.
6. Generally there is no lymph node involvement or swelling under the chin.
7. In the latter stages there is reduction of size, pain and often there is a nasty taste in the mouth as the abcess drains (usually around the neck of the tooth). However, the feeling of discomfort may remain.
8. They tend to be recurrent when left untreated.

Note: A periodontal abscess must be differentiated from a tooth abscess (periapical abcess). In a periapical abscess, there is often sensitivity to percussion, no nasty taste in the mouth, there may be loss of sleeping and eating, lymph node involvement, fever, and swelling under the chin and neck.

Temporary Treatments for Periodontal Abscess

The best way to get temporary relief from a periodontal abscess is through antibiotic therapy, and pain relieving medication such as ibuprofen or acetaminophen. This can generally be accomplished by seeing an emergency dentist, or going to an emergency medical facility. Generally it takes between 24-48 hours for antibiotics to take affect. While it is beyond the scope of this website to mention permanent treatment entities, periodontal treatment should be iniated immediately to prevent recurrent episodes, in some case tooth extraction may be indicated.