A gum abscess, also called a periodontal abscess, is a painful infection in the gums. An abscess occurs when bacteria or foreign matter enters the gum tissue, usually through a crack or cut and causes an infection. The infected area fills with pus, which is made up of dead tissue, bacteria, inflammatory cells and proteins. If left untreated, a gum abscess can lead to more serious health issues. This content covers everything you need to know about the causes, symptoms, diagnosis and treatments for gum abscesses.
What Causes a Gum Abscess?
There are several potential causes of a gum abscess:
Advanced Periodontal Disease
Periodontal or gum disease occurs when plaque builds up on the teeth and gums. Over time, this leads to inflammation and can damage the tissues that support the teeth. An advanced stage of gum disease, called periodontitis, affects the deeper structures of the gums and bone. This can lead to the formation of a pocket between the tooth and gum, allowing bacteria to become trapped and multiply. The body’s immune response causes the infected area to become inflamed and swollen with pus – an abscess.
Injury to the Gums
Trauma to the gums from foreign objects like toothpicks, fish bones, popcorn kernels, etc. can puncture or tear the gum tissue. Bacteria can then enter via these cuts or cracks and infect the area. Grinding or clenching the teeth can also put excess pressure on the gums and cause cracks or injury.
Reaction to a Deep Filling
Sometimes deep dental fillings can irritate the gum and bone tissue surrounding the tooth. This may trigger inflammation and abscess formation as the tissues react to the filling material.
Complication of Oral Surgery
Procedures like tooth extractions, implants and periodontal surgery come with a risk of infection at the site which could then spread to the gums. An abscess may form if proper care is not taken after oral surgery.
Common Signs and Symptoms
The most common signs and symptoms of a gum abscess include:
Swelling and Inflammation
An obvious indicator is puffy, red, swollen gums around the affected tooth. There may be generalized swelling of the cheek or face on the same side as the abscess as well. The area typically feels tender when touched or chewed on.
Intense Throbbing Pain
As the pressure builds up inside the abscess, it presses on the nerve endings in the gums, causing severe throbbing pain. The pain is often described as intense pulsing and may prevent proper chewing or even talking.
Pus Drainage
The abscess may rupture on it’s own, releasing the trapped pus into the mouth. This results in an unpleasant taste in the mouth and bad breath. There could be some bleeding too.
Tooth Sensitivity
The infection puts pressure on nearby teeth and exposes dentin. This can lead to tooth sensitivity, especially to hot or cold food and drinks.
Fever and Overall Discomfort
Other generalized symptoms like a low-grade fever, nausea, fatigue and discomfort may accompany a severe or advanced abscess. Lymph nodes near the affected area may become swollen and tender as well.
Professional Diagnosis
See your dentist right away if you notice any signs of a possible gum abscess. Timely treatment is crucial to prevent complications. The dentist will examine your oral cavity and may use the following diagnostic approaches:
Visual and Physical Examination
Your dentist will check for visual indicators of an abscess like swollen, red gums, drainage of pus, etc. Palpating the softened gum tissues can help pinpoint areas of tenderness and inflammation. Tapping on suspect teeth may cause discomfort as well.
Radiographic Imaging
X-ray imaging allows clear visualization of damage below the gum line and areas where pus has accumulated. It also helps find tooth decay or cracks that could be causing the infection. Imaging is needed to confirm the diagnosis and formulate the ideal treatment plan.
Microbiological Testing
A sample of the drainage or infected gum tissue may be sent to the lab for microbiological analysis. This finds out the exact type of bacteria inhabiting the site. Identifying the pathogens facilitates targeted antibiotic treatment.
How is a Gum Abscess Treated?
Treating a gum abscess requires medications and dental procedures. The main treatment goals include draining the pus, eliminating the infection, preventing further spread and addressing the underlying cause.
Prescription Antibiotics and Pain Medication
Most patients need about 7-10 days of prescription antibiotic therapy tailored to the bacteria detected on lab testing. Over-the-counter pain medications like ibuprofen can provide some relief from discomfort. Stronger prescription pain pills may be required as well.
Pus Drainage
The abscess needs to be opened and drained by a dentist to remove accumulated pus and debris. This provides immediate relief and speeds healing.
Root Canal Treatment
If the abscess occurred due to tooth decay or injury, you will likely need a root canal. This treatment cleans out diseased pulp and nerves within the tooth structure preventing further infection.
Gum Surgery
A surgical procedure called flap surgery or drainage may be done to cut and drain deep gum abscesses. The infected area and any unhealthy tissue is debrided to promote healing. Sutures anchor the healthy gum tissue back in place.
Dental Extraction
Sometimes if the tooth is too severely damaged to salvage, extraction is the only option. Removal of the infected tooth prevents the spread of bacteria and lets the region heal properly.
Further Periodontal Treatment
Underlying gum disease needs to be addressed via deep cleanings and procedures like scaling and root planing. This removes tartar and plaque from below and around the gum line. Further gum grafting or regeneration procedures may be required as well.
Home Remedies to Control Infection
The following self-care measures can supplement professional dental treatment and support the healing process:
| Warm Saltwater Rinses | Gently swishing with warm salt water 2-3 times a day removes debris from infected areas. This helps with pain relief too. But take care not to vigorously swish as it may rupture the abscess. |
| Cold Compress | Applying an ice pack or cold compress against the outer cheek can alleviate swelling and discomfort. Wrap ice cubes in a soft towel and apply for about 15 minutes at a time. |
| Over-the-Counter Pain Relievers | Anti-inflammatory pills like ibuprofen help manage sensitivity and pain until you can see the dentist. Use medication only as directed. |
| Soft Diet | Stick to a soft diet like soups broths, mashed vegetables or porridge. This minimizes trauma to the inflamed abscess and chewing discomfort. |
Avoid spicy, salty, acidic or sugary foods as they can irritate the area. Also hold off brushing or flossing around affected region until it heals.
Preventing Gum Abscesses
Good oral care and hygiene are key to preventing painful gum problems like abscesses. Follow these tips:
- Brush and Floss Daily: Brush gently twice and floss once daily to remove disease-causing dental plaque. Take special care around back molars and below the gum line.
- Get Regular Dental Cleanings: Professional cleanings every 6 months clear away hard tartar and plaque that regular brushing misses. Detecting and treating early gum disease can prevent abscess formation.
- Address Ill-Fitting Fillings or Crowns: Irritation from surrounding tissues encourages infection. Get cracked fillings or loose crowns properly adjusted or replaced.
- Quit Smoking: Smoking impairs healing after dental procedures and worsens gum disease. Quitting can drastically reduce abscess risk.
- Get Prompt Care After Injuries: See your dentist urgently after injuring your gums or teeth. Quick treatment helps prevent infections and complications.
When to Seek Emergency Care
A small gum abscess may resolve with conservative at-home treatment. However, immediately contact an emergency dentist if you experience:
- Difficulty breathing or swallowing due to excessive swelling
- Fever over 100°F which could indicate sepsis
- Significant swelling spreading to the eye or neck region
- Dizziness, high fever, stiff neck or severe illness indicating infection spread
Emergency surgery may be required to drain large abscesses accompanied by worrisome symptoms. Abscesses left alone can eventually spread deeper into tissues and to the bone. They can even penetrate into underlying structures like the floors of the mouth, sinuses or neck. This requires hospitalization for intravenous antibiotics and abscess removal.
So seek prompt dental assistance at the first sign of a gum infection before it gets out of hand. Monitor the lesion at home and follow your dentist’s post-op care recommendations closely after treatment. Report any persistent swelling, pain or pus discharge not resolving with antibiotics. With appropriate professional intervention and good home care, a gum abscess generally resolves without further complications.
References
Journal Title: Journal of Clinical Periodontology
Publisher Name: Wiley
Year: 2014
DOI Number: 10.1111/jcpe.12243
Overview of Study:
- Investigated the prevalence and risk factors of periodontal abscess in patients with periodontitis.
- Found that periodontal abscesses are common complications in untreated periodontal disease.
- Highlighted the importance of early diagnosis and treatment of periodontitis to prevent abscess formation.
Journal Title: Clinical Oral Investigations
Publisher Name: Springer
Year: 2017
DOI Number: 10.1007/s00784-016-1910-4
Overview of Study:
- Examined the microbiological profile of periodontal abscesses.
- Identified common bacterial strains involved, including Porphyromonas gingivalis and Fusobacterium nucleatum.
- Emphasized the need for targeted antibiotic therapy based on microbial findings.
Journal Title: International Journal of Dentistry
Publisher Name: Hindawi
Year: 2018
DOI Number: 10.1155/2018/3627150
Overview of Study:
- Reviewed treatment protocols for periodontal abscesses.
- Compare outcomes of different surgical and non-surgical treatments.
- Concluded that a combination of mechanical debridement and antibiotic therapy yields the best results.
Journal Title: Journal of Periodontal Research
Publisher Name: Wiley
Year: 2019
DOI Number: 10.1111/jre.12627
Overview of Study:
- Investigated the systemic impact of untreated, periodontal abscesses.
- Demonstrated that periodontal abscesses can lead to systemic inflammation and contribute to conditions such as cardiovascular disease.
- Highlighted the importance of comprehensive management of periodontal disease to prevent systemic complications.
Journal Title: Journal of the American Dental Association (JADA)
Publisher Name: American Dental Association
Year: 2020
DOI Number: 10.1016/j.adaj.2020.04.023
Overview of Study:
- Assessed patient outcomes following periodontal abscess treatment.
- Found that timely intervention and proper post-operative care significantly improve recovery rates.
- Recommended routine dental check-ups and hygiene practices to prevent recurrence of abscesses.
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