Periodontal Abscess

Inflammation or diseases of the teeth are very common, but patients often only notice them too late. Important nerve pathways can be affected. And abscesses and inflammatory diseases in the head area can quickly reach the brain or develop blood poisoning. Abscesses, including periodontal abscesses, are not uncommon. These are often dismissed as harmless pimples without the danger of these inflammations being recognized.

Periodontal Abscess

What is a periodontal abscess?

A periodontal abscess, also known as a periodontal pocket abscess, is an abscess that develops around the tooth. An abscess is a pus -filled cavity that becomes encapsulated in dead tissue. Since the pus cannot drain through this encapsulation, the abscess persists for a long time and can also spread to healthy neighboring tissue. See ezhoushan for What does LES Stand for.

In some cases, the pus can also spill into the bloodstream and cause sepsis (blood poisoning). In contrast to acne pimples, abscesses are larger and the resulting cavities are filled with dead tissue. Mouth abscesses are dangerous because there are numerous nerves and blood vessels in this area.

Causes

An abscess is caused by bacteria. Small inflammations can easily occur in the oral cavity in particular, as this area comes into contact with many bacteria. Poor oral hygiene can support this process. The bacteria inflame the gums, but also the inner areas of the tooth and the bone.

The tissue dies and encapsulates itself from the environment. This creates a pocket or cavity. The abscess cannot go away because the pus inside cannot escape. While it is possible for small valves to form, this rarely happens. When the bacterially contaminated pus drains away, there is a particular risk that neighboring tissue will become infected or pour into other areas of the oral cavity and inflame it.

Lancing the abscess is therefore not advisable. If left untreated, the abscess will spread and get bigger. The dead tissue is stored inside the abscess until there is an opportunity to spill into other tissue cavities or outward. If a bloodstream is reached, the abscess empties into it. This leads to life-threatening blood poisoning.

Symptoms, Ailments & Signs

A periodontal abscess begins as a small amount of redness and swelling. In the course of a few hours, a small pimple forms, which then becomes larger. This is accompanied by increasing toothache as the abscess spreads to the tooth itself. The gums become very red and bulge.

As the disease progresses, a pus-filled pocket forms that, unlike an acne pimple, doesn’t easily break open. In some cases, however, the abscess can also develop below, at the root of the tooth, and not be recognized by the patient. The tooth begins to degenerate – in everyday life people speak of a “rotten tooth”. The abscess cuts off blood flow to the tooth. The result is intense pain.

Other direct consequences are tooth loosening and even tooth loss. The entire region feels painful to the patient. Other symptoms can include fever and general tiredness and exhaustion. The quality of life can suffer significantly if the patient can hardly eat. Social contacts can also suffer from the disease if the abscess causes bad breath. If the symptoms have been ignored for a long time, subsequent abscesses can form.

Diagnosis & course of disease

A dentist can easily diagnose a periodontal abscess. Even the external observation of the tooth area, the swelling and possibly the gum dissolution are indications of this disease. To prevent subsequent damage to the bone area, the dentist will also take an x-ray of the area to be able to assess the exact course of the abscess.

The recording gives an exact picture of the course of the pus. If the disease has progressed for some time, the doctor will also examine the blood count. In this way it can be determined whether the bacteria have already entered the bloodstream. An abscess is relatively easy to treat so that the disease does not progress. After treatment, the symptoms disappear after a few days.

Complications

Periodontal abscesses are common and are usually the result of minor injuries in the mouth combined with poor oral and dental hygiene. Larger abscesses must necessarily be treated by a dentist. In the case of professional therapy, the abscesses heal again without serious complications occurring. However, these disorders can become dangerous if the person concerned ignores them, treats them himself or seeks medical help much too late.

If the abscess is not treated properly, it usually gets bigger and bigger. The dead tissue accumulates in the abscess capsule until it eventually ruptures and the contents of the capsule spill out into the surrounding tissue or bloodstream. The latter can be very dangerous, since the pathogens can reach and infect not only the adjacent mouth and throat area, but also other organs. In this case, there is a risk of severe blood poisoning, which can be life-threatening for the patient.

There is also a risk that the pathogens will infect the surrounding tissue if the dentist opens the abscess. However, it is much lower in the case of a controlled intervention under hygienically perfect conditions than in the case of an uncontrolled breakthrough. Under no circumstances should the accumulation of pus be pierced by the patient himself. If the abscess is treated too late, this inflammation can also lead to the destruction of the periodontium, which results in tooth loss.

When should you go to the doctor?

Redness and swelling in the mouth are signs of a disease. A doctor’s visit is necessary as soon as the irregularities persist or there is an increase in symptoms. A doctor should be consulted in the event of disturbances during tooth cleaning or food intake as well as problems with an existing denture. Pain, discomfort and a feeling of illness should be examined and treated. If you notice facial deformities or deformities, or if you feel tightness in your mouth, you should consult a doctor.

Fatigue, exhaustion or sleep disorders are further indications that require action. A disturbance of concentration or attention as well as reduced performance should be discussed with a doctor. Loosening of teeth or tooth loss should be presented to a doctor as soon as possible. A refusal to eat, loss of appetite, weight loss or bad breath are indications of a health impairment.

A doctor’s visit should take place so that a diagnosis can be made and steps for treatment can be initiated. Fever, an increased need for sleep or headaches are complaints that often occur in patients with a periodontal abscess. If there is a feeling of pressure in the mouth or throat or if hypersensitivity reactions occur, a doctor is needed. A reduced sense of well-being, inner restlessness and irritation in the jaw area should be examined by a doctor.

Treatment & Therapy

Periodontal abscess treatment must be performed by a doctor. Lancing the abscess by the patient will not eliminate the disease, but can lead to blood poisoning in the worst case. Treatment is carried out after a positive diagnosis of the abscess. The treatment can be done under local anesthesia. The dentist opens the abscess and drains the pus.

He will then remove the dead tissue. The fabric is not sewn because the bacteria are killed with the help of antibacterial inserts. The dentist has to perform this treatment several times to ensure no flare-ups. Gums heal very quickly, which supports the healing process.

During treatment, the dentist will also investigate other causes of the abscess. A decayed tooth or an inflamed root can cause the abscess. Consequential damage is also repaired during the treatment. The abscess may have severely damaged the tooth or the area around it. In the worst case, the tooth has to be extracted.

The treatment can be done on an outpatient basis. If the bacteria has spread, you will be hospitalized. The patient is then given antibacterial IV fluids, such as penicillin. Consequential damage is not to be expected with timely treatment. However, periodontal abscesses can always recur later.

Outlook & Forecast

With good and quick medical care, the prognosis of a periodontal abscess is favorable. The affected area is professionally opened by a doctor. The fluid that has formed in the abscess is then suctioned out. If the procedure proceeds without further complications, a complete freedom from symptoms is achieved within a few days or weeks.

Without medical treatment, various disorders and health impairments can occur. The pathogens can spread further in the organism and cause consequential damage. Teeth, gums and the roots of the surrounding teeth can be affected by other diseases.

In particularly severe cases, the person affected is at risk of blood poisoning and thus the risk of premature death is increased. Pus can get into the bloodstream and lead to the life-threatening development within a short time. There is also the possibility that the surrounding area could become further inflamed and ultimately lead to the loss of the tooth.

In addition to the medical intervention, drug therapy is initiated in a subsequent treatment for the fastest possible healing. The administration of medicines promotes the wound healing process and prevents existing pathogens and germs from spreading. It should be noted that people with a weakened immune system can experience delays in the recovery process.

Prevention

Prevention is difficult. The periodontal abscess is caused by bacteria. A healthy oral flora and a healthy immune system help prevent infection.

Aftercare

Consistent follow-up care is very important in the case of periodontal abscesses, as it also prevents a possible recurrence. Regular and thorough cleaning is the basis of optimal oral hygiene. This not only includes correct brushing technique and toothbrush. It is important to use dental floss or an interdental brush to clean the fine spaces between your teeth as this is an ideal breeding ground for the bacteria that can cause the periodontal abscess.

But brushing your teeth is not enough in the aftercare of periodontal abscesses, since even good brushing does not reach all regions of the mouth. It is therefore part of the aftercare to go regularly to professional tooth cleaning (PZR). Thorough cleaning is carried out here by trained prophylaxis assistants, which also covers areas that cannot be reached with conventional cleaning.

In addition to the gaps between the gums, this is mainly about the gum line. PZR removes both hard plaque (classic tartar) and soft plaque (biofilm) and reduces the bacteria that are usually responsible for abscess formation.

In addition, in the follow-up care, smoking and drinking too much alcohol should ideally be avoided. You should also make sure that you chew thoroughly at mealtimes, as this stimulates salivation, which can also have a positive effect on the development of bacterial processes.

You can do that yourself

It is important that the patient has the periodontal abscess treated by a dentist immediately. This is the only way to avoid complications such as tooth loss or infection. If the patient sees the doctor too late, the abscess can rupture and cause blood poisoning. In no case should the patient treat the periodontal abscess himself, for example, by puncturing it. This should only be done under sterile, controlled conditions at the doctor’s.

To prevent the wound from becoming infected again and to prevent another abscess, the patient should pay more attention to oral and dental care in the future. The treating dentist can advise accordingly. The affected patient should definitely avoid nicotine during this time, because it disrupts the healing process of the oral mucosa. Other toxins such as alcohol or coffee also irritate the oral mucosa unnecessarily. An inflamed root or decayed tooth may have caused the periodontal abscess. This leads to follow-up treatments at the dentist, which must be observed at all costs, otherwise the disease will repeat itself.

A periodontal abscess affects the entire body. The patient may have been tired, exhausted and feverish during the illness, all signs of an overburdened immune system. Now it’s time to support the immune system with a healthy lifestyle. This includes regular meals with a high proportion of fruit and vegetables as well as a regular sleep-wake cycle.