An abscess can be simply described as a pocket of infected liquid, commonly known as pus, that collects in a small area within the body tissues. It comprises proteins, bacterial cells, leukocytes and other cells of the immune system.
Periodontal abscess refers to the development of abscess on the periodontal tissues, namely gums, periodontal ligament and the alveolar bone. The ones that involve only gum tissues are called gum abscesses or gingival abscesses. The abscesses which involve gum tissues surrounding the crown of an erupted tooth are called pericoronal abscesses.
Gingival abscess may arise due to bacterial infection in teeth and gums. It leads to swelling and redness of the infected tissue, accompanied with a sharp throbbing pain. Gum abscess may even spread to the cheeks, tissues below the tongue, jaw bones and throat. If left untreated, the infection may spread into the surrounding organs, and may even affect the heart and lungs. Given below are the causes, symptoms, diagnostic methods, treatment options as well as a few home remedies to deal with gum abscess.
» Poor oral hygiene:
Oral microflora is influenced by oral hygiene as well dietary habits. Dental plaques and tartar arising due to poor oral hygiene leads to bacterial infection in the dental and gingival tissues. Such infection, and the immune reaction against them, leads to the formation of abscess on gums and other surrounding tissues.
» Tooth decay:
Tooth decay or severe injury affects the surrounding nerves and blood vessels. Infection in such damaged or necrotic tissue leads to the collection of purulent fluid and gum abscess.
» Cracked tooth:
Fractures or cracks in the enamel and dentin may allow bacteria to enter the pulp, which may lead to infection and abscess.
» Periodontal diseases:
Periodontal diseases lead to receding gums and formation of deep pockets of space between the teeth and gums. Bacteria can easily settle down in the food particles stuck in these pockets, and an abscess may develop on the gums.
» Unrepaired restorations:
Dental fillings used for treatment of dental caries and other dental issues may break down over time. Food particles and bacteria settle in such cavities, ultimately leading to the formation of abscess on gums and other dental tissues surrounding the cavity.
» Impaction of foreign bodies:
The entrapment of foreign bodies like fingernails, bristles, pieces of toothpick or dental floss, etc. in the gingival crevices leads to gum irritation, swelling and abscess formation.
» Other causes and risk factors:
- Excessive smoking
- Tobacco consumption
- Genetic predisposition
- Hormonal changes in women
Signs and Symptoms
- Difficulty while eating and swallowing
- Gum inflammation
- Red and tender gums
- Bad breath
- Loosening of teeth
- Tooth loss
- Nausea and vomiting
- Severe, throbbing pain around the infected gum
- Lesions on the gum
- Bleeding gums
- Drainage of pus from the gums
- Bad taste in the mouth
- Increased tooth sensitivity
- Chills and fever
- Damage to bones and fibers supporting the tooth
- Inflammation of lymph glands present in the neck
Oral and extra-oral examination for the above mentioned signs, coupled with the following diagnostic methods, are useful to confirm gum abscess and/or understand its etiology.
» Microbial test:
Exudate from the abscess is sent for culture tests in order to check for the presence of bacterial infection.
» Blood test:
In case of individuals suffering from fever and chills, determination of the complete blood count may be advised. Bacterial infection leads to a temporary increase in the number of leukocytes as a part of the inflammatory reaction, which can be identified through such an investigation.
» Pulp vitality test:
To evaluate tooth viability and check for the spread of infection to the dental pulp, sensitivity tests like hot tests, cold tests and electric pulp test may be conducted. Hot and cold tests assess thermal sensitivity of the infected tooth. In an electric pulp test, the response to mild electric current is measured for each tooth, using an electric pulp tester. A low response given by the affected tooth, as compared to the healthy teeth, indicates the presence of dental abscess.
Oral radiographs are advised, in severe cases, to check for the presence and extent of bone damage, if any.
The various treatment options available to deal with gum abscess have been listed below. However, the precise set of options to be used depends on severity of the condition, medical history of the patient as well as the extent of periodontal damage.
- Analgesics for alleviating pain
- Antibiotic treatment involving antibiotic tablets, gels and mouthwashes
- Drainage of pus by incising the abscess
- Root canal treatment in case of spread of infection to the root apex
- Tooth extraction and periodontal surgery, in severe cases
- Rinsing with warm, salt water (one-eighth teaspoon salt in eight ounces of warm water) several times a day helps to reduce bacterial load, and break open the abscess. Salt water serves as a natural antibiotic mouthwash.
- Application of cold compress on the cheek may help to alleviate the pain.
- Application of clove oil around the infected area helps to reduce the bacterial infection owing to the anti-bacterial properties of clove.
- Eating raw garlic cloves also aids to control the bacterial counts.
Gum abscess is the result of a bacterial infection in gums and other surrounding tissues. Gum abscess, if ignored or neglected may affect vital organs, and hence demands immediate medical attention.
Disclaimer: This article is for informative purposes only, and should not be used as a substitute for professional medical advice.