Gum abscess is an inflammatory disease accompanied by acute pain, swelling and deterioration of the general condition. In the oral cavity, infection tends to spread very quickly through soft tissue and bone, so this condition requires emergency medical attention. Modern dentistry has a number of techniques that can effectively and painlessly eliminate gum abscess, the treatment of which will protect the patient from serious complications.
Opening a gum abscess
The mainstay of treatment for most cases of gum abscess is surgery. An abscess is a source of infection, most often developing due to prolonged lack of treatment for carious complications of the corresponding tooth. A swelling that forms on one side of the gum may contain pus, exudate, dead lymphocytes and a large number of pathogenic microorganisms. Over time, the abscess becomes larger and the risk of the contents spreading into surrounding tissue increases. Therefore, for effective treatment, removal of pathological contents from it remains a prerequisite.
An abscess is opened as follows:
- the doctor examines the extent of the lesion and determines the causative tooth;
- the oral cavity is thoroughly treated with an antiseptic solution;
- an anesthetic is administered for pain relief;
- Using a scalpel, a small incision is made on the gum, which should pass through the most protruding area of the abscess;
- the cavity of the lesion is washed with drugs with antimicrobial activity, the pathological contents are removed;
- A therapeutic and protective bandage is applied, and recommendations on its contents are given.
After the operation, the acute period of the disease subsides, pain and swelling decrease. Further treatment consists of taking medications prescribed by the dentist; it is recommended to do rinses and mouth baths. In some clinical cases, an abscess can be treated only after extraction (removal) of the tooth that caused the development of the disease. After complete recovery, suitable prosthetic methods are considered. If during the diagnosis it turns out that it is possible to avoid removal and save the causative tooth, after stopping the acute processes in the area of the abscess on the gum, therapeutic treatment is carried out (preparation, cleaning of the canals).
Gum abscess - symptoms
A limited focus of infection in the gum most often forms during an exacerbation of existing periodontal pathologies, so signs of an abscess appear suddenly and grow rapidly. Quite pronounced local symptoms are characteristic, and due to intoxication with waste products of bacteria, the general condition also worsens.
An abscess is accompanied by the following symptoms:
- severe pain in the gums;
- limited tissue swelling (“flux”);
- temperature increase;
- redness and swelling of the mucous membrane;
- sometimes – tooth mobility;
- headache, weakness.
In the absence of timely treatment, a fistula can form - a canal in the gum with a hole through which pus spontaneously discharges from the lesion to the outside. After the fistula appears, the pain is relieved, but an abscess remains on the gum, treatment of which is necessary to completely relieve the infection.
Kinds
Dental inflammatory disease, accompanied by swelling and accumulation of purulent exudate, is divided into two categories according to its nature and course.
- Spicy. The disease has a pronounced clinical character. Pathological mobility of elements of the dental system and the formation of deep periodontal pockets are diagnosed. The patient experiences severe pain, malaise, fever, and deterioration in general health.
- Chronic. Painful condition of the gums, bleeding, filling of pockets with a purulent component with a certain frequency. When diagnosing, exposure of the roots of the molars and swelling of the gums may be detected. The patient experiences increased sensitivity to external stimuli.
When opening a periodontal abscess, the localization can be established both in the cervical area and in the apical part of the molar or canine. At this clinic, deep pathological pockets and hard subgingival deposits are recorded. In case of a chronic disease, exacerbation is observed in the autumn-spring period with a sharp change in temperature and immunodeficiency.
Periodontal abscess of the gum pocket
With the exacerbation of untreated severe or moderate periodontal diseases, a periodontal abscess develops. Periodontitis is always accompanied by destruction of the integrity of the dentogingival junction, as a result of which periodontal pockets of varying depths appear between the tooth and gum. Together with food debris, microorganisms, tartar and pathological granulations accumulate in them. In the absence of timely treatment, the disease becomes chronic, and external or internal unfavorable factors can cause exacerbations from time to time.
One type of exacerbation of periodontitis is periodontal abscess of the gum pocket. The causes may be dental trauma, hypothermia, infectious or viral diseases. As a result of weakened immunity, the activity of pathogenic microorganisms in periodontal tissues increases, microcirculation is disrupted and an acute inflammatory process begins in the periodontal pocket. The accumulation of pus and exudate is expressed in spontaneous pain, the tooth becomes mobile and can move due to an abscess. Therapy is also aimed at eliminating the source of infection. The pocket is washed with antiseptics; if conservative methods are ineffective, the abscess is opened. After stopping acute processes, patients with a periodontal inflammatory focus must have their gingival or bone pockets cleaned. Depending on the severity of periodontitis, the following may be performed:
- open curettage;
- closed curettage;
- flap surgery.
During these procedures, special attention is paid to cleansing the periodontal pocket and root surface from tartar and granulation growths; the tissues are treated with antimicrobial agents. For deep injuries, it is necessary to add osteoplastic materials to restore tissue. This is necessary to restore the periodontal connection and prevent recurrent exacerbations.
Diagnostics
The examination includes:
- patient interview,
- inspection,
- dental radiography,
- laboratory and instrumental methods.
During the examination, the doctor sees a painful local bulge and altered mucous membrane. There is no transitional fold from the periodontium to the tooth. The depth of the pockets is at least 3 millimeters.
X-ray shows:
- enlargement of the periodontal gap,
- destruction of the cortical plate,
- uneven resorption of spongy substance.
A blood test indicates nonspecific inflammation:
- high level of leukocytes,
- increase in ESR,
- shift of the leukocyte formula to the left.
PCR allows you to accurately determine the composition of the microflora of the gum pockets. With an abscess, the number of bacteria increases 100 times. During the examination, doctors exclude:
- acute periodontitis or exacerbation of the chronic form,
- cyst with suppuration,
- periostitis,
- osteomyelitis.
Purulent gum abscess
At the initial stage of the disease, the inflammation may contain only serous exudate and be accompanied by moderate pain and swelling. Treatment of this condition can be conservative (medication) without surgery. Over time, as a result of pathological processes, pus appears at the site of inflammation, the pain increases and often becomes pulsating. In the area of one or two teeth, a purulent abscess forms on the gum, the treatment of which requires surgical intervention.
Accumulating pus contains interstitial fluid, dead immune cells and microorganisms. As the disease progresses, the amount of pus increases and the pressure inside the abscess increases, microcirculation disorders worsen. Under such conditions, the risk of infection spreading to surrounding tissues and the development of complications increases.
After tooth extraction
Tooth extraction is a dental operation during which the gums are injured. If antiseptic rules have been violated or the patient does not provide the necessary postoperative care, infection can enter the wound. Bacteria will multiply quickly. Suppuration forms. If there is no treatment, the abscess affects the soft tissue.
Suppuration as a result of medical error after removal is rare. At the ARDC clinic, dentists use modern equipment, consumables, and medications. You can be confident in the quality of the procedure and compliance with the treatment protocol.
Improper postoperative care is a more common cause of abscess after removal. After the operation, the dentist must give recommendations on how to care for the wound. Careful adherence to all these rules will reduce the risk of suppuration at the site of the extracted tooth.
Why is an abscess dangerous?
The tissues of the oral cavity are rich in blood vessels, so it is easy for infectious pathological processes to spread from one area to another. A limited abscess without treatment can lead to the following local complications:
- abscess of the adjacent area;
- phlegmon - diffuse tissue damage by infection;
- periostitis – transition of inflammation under the periosteum;
- inflammation of the bone - osteitis.
In particularly severe clinical cases, if the symptoms of an abscess are ignored for a long time, osteomyelitis can develop - melting of part of the jaw bone tissue as a result of purulent inflammation. Pathology leads to the formation of voids in the bone, jaw fractures, and tooth loss.
An abscess in the area of the retromolar fossa (near the last chewing teeth) is especially dangerous, since the infectious-inflammatory process without adequate treatment can spread to the tissues of the pharynx, and from there to the mediastinum, which leads to serious complications from vital internal organs. Another possible way for the infection to spread is into the membranes of the brain, which leads to the development of meningitis. An abscess on the gum without treatment can also be complicated by sepsis when a large number of bacteria enter the bloodstream, which is life-threatening for the patient. You should not postpone a visit to the dentist if there are signs of inflammation of any location, since self-treatment of an abscess with purulent contents leads to a worsening of the condition and serious consequences.
Diagnosis of the disease
At the initial stage of diagnosis, the dentist-therapist performs a visual examination with palpation of the inflamed area. In order to determine what other structures are affected, X-ray and laboratory examinations are performed. An appropriate examination allows us to establish the localization of the purulent sac; it can be cervical, apical, or hilar. Laboratory analysis helps to identify markers of infection and determine the type of pathogen. Digital X-ray diagnostics allows you to determine whether the inflammatory process has reached the bone tissue, this will help to understand whether surgical treatment is required for periodontal abscess.
In accordance with the data obtained from the anamnesis and x-ray, a cytological examination of the salivary fluid may be required. The latter makes it possible to identify the number of damaged granulocytes. In case of suppuration in the area of the dental system and osteomyelitis, the help of a dental surgeon may be required. In each specific case, consultation with an experienced specialist is necessary in order to establish the clinical picture as accurately as possible and determine a scheme for endodontic treatment or surgical intervention.
Causes of gum abscess
The oral cavity has a complex microbial community, that is, a complex of coexisting microorganisms that under normal conditions do not cause harm. If hygiene is not observed or the body's immune forces are reduced, some bacteria are activated, actively multiply and cause tissue inflammation.
Abundant dental plaque is the cause of inflammatory and degenerative changes, first on the surface of the gum (gingivitis develops), then in the area between the tooth and the gum (periodontitis). The result of untreated caries or pulpitis is the involvement of dental ligaments in the infectious process, the appearance of periodontitis, the further spread of pathology and the acquisition of a chronic nature.
An abscess is a consequence of exacerbation of inflammatory diseases of the oral tissues. Its occurrence may be due to:
- accumulation of tartar in deep periodontal pockets;
- a disease of viral infectious origin (ARVI, pneumonia);
- hypothermia;
- mechanical damage to inflamed gums as a result of acute injury or wearing unsuitable or improperly manufactured dentures;
- bad habits.
The action of an unfavorable factor disrupts the balance established as a result of the chronicity of the underlying disease (pulpitis, periodontitis), which is expressed in a sharp increase in inflammation, activation of bacteria and the appearance of gumboil. To prevent the disease, first of all, you need to maintain hygiene, use dental floss and brush your teeth at least twice a day. Carrying out professional cleanings every six months to remove deposits in places inaccessible to a toothbrush is aimed at helping prevent the development of periodontitis, the most common cause of abscesses. It is necessary to seek dental care at the first unpleasant symptoms. All tissues and organs in the dental system are closely connected anatomically and functionally, so even a small problem in the form of a carious lesion can lead to inflammatory and destructive complications over time.
Prevention
- Thorough dental hygiene: brushing your teeth in the morning and evening, rinsing your mouth after every meal, using various devices: dental floss, brushes. If there are dentures in the mouth, it is recommended to clean them of food debris using an irrigator - a special device that supplies water under pressure.
- Timely treatment of diseases of teeth and gums.
- Preventative dental examinations are necessary at least 2 times a year to assess the condition of the teeth and oral cavity. If there is hard dental plaque, use hardware teeth cleaning.
Basic methods of treating abscess
After carrying out all diagnostic measures, the dentist determines the treatment tactics necessary in a particular clinical case. Abscess therapy is complex, including eliminating the cause of the pathology, alleviating symptoms and accelerating tissue regeneration. If the patient turned to dentistry in the early stages of the development of the disease, a conservative method can alleviate the condition. During this procedure, tissues affected by caries are removed and the canals of the tooth that are causing the abscess are cleaned. The source of inflammation is washed with antiseptic solutions, a course of antibiotics, painkillers, anti-inflammatory and hyposensitizing agents is prescribed.
With a more pronounced inflammatory process and the development of signs of suppuration, it is necessary to use a surgical method of treatment. After opening the abscess, conditions are created for the unhindered exit of exudate from the lesion and the gradual subsidence of symptoms. Rinses and mouth baths with an antiseptic effect speed up healing. Another method of surgical treatment of an abscess is tooth extraction. After extraction, the purulent contents of the abscess are released through the hole, which is cleaned and treated with antimicrobial agents.
At the Dentistry Academy Dent, located in the south-west of Moscow, abscess treatment is carried out using modern methods of high efficiency. The clinic is equipped with advanced dental equipment and materials, the quality of which is recognized throughout the world. A specialist with many years of experience in the successful treatment of inflammatory and destructive gum diseases, after a thorough diagnosis, will create an individual treatment package and give professional recommendations.
Content:
- What is a tooth abscess
- Classification of abscess in dentistry
- Causes of the disease
- Signs of illness
- Breakthrough of purulent masses with an abscess
- Treatment of the disease
- How to prevent a tooth abscess from occurring
A tooth abscess is an unpleasant and dangerous dental disease. It can occur in anyone. It is impossible not to notice its presence, since acute pain appears in the affected area and accumulations of pus form. Let's take a closer look at what this disease is, how to recognize it and treat it.
