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Gum abscess: Types, Causes, Signs, Complications & Prevention

Gum abscess is a pocket of pus that affects the area surrounding the tooth, it is characterized by swelling of the gum with difficulty during chewing. The abscess appears following an infection of bacterial origin, or trauma following an accident.
Untreated, it can lead to serious complications and may have effects on the general health.

Gum abscess can be:


  • Gingival abscess: limited to the marginal and interdental gingiva. It is painful with local swelling.
  • Periodontal abscess: appears due to periodontal disease. The abscess is extending apically and adjacent to a periodontal pocket.
  • Periapical abscess: It is an accumulation of pus at the end of the tooth root. Usually due to an infection that has spread from the tooth to the surrounding tissues.
    The accumulated pus is manifested by the appearance of an abscess in the gum.
  • Pericoronary abscess: it's an infection and inflammation of the gum partially covering a tooth, it frequently reaches the wisdom tooth during the eruption.
    Food debris and bacteria can accumulate and cause infection. These conditions are often very painful and need to be treated.

Symptoms of a gum abscess

gingival abscess
The gingival abscess is easily diagnosed. Characterized by a local swelling in the marginal gum.
Accompanied by a feeling of pain, heat, bleeding and discomfort during meals.
periodontal abscess Periodontal abscess: Symptoms vary according to severity.
The abscess is manifested by a redness, presence of a periodontal pocket with secretion of pus, accompanied by bone lysis (detected by radiography).
The pains are often present, sometimes the abscess can have effects on general health such as fever, fatigue, cervical Adenopathy.
pericoronal abscess Pericoronal abscess: Occurs in case of a partially erupted tooth. The gum that surrounds a partially erupted tooth is very sensitive to inflammation.
periapical abscess
Periapical abscess: As it's name, the abscess is located in the periapical zone, due to infection of the pulp.
Bone lysis is limited to the apical area.

Causes of a gum abscess

Usually abscess means the aggravation of a periodontal disease. The emergence of the abscess may occur following:
  • A foreign body stuck between the tooth and the gum: a gum that is not perfectly bonded to the tooth is an open door for small food debris and bacteria.
    Inaccessible to brushing, there is a high risk that this area develops an infection, leading to an abscess.
  • Bad oral hygiene: Bad hygiene causes the accumulation of plaque between the gums and the teeth. Plaque is a sticky, colorless film of bacteria. When it isn’t removed from teeth through regular brushing and flossing, an infection can occur in the surrounding tissue. This can result in the formation of an abscess.
  • The eruption of the wisdom tooth: When the eruption of the tooth is incomplete (partial eruption), the debris of food can be stored between the wisdom tooth and the gum, leading to infection.
  • Instrumental overflow: During root canal treatment, there is a risk of injuring the periodontium with endodontic instruments.
All these facts can lead to chemical and mechanical irritation causing inflammation of the tissues surrounding the teeth leading to an abscess.

Treatment procedure:

The treatment of the abscess depends on its location and stage.
  • The treatment of the gum abscess consists in applying a local anesthesia, removing the foreign body and carrying out a descaling if necessary.
    After treatment, oral hygiene should be maintained to avoid infection of the treated area.
  • For periodontal abscess, the treatment is done by draining the infection from the periodontal pocket by debridement of the abscess or by tooth extraction.
    Prescription of analgesic and antiseptic are associated. The antibiotic is prescribed if the abscess has impacted the general health (fever, headache) or in some cases (heart disease, diabetes).
  • For the periapical abscess, the treatment is done by performing an endodontic treatment accompanied by a drainage of accumulated pus at the root apex.

Complications:

Untreated, Gum abscess can lead to serious complications. At the advanced stage, the swelling will be seen externally. Ganglia can appear under the jaw, the infection then spreads in the soft tissues like the cheek, skin, muscles causing swelling. The pus makes its way through the tissues to drain through the gum or even skin of the face (cheek, chin).
Among the complications of the dental abscess:
  • Tooth loss: the abscess can infect the bone that holds the tooth and destroy it (periodontitis). In 90% of advanced cases, the infected tooth will be removed.
  • An infection of the sinuses (sinusitis): The roots of the upper molars are located near the sinuses. If the tooth abscess generates pus, the sinuses can then be filled with this pus. These can cause pain in the cheekbones and when the head is thrown forward. In some cases, a purulent discharge may occur and a feeling of bad smell.
  • Bacterial endocarditis: Bacteria from the dental abscess reach the heart through blood vessels. These bacteria reaching the heart can infect the valves and lead to fatal consequences.
  • Abscess of the brain: the infection could spread from the teeth to the brain through the veins. An infection of the brain can lead to coma.
  • To stop the infection and avoid serious complications, consult the doctor at the first symptoms. Go to the emergency if the fever exceeds 38 °C or if it becomes difficult to swallow and feed.

Prevention:

Prevention is the best solution to fight against different forms of dental abscess.
Adapting a good oral hygiene routine will help prevent gum abscess:
  • Maintain good oral hygiene: brush your teeth two to three times a day, make regular visits to the dentist for a descaling and a complete examination.
  • Complete your brushing with flossing to eliminate all the bacterial plaque. You can also use an oral irrigator or interdental brush, they work too.
  • Decrease or stop smoking.
  • Avoid acidic foods and drinks.
  • Avoid too sweet and sticky foods.

Conclusion:

Gum abscess is a periodontal emergency, untreated, the infection can be generalized leading to more serious complications. Even if the treatment is simple and effective, prevention is the best way to fight against.