Periodontal abscess

Background

• Occurs when plaque and debris become entrapped in periodontal pocket
• Other terms: lateral abscess, parietal abscess

Clinical Features

• Severe pain
• Sensitivity to palpation
• Suppuration with gentle pressure

Differential diagnosis

Dentoalveolar Injuries

• Dental fracture
• Dental subluxation
• Dental avulsion
• Bleeding dental socket

Odontogenic Infections

• Acute alveolar osteitis (dry socket)
• Acute necrotizing ulcerative gingivitis (trench mouth)
• Dental abscess
  • Periapical abscess
  • Periodontal abscess
• Ludwig's angina
• Pulpitis (dental caries)
• Pericoronitis
• Peritonsillar abscess (PTA)
• Retropharyngeal abscess
• Vincent's angina - tonsillitis and pharyngitis

Other

• Scurvy
• Gingival hyperplasia
  • Phenytoin
  • Cyclosporine
  • Nifedipine, Amlodipine
  • Leukemia

Evaluation

• Usually clinical

Management

• Local therapy for small abscesses
  • Penicillin VK 500 mg PO QID or clindamycin 300 mg PO QID
  • Warm saline rinses
• Larger abscesses require I+D
• Chlorhexidine 0.1% mouth rinses BID for short-term use

See also

Dental problems