Periodontal Abcesses are a common dental emergency seen in the dental office. The term periodontal refers to tissue and bone surrounding or encasing a tooth. Periodontal abcesses are a sequela to Periodontal Disease. This condition is directly related to the supporting structure of the teeth, the bone and the tissue (commonly referred to as the periodontium). A periodontal abcess is the result of extension of inflammation and or infection into the supporting structure of the teeth and the subsequent destruction of the periodontium. As the supporting structure is destroyed pockets are formed that provide an area for the accumulation of food, plaque, calculus (tartar) and bacteria. Ultimately a infection pursues, and an abcess is born.

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Unlike a toothache periodontal disease is usually painless in its early stages. It begins as an inflammation of the tissue round the neck of the tooth commonly referred to as Gingivitis and becomes Periodontitis as the supporting structure is destroyed. Most patients requiring emergency treatment are in the acute phase of periodontal disease.

1. A periodontal abcess is characterized by swelling of the gums (gingiva) adjacent to a tooth or teeth.
2. The mild painful swollen area often arises overnight.

3. In the early stages, there is a throbbing and burning sensation.

4. Usually does not prevent sleeping or eating.

5. The teeth are usually not sensitive to touch, but mobility may be present.

6. Generally there is no lymph node involvement or swelling under the chin.

7. In the latter stages there is a reduction of size of the abcess as it drains leaving a nasty taste in the mouth. However, the feeling of discomfort may remain.

8. They tend to be recurrent when left untreated.

Note: A periodontal abcess must be differentiated from a tooth abcess (periapical abcess). In a periapical abcess, there is often sensitivity to percussion, no nasty taste in the mouth, there may be loss of sleeping and eating, lymph node involvement, fever, and swelling under chin

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.The best way to get temporary relief from a periodontal abcess is through antibiotic therapy, and pain relieving medication such as ibuprofen or acetaminophen. This can generally be accomplished by seeing an emergency dentist, or going to an emergency medical facility. Generally it takes between 24-48 hours for antibiotics to take affect. Periodontal treatment should be iniated immediately to prevent recurrent episodes, in some case tooth extraction may be indicated