PERIODONTAL ABSCESS

Localised collection of pus within a periodontal pocket

Causes

  • Entry of virulent organisms into an existing pocket
  • Impact of a foreign body, e.g. a fishbone into healthy periodontal membrane

Clinical features

  • Localised, red and tender swelling of gum
  • Need to differentiate it from a dental abscess
DENTAL ABSCESS-PERIAPICAL
ABSCESS
PERIODONTAL ABSCESS
Associated tooth is non-vital Associated tooth is vital
Tooth is tender to vertical
percussion
Tooth is tender to lateral
movements

MANAGEMENT

  • Incision and drainage under a local anaesthetic
  • Debridement of the pocket with a scaler

Give an analgesic for 5-7 days

  • Paracetamol 1 g every 8 hours
    Child: 10-15 mg/kg every 8 hours
  • Or ibuprofen 400 mg every 8 hours
    Child: 7-13 mg/kg every 8 hours
  • Or diclofenac 50 mg every 8 hours

Give antibiotics for 5 days

  • Amoxicillin 500 mg every 8 hours
  • Plus Metronidazole 400 mg every 8 hours