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