Periodontal Abscess

Clinical Description

The clinical presentation arises as a complication of inflammation of the dental pulp or periodontal pocket. The condition may be acute and diffuse or chronic with fistula or localized and circumscribed. It is in the apical aspect of the supporting bone.

Signs and Symptoms

SIGNS SYMPTOMS

• Toothache, Pain during intake of hot or cold foods/drinks, Pain on bringing the tooth on occlusion, Tenderness on percussion (vertical percussion)
• Swelling of gingiva around the affected tooth

Treatment

For posterior teeth: Extraction of the offending tooth under local anesthesia

• Lignocaine 2% with Adrenaline 1:80,000 IU (to establish drainage) is the treatment of choice followed by analgesics
• Adult: Paracetamol 500 mg – 1g 8 hourly or 6 hourly for 3 days,
• Child: Paracetamol 10 -15 mg/kg 8 hourly or 6 hourly for 3 days.

For anterior teeth (incisors, canine and premolars: Extraction is carried out only where root canal treatment is not possible. Give antibiotics: Adult

• Amoxicillin 500 mg 8 hourly for 5-7 days.

Children

• Amoxicillin 25 mg/kg in 8 hourly doses for 5 days.

PLUS

• Metronidazole 400 mg 8 hourly for 5-7 days
• Children 7-10 years, 200 mg 8 hourly