Acute Periodontal Diseases: Gingival Abscess

Introduction

Gingival abscess is one of the five types of dental abscesses caused by bacterial infection.
This infection could be due to tooth decay, rough brushing, broken teeth, food stuck in the gum line, or when bleeding occurs in the gum line.
Traumatic injury or any excessive orthodontic force on the teeth can also cause Gingival Abscess.

Risk factors for Gingival abscess

Contributing systemic risk factors may affect progress treatment and therapeutic outcomes for chronic periodontitis.
These may include:

  • Diabetes
  • Smoking
  • Certain periodontal bacteria
  • Aging
  • Gender
  • Genetic predisposition
  • Systemic diseases and conditions (immunosuppression)
  • Stress,
  • Nutrition
  • Pregnancy
  • HIV infection,
  • Substance abuse, and medications.

Symptoms and clinical features of Gingival abscess

These abscesses follow an inflammation of the gingiva and periodontium.
As it progresses and following attachment loss, gums become red, slightly swollen, with obvious pus accumulation and bleeds on slight provocation.
The associated teeth show different degrees of mobility and mostly vital.

Treatment for Gingival abscess

Non-drug treatment

  • Instruction, reinforcement, and evaluation of the patient’s plaque control should be performed.
  • Supra- and subgingival scaling and root planning should be performed to remove microbial plaque and calculi.
  • Antimicrobial agents or devices may be used as adjuncts
  • Antiseptic mouthwashes:
    • e.g. chlorhexidinegluconate 2% three times daily for 1-2 weeks
    • Hexetidine mouthwashes to alternate with warm saline mouthwashes

Drug treatment

A. Analgesics
Paracetamol

  • Adult: 1 g orally every 8 hours for 3-5 days
  • Child:
    • 1-5 years: 125-250 mg,
    • 6- 12 years: 250 – 500 mg orally every 8 hours

B. Antibiotics
Amoxicillin

  • Adult: 250 mg orally every 8 hours for 5 days
  • Child:
    • 1 month – 1 year: 62.5 mg orally every 8 hours: dose doubled ill severe infections
    • 1-5 years: 125 mg every 8 hours;
    • 5- 12 years: 250 mg 8 hourly;
    • 12-18 years: 500 mg 8 hourly; all doses doubled in severe infections

Metronidazole

  • Adult: 200 mg orally every 8 hours for 5 days
  • Child:
    • 1-3 years: 50 mg orally every 8 hours:
    • 3 – 7 years: 100 mg every 12 hours;
    • 7 – 10 years: 100 mg every 8 hours