PERIODONTAL ABSCESS

A periodontal abscess is caused by an infection of the periodontal tissues. It is usually the result of a long-continued irritation by food debris, deep deposits of calculus or a foreign object packed in the sulcus or inter-proximal spaces.

The symptoms and signs for periodontal abscesses are similar to those for periapical abscesses.

Treatment

The emergency treatment plan for periodontal abscesses may include:

Performing the emergency treatment guidelines

Gently probing the affected area with a scaler or an explorer to establish drainage. Probe the space between the tooth surface and the gingival tissue.

If probing does not establish drainage, have the patient apply hot saline water rinses to the affected area.

PERICORONITIS

Pericoronitis is an inflammation of the gingiva around a partially erupted tooth. During eruption, the tooth breaks through the gingiva tissue, and sometimes a small flap of tissue remains over the crown of the tooth. Debris accumulates beneath the tissue flap resulting in an acute inflammation. Inflammation can also result from constant contact between the tissue flap and the tooth in the opposing arch. Pericoronitis most often affects mandibular third molars.

Symptoms

A patient with pericoronitis may complain of the following:

Pain when chewing

A bad taste in the mouth

Difficultly in opening the mouth

Swelling in the neck or in the area of the affected tooth

A fever

Signs

Signs of pericoronitis you may observe upon examination are as follows:

A partially erupted tooth

Red, inflamed tissue around a partially erupted tooth

Pus oozing from under an overlaying tissue flap

A painful reaction when finger pressure is applied

Swelling in the cheek near the affected tooth

Enlarged lymph nodes

Elevated temperature

Treatment

In the treatment of pericoronitis, you may perform the following emergency procedures:

Follow the emergency treatment guidelines.

Irrigate under the tissue flap with a warm saline solution (figure 6-5).

Gently clean the area with a sonic scaler or hand scaler.

Instruct the patient to rinse with a warm ^saline solution every 2 hours.

Contact dental officer if patient is febrile or if lymph nodes are palpable. The dental officer will determine the need to prescribe antibiotics.

Figure 6-5.\Irrigating beneath a tissue flap.

OTHER ORAL CONDITIONS

This section describes emergency conditions resulting from inflammation of the oral mucosa, postexodontic complications, and trauma to the teeth and their supporting structures.