Periodontal (Gum) Abscesses

Gum infections can be a sign of “bigger” problems

Dear Doctor,
I am having recurring swellings on my gums, one area in particular. The last one went away by itself, but this one is bigger and more uncomfortable. I am fifty-five, in fair health but quite stressed right now. I have not been to a dentist recently. What is causing this and what should I do?

Dear Robert,
It sounds very much like you have periodontal (gum) disease, one of the hallmarks of which is an acute periodontal or gum abscess. This manifests as a swelling on the gum next to an affected tooth which will vary in symptoms from virtually no pain to being quite painful, usually with an inflamed, enlarged and reddened area of the gum. In addition, the tooth may be slightly tender to bite on, and may also be associated with a loose tooth. These symptoms differ from a root (nerve) abscess which originates from a root canal infection which is usually intensely painful and feels like it's coming from a general area rather than a specific tooth.

An abscess, literally a pus-filled sac, is the result of underlying periodontal disease which has probably been present for some time and is therefore chronic (long standing) in nature. Going through stressful periods or having underlying diseases can lower resistance. Systemic diseases such as diabetes or even a common cold or flu can precipitate an abscess.

The treatment is quite simple and the same for any abscess anywhere in the body. It is important to establish drainage usually with local anesthesia, numbing the area then simply and quickly piercing the abscess to allow drainage of the infection. This is usually accompanied by cleaning the infected root surfaces to remove bacterial contamination, irrigation (flushing) of the area with saline (saltwater) and/or antibacterial solutions. This may be accompanied by a course of antibiotics and mild non-steroidal anti-inflammatory medication to control pain and swelling, such as aspirin or ibuprofen. The control of symptoms is quick and quite dramatic following this simple procedure.

Once the abscess is drained and has initially healed, which takes only a matter of a few days to a week, it is very important to have the underlying periodontal (gum) disease treated, which led to the problem in the first place. As part of your evaluation your dentist or physician will check your general health to see if there is any systemic (general health) condition that may be a contributing factor to the periodontal (gum) problem.

Don't delay, please see your dentist or a periodontist as soon as possible to have your periodontal status reviewed and treated — remember your teeth are supposed to last for a lifetime.