07 april 2025

Periodontal abscess: understanding, diagnosing and treating gum infection

gums recede solution

A periodontal abscess is not just a little temporary pain, it can quickly get worse if it is not taken care of. Pain, redness, swelling... all signs to take seriously. In this article, we explain how to recognize an abscess , how to treat it, and above all, how to avoid it. And as usual, this content does not in any way replace the advice of a dental professional! 🤓

Typologies of periodontal abscesses

Abscess associated with periodontitis

This is the most common form in people who have chronic periodontal disease. In this case, the abscess forms from an already present periodontal pocket which suddenly becomes infected.

Why is this happening?

  • An accumulation of bacteria ,

  • A mechanical blockage (food, scale, debris),

  • Poorly followed treatment disrupting balance.

There is sudden discomfort, enlargement of the gums , and sometimes a yellow discharge. This abscess can occur even in well-monitored patients in the event of a hygienic or immune imbalance.

Abscess not associated with periodontitis

This type of abscess can also affect people who have never had gum problems before. It often appears suddenly and isolated, generally due to a foreign body or a small local accident . Common causes include:

  • An injury to the gums or too vigorous brushing,

  • A piece of food that slips under the gum ,

  • A small shock or dental accident .

It can also develop around partially erupted wisdom teeth, where microbes easily take hold. The symptoms are similar: pain, redness, swelling ... but this abscess is not linked to a chronic disease, so its treatment is often quicker and simpler. 😊

Main signs and symptoms of the presence of a periodontal abscess

A periodontal abscess does not go unnoticed! It can cause quite strong affliction and very visible signs that deserve our attention.

  • Localized and intense pain in the gums : it can be sharp and localized, appearing suddenly, which can make chewing or speaking difficult. If discomfort persists despite painkillers, consult a dentist promptly.

  • Swelling, redness, and warmth in the infected area : The gum around the affected tooth may swell, red, and feel warm. These are signs of inflammation . Sometimes a small pimple may even appear.

  • Fluid leaking through a fistula : This sometimes escapes through an opening in the gum, providing temporary relief despite persistent infection.

  • Sensitivity to pressure or chewing : Pressing on the tooth or chewing can be bothersome because of pus and inflammation.

  • Bad breath : Bacteria from the abscess can cause bad breath and even a metallic taste, signs of advanced inflammation.

  • Fever in more severe cases : If the condition spreads, it may cause fever, fatigue or swollen glands. If you notice these signs, consult your healthcare professional.

Causes of periodontal abscess

This abscess never develops without reason, several factors can favor its appearance:

  • A bacterial infection caused by dental plaque: without brushing, it becomes tartar and can cause inflammation or an abscess.

  • Poor oral health : insufficient dental hygiene encourages the proliferation of bacteria and constitutes a significant risk of periodontal abscess. 🚨

  • Untreated periodontal disease : Gingivitis and periodontitis can develop into abscesses if left untreated, creating pockets where microbes accumulate, making the gum vulnerable to infection.

  • Trauma or injury : An injury to the gum or tooth can allow bacteria to enter, caused by aggressive brushing, harsh eating, shock or dental manipulation.

  • A weakened immune system : some people are more susceptible to oral infections, especially with poorly controlled diabetes, smoking, chronic stress, immunosuppressive treatments or diseases that weaken the defenses. A small accumulation of germs can cause a severe infection.

Diagnosing a periodontal abscess

When pain, swelling or pus appear, it is crucial to diagnose the abscess to begin the right treatment. The dentist uses various tools to assess the infection.

Clinical examination

This is the first step in diagnosis. The dentist examines the gums, teeth and surrounding tissues to detect:

  • Signs of inflammation : redness, swelling, bleeding,

  • The presence of a fistula , the channel through which fluid can flow,

  • Sensitivity to palpation or chewing.

An instrument can measure the depth of tooth pockets to assess periodontal health.

Dental X-rays

X-rays are an excellent tool for analyzing the invisible. They help the dentist to:

  • Detect bone loss in advanced periodontitis,

  • Locate a periodontal pocket,

  • Check for spread of an abscess .

They also make it possible to differentiate the types of abscess to best guide the treatment.

Microbiological tests

In complex cases, the dentist can analyze a sample to identify bacteria and choose the appropriate antibiotic. This test is not systematic, but useful for resistant or at-risk cases.

Treatments for a periodontal abscess

Treating a periodontal abscess is a two-step mission: first, we calm the acute infection, then we attack the root of the problem to prevent it from returning.

Treatment of acute injury

When an abscess occurs, it is important to first evacuate the inflammation and relieve the pain. The goal? Prevent germs from spreading while helping tissues heal quickly.

  • Drainage of the abscess : the pus is removed by incision or cleaning of the pocket.

  • Antibiotics : if the inflammation is extensive or the patient is at risk, they may be useful.

  • Analgesics : To quickly relieve pain, they help regain daily comfort while the area heals.

Treatment of the original or residual lesion

After the acute phase, it is essential to address the cause of the abscess, otherwise it could return.

  • Treatment of underlying periodontitis : scaling , root planing, elimination of infected pockets, and necessarily regular visits to your dentist.

  • Periodontal surgery : in some cases, especially if the periodontitis is advanced, surgery may be considered to eliminate deep pockets.

  • Maintaining dental hygiene : Finally, as always, maintaining good oral cleanliness remains the key.

Possible complications of a periodontal abscess

An abscess may seem harmless, but without prompt treatment, it can have serious consequences. Don't wait for "it to pass by itself". Here are the main risks.

Spread of infection

If the pus is not drained, the inflammation can spread to surrounding tissues and other parts of the head and neck. In rare cases, this can progress to phlegmon or facial cellulitis , requiring hospitalization. If you notice swelling, fever, or difficulty opening your mouth , consult a healthcare professional!

Tooth loss

Periodontal infection can gradually destroy the supporting tissues of the tooth, such as the alveolar bone. If it gets worse, the tooth may become loose and require extraction. Rapid treatment and regular follow-up are therefore essential to preserve natural teeth.

Systemic infections

In vulnerable people, such as diabetics, immunocompromised or elderly people, an untreated infection can lead to:

  • Bacteremia, or the presence of bacteria in the blood,

  • High risk of cardiovascular diseases,

  • Possible links with diabetes or premature birth.

This link between oral health and overall health is very real: taking care of your gums means taking care of your body!

The most frequently asked questions about periodontal abscess

How to treat an abscess?

It is essential to see a dentist to evacuate the abscess, alleviate the suffering and treat the infection. Subsequently, dedicated background treatment is often required 👍

How can I drain the abscess?

Never try to pierce the abscess on your own ❌ A professional is the only one who can drain it safely, without risking worsening the infection.

How do you know if you have a gum abscess?

Local tenderness, swelling, presence of pus, bad mouth odor or metallic sensation are common symptoms. If you have any doubts, a visit to the dentist is necessary.

Is it serious if a dental abscess breaks out?

The relief is temporary, but the condition remains present. You must consult quickly to avoid recurrence or complications.

Conclusion: Prevent and treat periodontal abscess

This type of abscess may seem impressive, but it is well treated with prompt intervention. Consult your dentist at the first symptoms to avoid complications. And to prevent recurrences:

  • Maintain good oral hygiene,

  • Make regular check-ups,

  • Treat any periodontal disease.

Appropriate follow-up = a bright, pain-free smile and a healthy mouth!

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