Have you been noticing some swelling around your gums and you think it may be a gum abscess? Well, that is certainly not good but we’ll explain what it is and what to do about it if you do indeed have it.
A gum abscess is a periodontal condition in which a pocket full of pus develops in the gingiva (gums). It is a type of dental abscess that is characterized by the infection originating from the gums itself. It may be bacterial induced or from a lodged foreign body and it has three distinct stages that it progresses through.
Since it is a periodontal condition, it will consequently require periodontal treatment. You can also refer to it as a periodontal abscess, which includes infections from the gingiva.
A gum abscess can be very painful since it is an infection after all. Here are some signs and symptoms of how it can present clinically.
- Bleeding gums. The gums bleed easily when you brush, floss, or even while spitting.
- Hurts to chew. Feels tender to chew on that side, which makes you avoid it.
- Inflammation. Gums look red and poofy due to inflammation.
- Loose gums. The gingiva are not taut and tend to peel away from the tooth easily.
- Malodor and taste. Terrible taste and smell coming from the swollen area.
- Pain. Gum pain or tooth pain when stimulated or non-stimulated. It can be a constant dull ache that may feel better whenever you rinse.
- Purulence. A white fluid called pus may ooze out of the gums when you touch it.
- Sensitivity. Teeth feel extra sensitive to hot and cold beverages and foods.
- Swelling. Gums are swollen around the affected area only.
If the entire mouth is swollen you may have gingivitis or periodontitis instead. A gum abscess is a localized infection and not a generalized one like gum disease.
When to see a dentist
See a dentist promptly and do not wait if you’re experiencing any of the symptoms above. It could be one or a combination of all of them but most of the time it is accompanied by pain. There is no reason to live with dental pain and trying to ignore it.
Our recommendation is to get it treated as soon as possible so that you can return to having the quality of life that you deserve. Even if it’s a false alarm and your dentist tells you that there is nothing wrong, that would be the best news for you for that day.
Note: Please don’t try to pop it yourself because draining it is not the full treatment.
You can probably tell that you have some sort of dental abscess but whether it is a gum abscess or not is uncertain. There is no way for you to diagnose it yourself at home. Only a dentist with all of their instruments and diagnostic tests can tell you what you have.
How your dentist diagnoses it:
- Periodontal probing. Your dentist will measure your gum pocket to see if it is healthy.
- Oral examination. A combination of visual, tactile, palpation, and percussion on the tooth. A healthy tooth will be asymptomatic while an unhealthy one will elicit pain.
- X-ray. A severe abscess may show up as radiolucent on the x-ray but only if it is chronic. Typically gum abscesses are acute so it may not show up on the x-ray. Although if there is tartar or a foreign body present, it may show up as radiopaque.
Measuring the periodontal pocket involves using a perio probe like in the photo shown above. Each line on the probe denotes 1 mm. This instrument is inserted in between the tooth and the gums to measure how deep it goes.
- Healthy pocket = 3 mm or less
- Unhealthy pocket = 3 mm or more; The greater the depth the more severe
There are two ways that you can develop a gum abscess, either through a foreign body impaction or localized periodontitis.
Yes, it is precisely what you’re thinking of. When we say foreign body impaction, we literally mean a foreign object that gets lodged into your gums. This most commonly happens while you’re eating during mealtimes.
Common foreign objects that get lodged into the gums:
- Popcorn kernel
- Seeds or small hard foods
- Fish bones
- Tortilla or potato chips
Most of these foreign bodies are food related items because those are the only things that you’re putting in your mouth. Hopefully. Although we wouldn’t discount people biting or chewing on non-food objects like pens due to nervous habits.
Untreated periodontal disease with significant tartar build up in certain spots of the mouth can develop an abscess. The gums become looser due to being inflamed and that makes it easier for regular food items to become lodged into it.
This is still similar to foreign body impaction but it was induced by localized periodontitis. The cause is a little bit different since gum disease increases the risk of it happening. Healthy gums are more taut and less prone to food and plaque getting trapped in it.
Note: You may coincidentally end up with a gum infection after a cleaning if you were supposed to get a deep cleaning but you turn it down.
Since a gum abscess is a periodontal condition, it will require periodontal therapy.
- Scaling and root planing. Otherwise known as a deep teeth cleaning, your dentist will clean below the gum line. This is to remove anything that may be stuck in the depths of the pocket and on the root surface.
- Gingival curettage. Instead of scraping the teeth, the inside of the gums can be scraped as well. This removes granulation tissue from the inside of the gingiva.
- Irrigation. After treatment, your dentist will usually flush out the entire surgical site with an antibiotic solution.
- Minocycline HCL. This is an antibiotic that is placed into the periodontal pocket using a special instrument. The brand name for this product is Arestin.
- Antibiotics. This involves taking antibiotic pills along with using a chlorhexidine rinse.
- Incision and drainage. If the deep cleaning and curettage doesn’t work, you may need a full blown I and D. This requires an incision to drain the infection.
Note: Treatment for this condition differs greatly from a tooth abscess because the latter is an endodontic condition. The tooth abscess utilizes a lot of endodontic treatments which is completely different from what you see above.
This shows the importance of having the correct diagnosis so that you can be prescribed the correct treatment modality. The point we want to make is that not all abscesses are the same and it is of utmost importance to see a dentist.
After getting the infection treated, you should stay away from hard foods that can potentially get stuck in there for the next few days. You may slowly reintroduce harder foods and return to a normal diet.
Be sure to keep the area extra clean while it is healing, it may take up to a week for it to fully heal. The gums are fairly efficient at repairing itself but it still takes time to do so.
Last but not least, take all of the prescribed medications and follow the instructions to the T.
Sometimes it may be inevitable because everyone will experience a gum abscess at some point in their life. Not everyone eats soft foods and drink soup as their only meal. Therefore there will come a time when your food will get lodged into the gums.
However if you’re able to minimize the amount of hard foods that you eat, you can potentially decrease the chances of it happening. Although if you do get a mishap, just know that your dentist can bail you out any day!
Aside from that just make sure you stay on top of your oral hygiene routine and practices:
- Routine dental check ups so that you don’t get excessive calculus build up.
- Brush and floss twice a day if you can. Sometimes stuck food that you can’t get out will cause swelling.