How do you do to treat a periodontal abscess?

This post really just reflects my opinions. I believe that when treating periodontal abscesses (infections around a tooth that do not stem from fractures or endodontic issues) its best to catch them early. During the initial acute stage there can be rapid bone loss, but because its an active process, treatment can result in some bone regrowth and  more likely result in a resolution of the infection.

All too often patient come in with an abscessed tooth that has been bothering them for longer than a month and report that they waited to see if the problem would "go away" on it's own. Although this can occur, its more likely to resolve if a dentist can debride
 and root plane the tooth involved.

When I see the patient with a perio abscess, I take a periapical radiogrpah or two and then set up my cavitron and place some sharp periodontal currettes on my bracket table. These instruments can be used to clean around the tooth and scrape any tarter that is along the tooth's root surface. I use 4.4 power loupes with strong illumination to survey the root surface while cleaning, so that I can ensure that they become completely clean of calculus (tarter).  Calculus tends not to be sterile and its rough surface will allow plaque to adhere easily to the subgivival portion of the root and this can both be the source of the infection and if not removed can hinder the potential for healing afterwards.

After my single tooth root planning, my patient is prescribed 100 mg Doxycycline twice a day for ten days and given  appropriate home care instruction. I ask the patient to return for an observation after a week or two. When they return, if there appears to be good healing going on and no longer any  purulent material draining from the tooth surface, I assume my treatment has been successful for now.

This doesn't mean that the long term prognosis of the tooth is not guarded, but the infection has for the time being been resolved and for now the patient has a "happy" and comfortable tooth.

from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/06/what-do-you-do-to-treat-periodontal.html - http://lspindelnycdds.blogspot.com/

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