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/

Comments

Post a Comment

Popular posts from this blog

Help! My Child is Terrified of the Dentist

Image
If you’re the parent of a young child, you know their brains are similar to sponges that soak up everything around them—especially in their first five years, which neuroscientists say is when they’ll do the most learning and developing in their entire life. At this formative time, your child may amaze you with what they notice: your facial expressions, the different tones of your voice, and your habits. If your habits include regular dental visits and an excellent oral hygiene routine, they’ll notice and want to emulate you. If you happen to feel anxious about your dental visits, or you groan when you’ve got to floss and brush, they may synchronize and feel your dread. This could lead to dental fears that stick with them for years—potentially a lifetime! Kids Can Be Courageous If you’re feeling guilty right now, go ahead and put that away as it won’t serve you or your little one. Everyone has some room for improvement, and Coastal Pediatric Dentistry® is here to help show you an...
Read more

Going for the Gold?

Image
On the left is the older allow, on the right the new one that my lab has chosen to use The cost of a penny weight of pure gold is currently $79.53. The cost of a penny weight of pure palladium is $130.6. It used to be that palladium was added instead of gold to the precious metals often used for pfms, but now laboratories are finding that palladium is no longer affordable. The lab that I am using has just changed the formulation of the metal it's using to one that has more gold than palladium. I really do not mind, but metals with more gold are softer and often easier for a dentist to accidentally polish off delicate margins. It is important when polishing "higher gold" formulations to exert less hand pressure when performing the final polishing of the crown's margins. Other wise there should be no problem with this change. Traditionally labs have chosen alloys with higher gold percentages for optimal esthetics, since alloys with higher concentrations of ...
Read more

Lemon Juice – The Good, the Bad, & the Sour

Image
In a great tale of opposites, lemon juice can be both acidic and basic, or alkaline. Read on to find out why people are talking about this, and what it means for your oral and overall health . What is pH and why does it matter? Drinking lemon juice (usually diluted in a glass of water or added to a cup of tea) is a beloved health tonic among fans of natural medicine. Potential benefits include lower cholesterol, lower inflammation in the body, and increased metabolism and energy. Lemon also contains high levels of antioxidants and vitamin C that boost your immune system. On a scale from 0-14, a pH of 7 is neutral (pure water) while numbers below 7 are acidic (unhealthy), and above 7 are basic or alkaline (healthy). Believers in holistic health blame many ailments on the body’s pH being too low or too acidic. Increasing your body’s pH is called “alkalizing.” Lemon juice in its natural state is acidic with a pH of about 2, but once metabolized it actually becomes alkaline with a pH ...
Read more