A localized purulent inflammation of the periodontal tissues. It is also known as lateral periodontal abscess or parietal abscess. (AAP Glossary 1992)
Periodontal abscesses can be acute or chronic. Acute abscesses are painful, edematous, red, shiny, ovoid elevations of the gingival margin and/or attached gingiva. After their purulent content is partially exuded, they become chronic. Chronic abscesses may produce a dull pain and may at times become acute. (Carranza & Newman, 1996)
Clinical Findings
Periodontal abscesses occur with pre-existing periodontitis. This acute infection occurs in the walls of periodontal pockets as a result of the invasion of bacteria into the periodntal tissues. While abscesses usually spontaneously occur in patients with untreated periodontitis, it is more common in periodontitis patients with a systemic disease such as diabetes, in which there is a reduced ability to combat infections. In some cases an abscess can even occur a few days after dental cleaning as a result of mechanical disruption of junctional epithelium, allowing the bacteria to gain entrance into the tissues.
microbial Findings
Periodontal abscesses are termed “mixed anaerobic infections,” due to the microbiological findings. Generally specking, the bacteria found in abscesses are of similar composition to what is found in the periodontal pockets.A lateral periodontal abscess is a result of rapidly-growing bacteria within a periodontal pocket. A periodontal pocket forms in the presence of periodontal disease, as the gums become infected and pull away from the surface of the teeth. This deepens the sulcus – the space between the teeth and gums – to a space greater than three millimeters. The deepened sulcus is called a pocket.
An abscess forms when the pocket deepens to the point that plaque bacteria, tartar and/or food become trapped within it, and the body’s immune system cannot adequately combat the infection. A large swelling develops on the gums as a result of this uncontrolled, rapid growth of bacteria, bacterial products and infected gum tissue. As a result, what occurs is a fast, painful destruction of the supporting connective tissue and bone that surround the tooth.
Lateral periodontal abscesses form anywhere along the side of the gums where the periodontal sulcus has deepened to become a pocket. They are common in cases of advanced periodontal disease, when bone loss has occurred as a result of the infection, because the pocket depth of five millimeters or more creates an ideal environment for abscess formation.
Abscesses can be very painful, tender lesions that often appear suddenly. Even small abscesses can produce a great deal of pain. Abscesses are most common in those 40 years old and above, but occasionally occur in children.
Lateral periodontal abscesses are smooth to the touch and range in diameter from two to ten centimeters. In some cases, they form as a result of an immune system disorder or deficiency, or uncontrolled diabetes.
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