A gingival abscess is a pus-filled sac that forms in the gum line (gingiva) of the teeth.

Gingival abscess is one of three kinds of dental abscesses that resemble each other. The other two kinds are periodontal and periapical abscesses. A periodontal abscess occurs when the infection of a gingival abscess moves deep into gum pockets and drainage of pus is blocked. A periapical abscess occurs when the inner layer of a tooth (pulp) becomes infected, usually secondary to tooth decay. Gingival abscess is caused by infection from bacteria that enter the gums following injury from aggressive tooth brushing, toothpick punctures, or from food that is forced into the gumline. The infection may spread into surrounding tissue, and if left untreated, it can progress, damaging the support structure of the teeth.

Incidence and Prevalence: According to reports issued by the Centers for

Disease Control and Prevention (CDC) in 1998, 11,000 cases of gingival abscess were diagnosed in the US.

Source: Medical Disability Advisor

Diagnosis
History: Although most gingival abscesses develop quickly, a slowdeveloping gingival abscess may go unnoticed and present no symptoms until it has become severe. Symptoms may include tenderness and swelling in the gum line, a feeling of loose teeth, or teeth that have become unusually sensitive to heat and cold. If the abscess has progressed, it may be releasing a foul-tasting pus. Severe abscesses can cause fever, headache, chills, diarrhea, nausea, and a dull, throbbing pain. There may be difficulty opening the mouth or swallowing.

Physical exam: In its initial stages, a gingival abscess causes the gum line
to swell and appear red and shiny. A point may appear from which pus can be released under gentle pressure. Lymph nodes in the neck may also be swollen.

Tests: Tests are usually not required to diagnose a gingival abscess. An x-ray
will help to determine the exact location of the abscess and to see if the abscess has penetrated the structure supporting the teeth (periodontal structure).

Source: Medical Disability Advisor

Treatment
The first step of treatment is to drain all pus that has accumulated in the abscess. One way to accomplish the drainage is to pass a probe into the abscess and to gently scrape away the infected material. It may be necessary to make a small incision in the gums in order to reach the abscess. If the abscess has not progressed into the periodontal structure, antibiotic therapy is usually effective in eliminating the infection. If the abscess has progressed into the periodontal structure, deep cleaning will be required for the gum pocket. If too much bony support and periodontal ligament attachment have been lost or if the tooth is too loose, the tooth may need to be removed (dental extraction).
Source: Medical Disability Advisor

Prognosis
Following drainage, if the abscess has not progressed into periodontal structure, antibiotic therapy is effective in eliminating the infection. However, the prognosis to save the tooth is poor if the abscess has progressed into the periodontal structure.
Source: Medical Disability Advisor

Complications
A gingival abscess near a molar rarely progresses into an abscess involving a tooth root (dentoalveolar abscess). Pus from an abscess may be discharged into the jaw and throughout the floor of the mouth, causing difficulty in swallowing and breathing. The discharge of pus may also cause swelling so severe that breathing is obstructed, making it necessary to create a surgical opening in the trachea (emergency tracheostomy).
Source: Medical Disability Advisor