NUR KAMALIAH JAMEL

(DIA160039)

PERIODONTAL EMERGENCIES
acute condition involving periodontium which causes pain and requires urgent
dental care

GINGIVAL ABSCESS PERIODONTAL ABSCESS

A localised purulent infection that involves the A localised accumulation of pus within the gingival wall of a
marginal gingiva or interdental papillae. periodontal pocket resulting in the destruction of the collagen fibre
attachment and the loss of nearby alveolar bone.

ovoid elevation on
attached gingiva/ painful & tender
rapidly to palpation
expanding mucosa
localised shiny & smooth
swelling / pointed tooth may feel more
deep pocket depth
mobile & 'high' in occlusion
painful & tender suppuration may
to palpation present
Aetiology Management
Aetiology Following debridement – Emergency:
calculus fragments may manage the acute condition &
subgingivally impacted foreign objects
become dislodged and pushed symptoms
(piece of nail)
into the periodontal tissues. pus drainage
After surgical therapy – scaling & RSD
Management associated with foreign irrigate with normal saline/
bodies (membranes or antiseptic
incision & drainage occlusal adjustment for
irrigate with saline to relieve the acute sutures)
immediate relief
symptoms Acute exacerbation of antibiotic (systemic
scaling & RSD periodontitis involvement)
remove foreign body Systemic antimicrobial intake extraction (poor prognosis)
short term use of chlorhexidine 0.2% / without subgingival long term:
warm saline debridement in severe periodontal therapy after
follow up periodontitis resolution of acute phase
NUR KAMALIAH JAMEL
(DIA160039)

PERIODONTAL EMERGENCIES
acute condition involving periodontium which causes pain and requires urgent
dental care

PERIO-ENDO ABSCESS NECROTISING PERIODONTAL DISEASES

pathologic communication between the pulpal and the most severe inflammatory lesions associated with the
periodontal tissues at a given tooth that may occur in oral biofilm
an acute or a chronic form

The tooth may be painful a ‘punched

tender to out’
percussion & appearance
palpation and Marginal
mobile. erythema
anterior teeth are
most commonly affected
deep pocket A smooth, shiny swelling of the
surrounding a non- gingiva or mucosa, purulent exudate
vital tooth or fistula may present Aetiology Management
Emergency:
Aetiology Management Organisms:
Prevotella Superficial debridement to
may arise primarily Emergency: intermedia remove soft and mineralised
from pulpal incision & drainage Fusobacterium sp. deposits
inflammatory disease pulp extirpation Treponema sp. advice patient to use
scaling & RSD chemical plaque control
expressed through the
irrigate with normal Predisposing factor: agents (chlorhexidine
periodontal ligament mouthwash 0.2% twice daily)
saline/ antiseptic immunosuppressed /
or the alveolar bone prescribe antimicrobials if
occlusal adjustment for HIV
to the oral cavity immediate relief no improvement
may be initiated from malnutrition
antibiotic (systemic stress (Metronidazole 400 mg tds x
a periodontal pocket involvement) 5/7)
smoking
communicating to the long term: Long-term:
poor oral hygiene
pulp apically or RCT strict OHE enforcement
through accessory extraction (poor prognosis) treat any preexisting
canals root resection (multi- periodontal disease
rooted teeth) control predisposing factor