Treatment of jaw periostitis (dental abscess)

Pain, swelling, redness of the gums, and a sharp deterioration in well-being may indicate a serious inflammatory process that requires urgent care. This is how periostitis — inflammation of the periosteum of the jaw — may manifest itself. Its most common form in dentistry is periostitis of the jaw, which in everyday life is more often called a gumboil.

The problem is that in the initial stages, the disease may manifest itself only as minor discomfort or toothache. Without timely treatment, the inflammation may progress to a purulent form, cause pronounced facial swelling, spread to the surrounding tissues, and lead to the development of dangerous complications, including phlegmon.

At Oxford Medical dentistry in Kyiv, the doctor determines the source of the infection, assesses the extent of the inflammatory process, and selects the optimal treatment tactics. Make an appointment for a dentist consultation by phone or through the online appointment form.

According to European Society of Endodontology (ESE), the main cause of a gumboil is the spread of bacterial infection from the tooth to the periosteum of the jaw. Most often, this occurs when the inflammatory process remains untreated for a long time.

Jaw periostitis may develop as a result of:

• deep caries complicated by inflammation of the pulp;
• periodontitis, when the infection spreads beyond the root of the tooth;
• inflammation of the tissues around a wisdom tooth during its eruption;
• infection of the tissues after trauma to the tooth or jaw.

Doctors at «Oxford Medical» explain: in most cases, tooth periostitis does not occur suddenly. It is usually preceded by untreated caries, pulpitis, or periodontitis, due to which the infection gradually spreads beyond the tooth and affects the periosteum of the jaw.

Doctors at «Oxford Medical» recommend: consult a dentist as soon as the first symptoms appear. And if the pain quickly intensifies, the swelling increases, or the body temperature rises, all the more do not postpone a visit to the doctor.

The main danger of a gumboil is that the infection does not remain localized. Without treatment, the inflammatory process can spread beyond the periosteum, affecting neighboring soft tissues, bone, and other anatomical structures.

Possible complications of a gumboil include:

• formation of an abscess with accumulation of pus;
• spread of the infection to the soft tissues of the face with the development of phlegmon;
• damage to the bone tissue of the jaw (osteomyelitis);
• entry of the infection into the bloodstream with the development of severe infectious complications.

Doctors at «Oxford Medical» recommend: do not try to open a gumboil yourself or take antibiotics without a doctor's prescription. This does not eliminate the source of the infection and may only temporarily reduce the manifestations of the disease, while the inflammatory process continues to develop.

Treatment methods depend on the stage of the inflammatory process, the presence of pus, and the condition of the tooth that became the source of infection. After examination and assessment, the dentist determines what to do with a gumboil in each specific case and draws up an individual treatment plan. It may include conservative or surgical methods, and in many cases — their combination.

Conservative Therapy

Conservative treatment is possible only in the initial stages of the disease or as part of comprehensive therapy after surgical intervention. It may include medication treatment, as well as treatment of the tooth that became the source of infection, if it can be preserved. At the same time, conservative therapy alone does not ensure recovery if a purulent focus has already formed.

Surgical Intervention

If pus has already accumulated in the area of the periosteum, surgical treatment is performed. It involves opening the purulent focus, ensuring the drainage of pus, and eliminating the source of infection. Depending on the clinical situation, the doctor may treat the tooth or, if it is impossible to preserve it, recommend extraction.

The dentist determines the need for surgical treatment after examination and assessment. The decision to perform surgery is made when it is necessary to ensure the drainage of pus to eliminate the inflammatory process or when there is a high risk of further spread of the infection.

Indications for surgical treatment of tooth periostitis are:

• a formed purulent focus in the area of the periosteum;
• absence of natural drainage of pus;
• rapid increase in swelling of the soft tissues;
• ineffectiveness of conservative treatment.

After determining the indications, the doctor chooses the optimal extent of the intervention.

Surgical treatment of jaw periostitis is performed under local anesthesia. The extent of the intervention depends on the extent of the inflammatory process and the individual characteristics of the clinical situation.

The main stages of the operation:

1. Preparation for the intervention — before the operation begins, the doctor administers local anesthesia and treats the surgical field with an antiseptic solution.
2. Incision of the soft tissues — a small incision is made in the area of inflammation to provide access to the purulent focus.
3. Drainage of the purulent focus — the doctor performs abscess removal, removes the pus, and rinses the cavity with an antiseptic solution.
4. Placement of drainage — if necessary, drainage is placed, which ensures the outflow of pus and prevents its repeated accumulation.

After the surgical intervention, the doctor assesses the condition of the tooth that caused the development of periostitis of the jaw bones. If it can be preserved, treatment is performed. If this is impossible, the doctor may recommend tooth extraction.

If indicated, the patient is also prescribed medication treatment, which may include antibacterial, anti-inflammatory, and pain-relieving medications. The doctor also provides recommendations for oral care and schedules the date of a follow-up examination. During the follow-up visit, the healing process is assessed, the drainage is removed, and, if necessary, further treatment is adjusted.

In most cases, pain begins to decrease within 1–3 days after surgery, and swelling gradually subsides within 3–7 days. The duration of recovery depends on the extent of the inflammatory process, the extent of the intervention performed, and the individual characteristics of the body.

During the recovery period, it is recommended to:

• take the medications prescribed by the doctor in a timely manner;
• maintain thorough oral hygiene, avoiding injury to the surgical area;
• during the first few days, avoid hot food, alcohol, and smoking;
• limit intense physical activity until the acute inflammatory process has completely subsided;
• attend follow-up examinations in a timely manner.

Doctors at «Oxford Medical» recommend: if pain or swelling increases after surgery, there is abundant discharge of pus, a high body temperature, or other symptoms that cause concern, it is necessary to consult a dentist as soon as possible. This may indicate the development of postoperative complications or the repeated spread of infection, which requires a doctor's examination and adjustment of treatment.

The cost of treatment depends on the stage of the inflammatory process, the need for surgical intervention, treatment or extraction of the tooth, as well as the extent of other procedures that may be required in a particular case. The doctor determines the preliminary treatment plan and its approximate cost after an examination and the necessary assessment.

You can find out the cost of a dentist consultation here. To make an appointment, submit a request through the online appointment form or call the contact center.

The information is for informational purposes only and does not replace a consultation with a doctor.

Sources:

• American Dental Association
• US National Library of Medicine
• National Center for Biotechnology Information