Gum Abscesses: Causes, Treatments, and When to Seek Help

Gingival abscess

Hello Doctor, following up on my previous issue, this Thursday I will have undergone three root canal treatments on my molar, but I am still experiencing pain.
The doctor mentioned that I might need to undergo microscopic root canal therapy, which is quite expensive, so I have decided to extract the tooth, with the appointment scheduled for March 30th.
The abscess next to the molar has also resolved.

Now, I would like to ask the first question regarding the small abscess that appeared on my upper gum shortly after the last one.
It has not healed for three weeks, and I consulted an ENT specialist who said it was inflammation and that it was not a concern.
Last Friday, I visited a doctor at National Taiwan University Hospital, who suggested it was a salivary gland inflammation, stating that it was too far from the molar to be caused by it.
They scheduled an outpatient procedure for April 22nd, along with some tests.
Recently, I have felt that the small abscess on my upper gum seems to be getting smaller, and I can feel it when my tongue touches it.
I even recorded it with my phone.

I would like to ask the doctor whether this is simply inflammation or salivary gland inflammation, as there is no pain.
Later, I visited another clinic where the doctor mentioned that the area on the upper gum fold is where the salivary gland is located, but it has already been three weeks.
Should I consult an oral and maxillofacial surgeon?
Additionally, I have been experiencing recurrent mouth ulcers that heal and then reappear, which has never happened to me before.
Recently, I have been under more stress at work.
Could this be the reason for the mouth ulcers, especially since they take almost three weeks to heal? Would it be advisable to supplement with vitamin C? I usually go to bed around 10 PM and wake up at 6 AM for work.

Wenwen, 40~49 year old female. Ask Date: 2022/03/27

Dr. Zeng Guanghui reply Dentistry

Gingival inflammation is caused by an infection of the periodontal tissues surrounding the teeth or may be due to inflammation of the minor salivary glands.
It is recommended to consult a dentist or an oral surgeon for further diagnosis and treatment, including X-rays.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2022/03/27

More Info

Understanding gum abscesses is crucial for maintaining oral health, especially when experiencing symptoms like pain or swelling. A gum abscess, also known as a periodontal abscess, is a localized collection of pus that can occur in the gums due to bacterial infection. Here, I will discuss the causes, treatments, and when to seek help regarding gum abscesses.

Causes of Gum Abscesses
Gum abscesses typically arise from untreated dental issues, such as:
1. Periodontal Disease: This is the most common cause of gum abscesses. Bacteria build up in plaque and tartar, leading to inflammation and infection in the gums.

2. Tooth Decay: If a cavity is left untreated, it can progress to the pulp of the tooth, leading to infection that can spread to the surrounding gum tissue.

3. Trauma: Injury to the gums or teeth can introduce bacteria, resulting in an abscess.

4. Foreign Objects: Sometimes, food particles or other foreign materials can become lodged in the gums, leading to infection.

5. Systemic Conditions: Certain health conditions, such as diabetes, can increase the risk of infections, including gum abscesses.

Symptoms
Common symptoms of a gum abscess include:
- Swelling and redness in the gums
- Pain or tenderness in the affected area
- A bad taste in the mouth or foul breath
- Pus drainage from the abscess
- Difficulty chewing or swallowing

Treatments
Treatment for a gum abscess typically involves:
1. Drainage: The primary treatment is to drain the abscess to remove the pus. This can often be done in a dental office.

2. Antibiotics: Dentists may prescribe antibiotics to help clear the infection, especially if it has spread or if the patient has underlying health issues.

3. Root Canal Treatment: If the abscess is related to an infected tooth, a root canal may be necessary to remove the infected pulp and seal the tooth.

4. Surgical Intervention: In some cases, surgical procedures may be required to remove the abscess or treat underlying periodontal disease.

5. Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain and inflammation.

When to Seek Help
It is essential to seek dental care if you experience:
- Persistent pain or swelling in the gums
- Fever or systemic symptoms indicating a more severe infection
- Difficulty swallowing or breathing
- Abscess that does not improve with home care
Given your situation, where you have undergone multiple root canal treatments and are experiencing ongoing pain, it is advisable to follow through with the extraction of the tooth as planned. Additionally, since you mentioned the presence of a small abscess in the upper jaw that has not resolved, it is wise to consult with an oral surgeon or a specialist in oral and maxillofacial surgery. They can provide a thorough evaluation and determine whether the issue is related to the salivary glands or if it is indeed a continuation of the dental infection.

Additional Considerations
You also mentioned experiencing mouth sores and increased stress. Stress can indeed contribute to oral health issues, including canker sores. Maintaining good oral hygiene, managing stress through relaxation techniques, and ensuring adequate nutrition, including vitamin C, can support your overall health and healing.

In summary, gum abscesses can stem from various dental issues, and timely treatment is crucial to prevent complications. Given your ongoing symptoms and the complexity of your dental situation, seeking specialized care is advisable.

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