Recurring Gum Boils: Causes and Treatment Options

Repeated formation of abscesses in the gums?

Hello, about six months ago, I started developing abscesses in the gums next to my molars.
I consulted two dentists who diagnosed it as periodontal disease.
They performed cleanings, but the abscesses did not resolve.
I then saw a third dentist who mentioned that there are bacteria hiding in my teeth, and even the underlying bone has been affected.
After several months of ongoing treatment involving draining the abscesses and applying medication, there was some improvement, but it has recently recurred.
The dentist explained that there is a small hole between my teeth and gums, which makes it easy for food particles to get trapped and not be cleaned properly.
Additionally, the bacteria have not been eradicated.
Now, he mentioned that if this continues, I may need to have the tooth extracted.
I would like to know if there are better options available, as once the tooth is removed, I won't be able to get dentures.
Thank you.

MMI, 20~29 year old female. Ask Date: 2016/03/16

Dr. Zeng Guanghui reply Dentistry

In the aforementioned situation, if the infection is determined to be caused by bacteria within the tooth's root canal, root canal therapy should be performed.
However, if there is a small cavity between the tooth and the gum, it indicates that there may be a crack at the root or the bottom of the pulp chamber, which would compromise the effectiveness of root canal treatment.
In this case, extraction of the tooth is recommended, and it is advisable to consult a dentist for further examination.

Reply Date: 2016/03/16

More Info

Recurring gum boils, also known as periodontal abscesses, can be a frustrating and painful condition. They often arise due to underlying dental issues, primarily related to periodontal disease, which is an infection of the tissues that support the teeth. Understanding the causes and exploring treatment options is essential for managing this condition effectively.

Causes of Recurring Gum Boils
1. Periodontal Disease: As you mentioned, periodontal disease is a primary cause of gum boils. This condition occurs when plaque and tartar build up on the teeth, leading to inflammation and infection of the gums. If left untreated, the infection can progress, causing pockets to form between the teeth and gums, which can fill with pus, resulting in abscesses.

2. Bacterial Infection: The presence of bacteria in the mouth can lead to infections that cause gum boils. In your case, it seems that bacteria may be hiding in the small cavity between your teeth and gums, making it difficult to eliminate the infection completely.

3. Food Particles: The small hole you mentioned between your teeth and gums can trap food particles, creating an environment conducive to bacterial growth. This can lead to recurrent infections and the formation of abscesses.

4. Bone Loss: If the infection has progressed to the point where it has affected the underlying bone, this can complicate treatment and increase the likelihood of recurrence.

Treatment Options
1. Deep Cleaning (Scaling and Root Planing): This is often the first line of treatment for periodontal disease. It involves removing plaque and tartar from below the gum line and smoothing the roots of the teeth to help the gums reattach. If you haven't had this procedure recently, it may be worth discussing with your dentist.

2. Antibiotics: If there is a persistent bacterial infection, your dentist may prescribe antibiotics to help eliminate the bacteria causing the abscess. This can be particularly useful if the infection is localized and not responding to other treatments.

3. Surgical Intervention: If the abscesses continue to recur and there is significant bone loss or deep pockets, surgical options may be necessary. This could involve flap surgery to clean the roots of the teeth and reduce the depth of the pockets, or even bone grafting if there is significant bone loss.

4. Addressing the Cavity: It’s crucial to address the small hole between your teeth and gums. This may involve restorative dental work, such as fillings or crowns, to eliminate the space where food can get trapped and bacteria can thrive.

5. Regular Dental Visits: Maintaining regular dental check-ups is essential for monitoring your oral health and catching any issues early. Your dentist can provide professional cleanings and assess the health of your gums and teeth.

6. Oral Hygiene Practices: Improving your oral hygiene routine can significantly impact your gum health. This includes brushing twice a day with fluoride toothpaste, flossing daily, and using an antibacterial mouthwash to reduce plaque buildup.

Conclusion
While the prospect of tooth extraction can be daunting, it is essential to explore all possible treatment options before resorting to that. Consulting with a periodontist, a specialist in gum disease, may provide additional insights and treatment options tailored to your specific situation. Remember, maintaining good oral hygiene and addressing any underlying issues promptly can help prevent the recurrence of gum boils and preserve your natural teeth.

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