Treatment of Flux (Periostitis)

We treat gum flux or inflammation of the tooth periosteum

The dental clinic of authorial prosthetics "Kiadent" provides treatment for acute and chronic jaw periostitis. Using modern equipment, we perform surgical incision and drainage of abscesses (dental abscess). We also prescribe therapeutic treatment for the gums and the affected tooth.

Book an appointment with a periodontist at "Kiadent" on Tiraspol Street 12.

What is it? How does an abscess appear?

Jaw periostitis (dental abscess) is an acute or chronic inflammation of the periosteum in the area of the affected tooth, accompanied by gum swelling and severe pain.

The infection affects the diseased tooth, and an inflammation focus forms in the alveolar process (abscess). It appears as a painful lump filled with pus on the gum (periosteal abscess), which gradually swells and is accompanied by sharp pain.

How dangerous is a dental abscess?

Chronic periostitis can lead to dangerous complications such as phlegmon or swelling under the tongue, in the cheeks, or the floor of the mouth. If pus starts to drain through a fistula into the oral cavity, the general condition worsens, fever develops, and swallowing becomes painful. Timely treatment of an abscess helps avoid tooth loss, sepsis, and the development of osteomyelitis beneath the periosteum.

Price for Abscess Treatment at "Kiadent"

The cost of periostitis treatment does not include expenses related to caries removal, root canal retreatment, or restoration of the tooth crown with a filling. In complicated clinical cases, removal of the problematic tooth and implant placement may be required.

Full list of services for abscess treatment:

Consultation with a dentist
Physiotherapy
Incision and drainage of the abscess on the gum
Endodontic treatment of tooth canals
Extraction of a defective tooth

Symptoms of Periostitis

Inflammation can begin with an intense reaction from the body and escalating pain. Sometimes, the dental condition develops within 1-2 days. During this time, body temperature increases in the area of the tooth, and the swelling disrupts facial symmetry.

General pathological symptoms of an abscess:

swelling of the gum and facial asymmetry;
redness and swelling;
a painful pus-filled lump on the mucosa;
caries on the tooth or darkening of the enamel;
enlargement of the lymph nodes in the neck;
pain of varying intensity radiating to the temples, ears, and eyes;
general weakness and loss of appetite;
fever.

Causes of a Gum Abscess

The primary cause of the disease is an inflammation in the pulp of the tooth or the periodontal pocket.

Infection penetrates the supporting apparatus of the tooth and causes an inflammatory process—periodontitis. When this inflammation worsens or complications arise, periostitis develops.

Other causes of periostitis development include:

Moderate and severe periodontitis (infection of the alveolar process periosteum occurs through deep periodontal pockets);
Jaw trauma;
Suppuration of an inflammatory cyst;
Suppuration of a wound after tooth extraction;
Difficulty in the eruption of wisdom teeth;
Sinusitis (in the upper jaw).

Unclear without a doctor

Periostitis can provoke an abscess, fistula formation, and abscesses on the gums due to hypothermia, weakened immunity, or viral infections.

The cause of an abscess can only be determined by a dentist after an examination of the patient's oral cavity and radiological imaging.

Types of Periostitis

Periostitis progresses in two stages—acute and chronic, with transitioning forms. Depending on the number of affected teeth, the disease can be:

localized (1 tooth);
diffuse (several teeth).

There are different classifications of periostitis (abscess), which describe the location, causes, and histology of the disease. These classifications are discussed in informative articles on gum inflammation but do not influence the treatment strategy for acute or chronic abscesses.

Acute

The clinical picture of the disease in the acute stage develops rapidly. The inflammatory process is localized in the area of the affected tooth and one or two neighboring teeth. The mucous membrane over the inflamed periosteum swells.

Acute odontogenic periostitis has two phases:

Serous. Typically arises due to trauma to the mucosa or exacerbation of periodontitis. It begins with pain in the area of the problematic tooth and slight gum swelling. The swelling gradually increases and becomes visible. Depending on the location of the inflammation (upper or lower jaw), the cheek or submandibular area swells. When the upper incisors are affected, the lips and soft tissues near the nose swell.
A few days after the onset of symptoms, the temperature rises to 38-39°C, and the patient complains of increasing tooth pain, which spreads throughout the jaw, radiating to the ear, neck, and temple area. The lymph nodes are enlarged and painful.
Purulent. Occurs when the tooth is severely affected, and it becomes pathologically mobile. The infection spreads to the gum, causing swelling, and a periapical abscess forms. Treatment for acute periostitis is comprehensive and involves emergency surgery and medication therapy.

Chronic

Patients mainly complain of thickening of the jawbone and periodic pain in the affected tooth. Symptoms are not as pronounced—there is swelling, pain, and hardening of the gum tissue. Chronic abscess symptoms appear over several days. On the radiograph, excessive bone formation under the periosteum and changes in the bone tissue around the roots of the affected tooth are visible.

Treatment starts with the problematic tooth, and the course includes antibiotic therapy and physiotherapy. If necessary, the defective tooth is removed.

Better to not delay

Without timely treatment, periostitis can quickly progress to a purulent form, leading to a serious complication—osteomyelitis of the jawbone. To prevent this, it is necessary to see a doctor as soon as the first symptoms appear.

Abscess Treatment Methods at Kiadent

The main goal of the doctor in treating periostitis is to preserve the affected tooth and relieve painful symptoms. To achieve this, the doctor addresses several key tasks:

identifies and eliminates the infection source to stop the inflammation;
treats complications—restores bone tissue volume, fills the root canal, and restores the tooth cavity;
in complicated clinical cases—removes the affected tooth and prepares the patient for prosthetics or dental implantation.

Diagnosis

1. Step. Complaint and history collection
The dentist clarifies how long the pain and swelling have lasted, how difficult it is to open the mouth, and whether swallowing is painful. The presence of acute or chronic diseases and allergies is noted. During the interview, the timing, nature of symptoms, and previous treatments are determined.
2. Step. Oral examination
The soft tissues of the gums are checked, and the lymph nodes are palpated. Tooth sensitivity and oral hygiene are evaluated. A thermal test is performed on the affected and neighboring teeth. The mobility of the teeth and the presence of purulent exudate are noted.
3. Step. Additional examination
To confirm or clarify the diagnosis, dental radiography is performed. X-rays reveal changes at the root of the affected tooth (granulomas) and the condition of the root canals (whether they are clear or filled).
4. Step. Diagnosis
The doctor makes a final diagnosis and prepares a treatment plan, indicating the form of the disease, location, and complications (if any). For example, acute serous periostitis of the upper jaw due to exacerbation of chronic periodontitis of tooth 25.

Treatment Stages

The primary method of treating acute periostitis is the surgical incision of the abscess and drainage of the pus. Tooth extraction is performed only if the tooth is severely damaged or cannot be treated due to nonviable canals. If the affected tooth is intact, conservative treatment is provided.

Conservative Treatment

Conservative methods are effective only in the early stages of acute serous periostitis. After the diagnosis, the following steps are taken to eliminate the abscess:

1. Step.
Preparation of the crown part of the affected tooth and cleaning of the root canals, similar to periodontitis treatment.
2. Step.
The patient is prescribed antibiotics, antihistamines, and anti-inflammatory medications, along with at-home mouth rinses.
3. Step.
Physiotherapy (usually scheduled 2-3 days after the first visit).

Surgical Treatment

Surgical intervention is performed when the disease progresses to the purulent stage, and conservative treatment proves ineffective, according to the following procedure:

1. Step.
Incision of the gum mucosa down to the bone, opening the abscess, and placing a drainage tube to allow the pus to drain from the infected area (a strip of medical rubber is used for drainage).
2. Step.
Washing and antiseptic treatment of the periosteal area.
3. Step.
Cleaning and antiseptic treatment of the tooth cavity.
4. Step.
In cases of severe crown or root destruction where tooth-saving procedures are not feasible, the defective tooth is extracted. Tooth extraction and subsequent socket curett

age are performed simultaneously with abscess incision.

Doctor's Advice

Typically, we begin treating jaw periostitis with conservative methods. However, in most cases, a combination of conservative, surgical, and physiotherapy treatments is necessary to achieve lasting results.

Medication Treatment

The doctor may recommend medications to help relieve pain before the appointment and for post-treatment at home.

How to relieve pain?

If the pain is severe, contact your doctor for a prescription for a pain-relieving medication. Nimesil, Ketanov, or other over-the-counter painkillers can help (the dosage should be clarified by the doctor). It is strictly forbidden to apply compresses to the swelling or make dressings before seeing the doctor.

Antibiotics

Antibiotic therapy is prescribed for acute jaw periostitis when the temperature is significantly elevated, and the affected tooth is not removed. The doctor may prescribe:

Doxycycline—1 tablet (0.1 g) twice on the first day, then once daily after meals, taken with plenty of water.

Lincomycin—half a tablet 3 times a day.

What to rinse with?

Before or after the doctor’s visit, you can rinse your mouth with the following solutions:

Salt and soda solution 1-2%.
Chlorhexidine 0.05%.
Furacilin 0.02%.

Rinses help reduce swelling and clean the pus after the abscess is drained. You can perform 3-4 gentle rinses or oral baths throughout the day.

What ointment to use?

Ointments help speed up wound healing and reduce residual gum inflammation. After abscess drainage, the doctor may prescribe Levomekol, Holisal, Stomatofit, or another antiseptic ointment. The ointment should not be applied to an open wound but rather to the healing area using a tampon.

Questions and Answers

Can a gum abscess be treated with antibiotics?
The main condition for successfully treating periostitis is the incision of the abscess to ensure the contents can drain from the inflammation site. Therefore, antibiotic treatment alone, without draining the pus, will be ineffective.
How to get rid of an abscess at home, and what to rinse with?
Self-treatment of periostitis is dangerous and can lead to serious complications. Home rinses with antiseptic and folk remedies are possible as a supplement to the primary treatment, but only after consulting your dentist. Typically, a dentist may recommend salt solution, peroxide solution, and ointments or gels containing chlorhexidine for rinsing.
Is it painful to incise the gum?
Before surgically incising the abscess, anesthesia is administered, and sometimes the procedure is done under general anesthesia. If the abscess is not deep, the gum near the tooth is incised, and with anesthesia, it is painless, though some discomfort may occur in the hours following the procedure. Inserting the drainage tube may cause more discomfort, but it is necessary until the wound is disinfected.
What can an abscess be mistaken for?
Serous periostitis is often mistaken for pulpitis or periodontitis with "periosteal symptoms." In the purulent phase, the symptoms can be similar to those of purulent periodontitis, acute osteomyelitis, abscesses, phlegmon, or sinusitis. In the early stages, an abscess is difficult to distinguish from other acute inflammatory conditions of the jaw. Only a dental therapist can accurately diagnose the disease during a consultation.
Is it better to wait for an abscess to burst on its own?
If untreated periostitis does not develop into phlegmon, the abscess may burst through a fistula. Pus will start draining into the oral cavity, and the pain and inflammation will subside. HOWEVER—without treatment, the abscess will become chronic, meaning it will flare up again. Moreover, it can take 2 to 7 days for the fistula to form, while the pain will persist. Therefore, don't rely on "luck"; instead, visit a dentist to get rid of the pain as soon as possible.