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Abstract: This case is of a young guy who complained of discomfort such as swollen, painful and bleeding gums 2-3 times in 1 year. Through a series of examinations such as oral examination and imaging, fasting blood glucose screening, etc., combined with the medical history, a diagnosis of periodontal abscess was made. After the administration of systemic anti-inflammatory and periodontal basic treatment, the patient’s periodontal swelling and pain were significantly relieved.
Basic information】Male, 27 years old
Disease Type】Periodontal abscess
Hospital】Nei Mongol Autonomous Region Maternal and Child Health Hospital
Date of consultation】March 2022
Treatment plan] Periodontal irrigation + abscess drainage + anti-inflammatory treatment (cefradine, metronidazole, etc.) + basic periodontal treatment
Treatment period】3 weeks of outpatient treatment, 1 weekly outpatient follow-up, 2 times in a row
Treatment effect】The patient’s periodontal swelling and pain were significantly relieved.
I. Initial consultation
A young male patient came to the clinic complaining of 2-3 times of gingival swelling within a year, sometimes single and sometimes multiple, without physical examination. The patient was given a detailed examination and was found to have misaligned teeth, 11 and 21 with large mesial gaps, looseness Ⅰ°, periodontal pockets about 6-8 mm deep, labial gingival abscess, fluctuating sensation on palpation, pus with bleeding in the periodontal pockets on probing, rough tartar on the root surface on probing, full mouth tartar Ⅱ°, bleeding on light probing, 16 and 26 with severe gingival atrophy, probing pain (-), percussion pain (-), looseness (-), 48 elongation Occlusal interference, 46 proximal and middle adjacent surfaces were detectable caries, probing pain (+), percussion pain (-), looseness (-), pain sensitivity in hot and cold test. The whole-mouth surface tomogram showed that there was horizontal resorption of alveolar bone height, angular resorption of 11 and 21 proximal and distal alveolar bone, angular resorption of 16 and 26 proximal and middle alveolar bone, 38 ambiguous obstructed teeth, and 46 proximal and middle crowns showed large low-density images near the pulp chamber. The initial diagnosis was periodontal abscess, and the patient was recommended to be referred to the endocrinology department for further treatment after oral treatment.
II. Treatment history
The patient’s periodontal abscess was treated with periodontal irrigation, abscess drainage and anti-inflammatory treatment (oral cefradine and metronidazole), and was instructed to rinse the mouth with compound chlorhexidine rinse after meals daily. The patient was instructed to brush and floss properly. It was recommended to come to the hospital for review once a week for 2 consecutive times and to treat the extraction of the blocked wisdom teeth. In addition, since the patient had abnormal fasting blood glucose values, it was recommended to consult the endocrinology department to clarify whether diabetes was present, and if so, glucose-lowering treatment was required.
III. Treatment effect
After 3 weeks of medication and periodontal basic treatment, etc., the patient’s gingival swelling subsided, and there was no gingival bleeding when brushing teeth, and the patient was satisfied with the treatment effect. The patient had good compliance, cooperated with the doctor to complete the basic treatment, and made regular follow-up visits and actively took good oral care, and there was no obvious tendency of recurrence in the 2 follow-up visits, and the periodontal treatment effect was good. The patient was recommended to come to the hospital for scaling treatment once every six months to avoid tartar accumulation.
IV. Notes
We are glad that the patient’s periodontal abscesses subsided after clinical treatment as well as care, and there was no recurrence. It is recommended that the patient should master the correct brushing method in daily life, often use the pasteurization method to clean the soft food scale and plaque attached to the teeth as much as possible, and master the use of dental floss correctly to clean the food residue embedded in the interdental space as much as possible. Avoid drinking carbonated drinks and a lot of sticky food with high sugar content, and develop good eating habits.
V. Personal insight
Dental diseases are usually caused by poor oral hygiene, and the onset of the disease is relatively insidious, usually only when there is toothache and swollen gums to attract attention, at this time may have led to periodontal abscesses, and untimely treatment may lead to tooth loss. Especially in recent years, the onset of periodontal abscesses has a tendency to be younger, so it is important to pay attention to this and to seek medical attention in time to avoid delays in such symptoms. Oral health care is very important, advocating an annual oral examination, half a year or once a year scaling, regular tartar cleaning, rinsing after meals and brushing in the morning and evening can effectively prevent periodontal abscesses.