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Each Stage of a Gum Abscess

There are three stages to a gum abscess and they can be differentiated from one another based on the severity of the swelling.


The infection originates as a localized swelling of the gums affecting a single tooth. However when it is left untreated, it starts to progress and spread with the swelling increasing in size.


Gum abscess progression
Gum abscess progression

Gum abscess stages:

  1. Localized gum swelling around one tooth.

  2. Generalized gum swelling around multiple teeth.

  3. Gum swelling with facial swelling.

The progression of this dental abscess involves greater swelling with each subsequent stage. Consequently the treatment for it also becomes more complex and costly.


Stage 1 - Localized swelling

The first stage of a gum abscess is localized gum swelling around the affected tooth. The infection is limited to a single tooth because it is the beginning of the abscess. Essentially it starts with one tooth.


Localized gum abscess
Localized gum abscess

Signs and symptoms:

  • Swollen gums but limited to a single tooth

  • Red and poofy looking

  • Bleeds easily upon touching or brushing

  • Constant mild dull tooth pain

The abscess is fairly mild and small in size at this stage but when left untreated, it will start growing and involving more teeth.


Stage 2 - Generalized swelling

The second stage of a gum abscess is generalized swelling which affects multiple teeth. The infection has spread from the affected tooth to the adjacent teeth. The size of the abscess is significantly larger than the first stage.


Generalized moderate gum abscess swelling
Generalized moderate gum abscess swelling

Signs and symptoms:

  • Swollen gums around multiple teeth that are adjacent

  • Very red and poofy looking gingiva

  • Bleeds very easily upon touching or brushing

  • Constant moderate dull pain

The longer you leave this stage of the abscess untreated, the more the swelling will spread. At first it may only affect 2-3 teeth but it can grow to involve the entire quadrant of teeth.


Stage 3 - Facial swelling

The third stage of a gum abscess is facial swelling in addition to generalized gum swelling. The abscess has spread beyond just the gums and the teeth at this stage because it now affects your face.


Severe facial swelling that has spread to throat
Severe facial swelling that has spread to throat

Signs and symptoms:

  • Gums swollen around multiple teeth

  • Very red and poofy looking gingiva

  • Bleeds very easily upon touching or brushing

  • Severe pain

  • Face is swollen and looks disfiguring

This condition can look incredibly disfiguring because the face can be swollen to the size of a golf ball or bigger. Typically once patients have this, it becomes a dental emergency where they'll drop everything that they're doing to get it treated.


Treatment

The treatment for each stage of a gum abscess will differ since the extent and severity of the infection are different. Of course the more advanced the disease is, the more complex and expensive the treatment will be.


Treatments for a gum abscess:

  • Scaling and root planing. Commonly known as a deep cleaning, the root surfaces below the gum line will be cleaned. That is in addition to what is above the gum line.

  • Gingival curettage. Instead of cleaning the teeth, the insides of the gums will be scraped to remove granulation tissue and infection.

  • Incision and drainage. For severe swelling, full drainage of the abscess is needed. An incision into the swelling followed by manually draining it.

  • Antibiotics. Oral antibiotics in pill form along with a rinse may be prescribed. Their purpose is to help clear out the infection and reduce the chances of recurrence.

In case you were wondering, no you shouldn't try to drain a gum abscess at home.


Which treatment do I need?

The more severe your condition is, the more involved the treatment will be. We've created a decision tree as a guide so you have an approximate idea of what to expect.


Treatment for each gum abscess stage
Treatment for each gum abscess stage

In the case for gum infections, you may find it interesting that more treatments are added on as the condition advances. The procedure doesn't simply change as you move from one stage to the next, it simply gets added on to the list.


Treatment for each stage of a gum infection:

  • Stage 1 - scaling and root planing, gingival curettage

  • Stage 2 - scaling and root planing, gingival curettage, incision and drainage

  • Stage 3 - scaling and root planing, gingival curettage, incision and drainage, antibiotics


What you can take away from this is that you should get it treated as soon as possible. Less procedures will be involved which also means it'll be less expensive.


Takeaway

A gum abscess will progress through three distinct stages when left untreated. With each stage the infection grows bigger and the swelling worsens. Treatment for each stage also becomes more complex and more costly.


You should see your dentist as soon as you suspect a gum infection. You can potentially minimize the pain, severity, and cost of treatment if you get it treated as soon as possible.

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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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