Perform the emergency treatment guidelines. If the patient has an elevated temperature (101° or above), the dentist should treat the patient. If you are authorized to treat the patient, the treatment plan will be the same as for marginal gingivitis.
Periodontitis is an inflammation of the gingiva that involves the crest of the alveolar bone and the periodontal ligament above the alveolar crest. It usually results from untreated marginal gingivitis. It is marked by the gradual loss of attachment of the periodontal tissues. Periodontitis may affect the entire dentition or only localized areas.
A patient may present some of the following symptoms if periodontitis is suspected:
A "deep, gnawing pain"; in the affected area
Itching of the "gums"
Sensitivity to heat and cold
Food sticking between the teeth
Loose or elongated teeth An uneven bite
A toothache with the absence of caries
Increased spacing between the anterior teeth
Upon examination you may observe the following sign of periodontitis:
Heavy plaque and calculus deposits
Gingival inflammation, bleeding, or discoloration (bluish-red)
Localized or generalized gingival bleeding
Ulcerated or cratered papilla
A periodontal abscess is caused by an infection of the periodontal tissues. It is usually the result of a long-continued irritation by food debris, deep deposits of calculus or a foreign object packed in the sulcus or inter-proximal spaces.
The symptoms and signs for periodontal abscesses are similar to those for periapical abscesses.
The emergency treatment plan for periodontal abscesses may include:
Performing the emergency treatment guidelines
Gently probing the affected area with a scaler or an explorer to establish drainage. Probe the space between the tooth surface and the gingival tissue.
If probing does not establish drainage, have the patient apply hot saline water rinses to the affected area.
Pericoronitis is an inflammation of the gingiva around a partially erupted tooth. During eruption, the tooth breaks through the gingiva tissue, and sometimes a small flap of tissue remains over the crown of the tooth. Debris accumulates beneath the tissue flap resulting in an acute inflammation. Inflammation can also result from constant contact between the tissue flap and the tooth in the opposing arch. Pericoronitis most often affects mandibular third molars.
A patient with pericoronitis may complain of the following:
Pain when chewing
A bad taste in the mouth
Difficultly in opening the mouth
Swelling in the neck or in the area of the affected tooth
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