Alveolar Abscess

ALVEOLAR ABSCESS, parulis (from Greek para-around and oulon-gum), forms on the alveolar process of the jaw as a result of suppurative inflammation of the root periosteum of a tooth. The pus, initially accumulated at the root apex, infects the alveolus and causes limited inflammation of the bone marrow of its walls, which spreads through Haversian canals under the periosteum of the jaw. The pus bulges the gum and forms an abscess beneath it. Such a subperiosteal abscess of the alveolar process has long been called parulis, parulid, or flux. Alveolar abscess usually appears on the outer side of the jaws and more rarely on the palate—so-called palatal abscesses. Initially, a firm tumor forms, in which only later, after the periosteum is penetrated by pus, fluctuation appears. Due to the involvement of the periosteum and adjacent cellular tissue in the inflammatory process, significant swelling of the cheek, lip, and eyelid often develops. In the oral cavity, in the area of the tooth causing the abscess, a greater or lesser pronounced characteristic bulging of the transitional fold of the mucosa is always observed. The formation of the abscess is usually accompanied by severe neuralgic pain, general malaise, and an increase in temperature to 39° and higher. The cause of alveolar abscess is infection from the root canal through its apical foramen. Treatment: in the initial stage, it is necessary to immediately remove the filling and open the root canals. In an acutely progressing process, an early incision of the tumor on the gum is possible, even without pus, and in particularly severe cases, simultaneous extraction of the tooth. In mild cases, the process can be controlled by warm compresses, hot poultices, hot rinses with sage or chamomile; the gum is lubricated with counterirritants. Internally—analgesic and sedative agents. The formed abscess is widely incised.