The build up of pus, if untreated will eventually find a place to discharge, either up through the pocket, around the tooth or out through the side of the gum next to it. This may have been happening already without you really noticing anything except a bit of a bad taste occasionally and maybe your tooth was slightly loose. If the path along which the pus is draining suddenly becomes blocked, then the tooth can become sore all of a sudden with the increase in pressure.
To treat the problem, the area is made numb by the dentist, the pus drained and the pocket cleaned of any plaque and calculus that has built up there. An ultrasonic scaler may be used to flush out all the rubbish and some dentists would irrigate down into the pocket with an antimicrobial mouthwash such as chlorhexidine or with saline. There is likely to be a lot of bleeding as the area is almost always inflamed.
This treatment will normally clear things up pretty rapidly and provide relief of the pain, but the real issue generally still remains. That is, that the bone loss that has occurred has created an area under the gum which is very difficult to keep clean at home. Depending on just how much bone has been lost or if abscesses keep re-occurring, it might be that you need further periodontal treatment
or to think about having the tooth extracted
If the tooth has very little bony support holding it in and is very loose, the most sensible option may be to remove the tooth there and then if the dentist is able to get you numb. Other treatment may temporarily improve the situation but if the prognosis is hopeless- the tooth may be better off in the bin.Your dentist will be able to advise you on the best course of action after examining the tooth and seeing an xrays
Antibiotics may be needed if:
- A number of periodontal abscesses happen all at the same time
- The swelling is considerable
- The dentist can't get you numb
- The pus cannot be drained
- The infection starts spreading (your glands are up, you feel unwell and often have a temperature)