Multiple acute periodontal abscesses due to clenching

Abstract

This case report presents clenching as one of the etiological factors in the causation of multiple acute periodontal abscesses.Acute inflammatory periodontal diseases often present diagnostic problems for the clinician. These are not numerous, but cannot be glossed over. Acute periodontal abscess is one such condition which requires timely intervention and management. The development of the acute exacerbation occurs from an alteration in the tissues immediately adjacent to the affected teeth. Occlusion of the orifice of the periodontal pocket, diabetes, and clenching or bruxism are factors that can cause such an alteration. Here, we report a rare case of multiple acute periodontal abscesses due to clenching in an adult male. A 19-year-old male patient reported to the Department of Periodontics, College of Dental Sciences, Davangere, Karnataka, India, with pain and swelling of left cheek and left lower back teeth region of 2 days duration associated with difficulty in mouth opening. Detailed history revealed forceful clenching of teeth during his sleep. He appeared toxic and febrile. There was a diffuse, tender extraoral swelling in the left cheek. The patient had trismus and intraoral examination revealed multiple periodontal abscesses from 34 to 37. The drainage of the abscesses was obtained through the pocket orifice. The root surface was thoroughly planed to remove the deposits and to enhance further drainage. Subgingival irrigation with 0.1% povidone iodine was done and systemic antibiotics were prescribed. The patient was explained regarding the cause of the disease and motivated to stop clenching again. Subgingival irrigation with povidone iodine was continued for the next 3 days and the area curetted after 1 week to prevent recurrence. The healing was uneventful. Clenching of teeth can be one of the etiological factors for the causation of multiple acute periodontal abscesses which can be managed with proper and timely intervention of periodontal therapy.