Bad taste Bleeding gums Food  sticking  between  the  teeth Toothache  (in  the  absence  of  caries) Increased spacing between anterior teeth Loose  or  elongated  teeth Uneven bite SIGNS—Examination will reveal any or all of the  following. Heavy  plaque  and  calculous  deposits Gingival   inflammation,   bleeding,   or bluish-red   discoloration Local  or  general  gingival  recession Ulcerated  or  destroyed  interdental  papillae Tooth   mobility TREATMENT—The   emergency   treatment for  periodontitis  is  the  same  as  for  marginal gingivitis  and  NUG. Periodontal Abscess A   periodontal   abscess   is   caused   by   an infection in the periodontal tissues. This infection is usually the result of long-continued irritation by  food  debris;  deep  deposits  of  calculus;  or  a foreign   object   such   as   a   toothbrush   bristle or a popcorn husk being tightly packed into the interproximal  spaces  or  between  the  tooth  and  the soft tissues. SYMPTOMS   AND   SIGNS—The   symptoms and signs for periodontal abscesses are similar to those  for  periapical  abscesses. TREATMENT—Gently  probe  the  affected area  with  a  scaler  or  a  periodontal  probe  to establish drainage. Probe the space between the tooth  surface  and  the  soft  tissue. If probing fails to start drainage, apply warm saline  soaks  to  the  affected  area.  NOTE:  Never apply soaks to the face because they may cause drainage   through   the   face   rather   than   the abscess. Pericoronitis This is an inflammation of the gingiva around a  partially  erupted  tooth.  When  a  tooth  begins to erupt, breaking through the gingival tissue, a small  flap  of  tissue  may  remain  over  the  tooth surface.  Debris  can  accumulate  beneath  the  tissue flap, and if the patient is unable to keep the area properly  cleansed,  inflammation  can  result.  It  can also  result  from  constant  contact  between  the tissue  flap  and  a  tooth  in  the  opposing  arch. Pericoronitis  most  often  affects  mandibular third  molars,  although  any  erupting  tooth  may be involved. The condition often occurs in the 18- to  25-year  age  group.  Because  many  Navy personnel  are  in  this  age  group,  pericoronitis  is one of the most frequent periodontal emergencies encountered. SYMPTOMS—A   patient’s   symptoms   may include  the  following. Pain  when  chewing Bad taste Difficulty  in  opening  the  mouth Swelling in the neck or in the area of the affected   tooth Sore  neck  or  throat Elevated temperature SIGNS—Your    examination following. may  reveal  the Partially  erupted  tooth Red,  inflamed  tissue  around  a  partially erupted  tooth Pus oozing from under an overlying tissue flap Painful  reaction  when  finger  pressure  is applied  to  affected  tissue Swelling in the cheek near the affected area Enlarged  lymph  nodes  under  the  mandible or  on  the  side  of  the  neck Elevated temperature 2-49