Elevated   temperature. Treatment 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 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. Symptoms 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 Bleeding  “gums” A toothache with the absence of caries Increased spacing between the anterior teeth Food sticking between the teeth Loose or elongated teeth An uneven bite Signs Upon examination you may observe the following sign of periodontitis: Heavy plaque and calculus deposits Gingival   inflammation,   bleeding,   or   dis- coloration (bluish-red) Localized or generalized gingival bleeding Ulcerated or cratered papilla Tooth  mobility Treatment Perform the emergency treatment guidelines. The emergency treatment plan will be the same as for marginal gingivitis and NUG. PERIODONTAL ABSCESS 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. Treatment 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 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. Symptoms 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 A fever 6-5