Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Gingival Abscess


Related Terms

  • Alveolar Process Fistula
  • Dental Fistula
  • Parulis
  • Periapical Abscess with Sinus

Differential Diagnosis

Specialists

  • Dentist
  • Oral/Maxillofacial Surgeon

Comorbid Conditions

Factors Influencing Duration

Length of disability may be influenced by the severity and extent of the abscess, and by the individual's response to the antibiotic treatment.

Medical Codes

ICD-9-CM:
522.7 - Periapical Abscess with Sinus
523.3 - Periodontitis, Aggressive and Acute
523.31 - Aggressive Periodontitis, Localized

Overview

© Reed Group
A gingival abscess is a pus-filled sac that forms in the gum line (gingiva) of the teeth.

Gingival abscess is one of three kinds of dental abscesses that resemble each other. The other two kinds are periodontal and periapical abscesses. A periodontal abscess occurs when the infection of a gingival abscess moves deep into gum pockets and drainage of pus is blocked. A periapical abscess occurs when the inner layer of a tooth (pulp) becomes infected, usually secondary to tooth decay.

Gingival abscess is caused by infection from bacteria that enter the gums following injury from aggressive tooth brushing, toothpick punctures, or from food that is forced into the gumline. The infection may spread into surrounding tissue, and if left untreated, it can progress, damaging the support structure of the teeth.

Incidence and Prevalence: According to reports issued by the Centers for Disease Control and Prevention (CDC) in 1998, 11,000 cases of gingival abscess were diagnosed in the US.

Source: Medical Disability Advisor



Diagnosis

History: Although most gingival abscesses develop quickly, a slow-developing gingival abscess may go unnoticed and present no symptoms until it has become severe. Symptoms may include tenderness and swelling in the gum line, a feeling of loose teeth, or teeth that have become unusually sensitive to heat and cold. If the abscess has progressed, it may be releasing a foul-tasting pus. Severe abscesses can cause fever, headache, chills, diarrhea, nausea, and a dull, throbbing pain. There may be difficulty opening the mouth or swallowing.

Physical exam: In its initial stages, a gingival abscess causes the gum line to swell and appear red and shiny. A point may appear from which pus can be released under gentle pressure. Lymph nodes in the neck may also be swollen.

Tests: Tests are usually not required to diagnose a gingival abscess. An x-ray will help to determine the exact location of the abscess and to see if the abscess has penetrated the structure supporting the teeth (periodontal structure).

Source: Medical Disability Advisor



Treatment

The first step of treatment is to drain all pus that has accumulated in the abscess. One way to accomplish the drainage is to pass a probe into the abscess and to gently scrape away the infected material. It may be necessary to make a small incision in the gums in order to reach the abscess. If the abscess has not progressed into the periodontal structure, antibiotic therapy is usually effective in eliminating the infection.

If the abscess has progressed into the periodontal structure, deep cleaning will be required for the gum pocket. If too much bony support and periodontal ligament attachment have been lost or if the tooth is too loose, the tooth may need to be removed (dental extraction).

Source: Medical Disability Advisor



Prognosis

Following drainage, if the abscess has not progressed into periodontal structure, antibiotic therapy is effective in eliminating the infection. However, the prognosis to save the tooth is poor if the abscess has progressed into the periodontal structure.

Source: Medical Disability Advisor



Complications

A gingival abscess near a molar rarely progresses into an abscess involving a tooth root (dentoalveolar abscess). Pus from an abscess may be discharged into the jaw and throughout the floor of the mouth, causing difficulty in swallowing and breathing. The discharge of pus may also cause swelling so severe that breathing is obstructed, making it necessary to create a surgical opening in the trachea (emergency tracheostomy).

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Restrictions are necessary for the individual whose duties involve telephone communication, giving in-house or sales presentations, conducting interviews, or any other work responsibilities where the individual is required to talk. Work responsibilities may need to be shifted, temporarily, to less verbally demanding duties.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Have the gums had injuries from aggressive tooth brushing, toothpick punctures or food that has been forced into the gum line?
  • Was the diagnosis confirmed with a dental exam?
  • Did the abscess develop quickly or gradually?
  • Was an x-ray done? Did the abscess penetrate the periodontal structure?
  • Were other similar conditions, such as acute gingivitis, periodontal or dentoalveolar abscesses ruled out?

Regarding treatment:

  • Was the pus drained from the abscess?
  • Was the individual given antibiotics?
  • Did it become necessary to remove the tooth because of severe damage?

Regarding prognosis:

  • Have the symptoms persisted despite treatment? Was the individual re-examined by the dentist to rule out the possibility of complications?
  • Does the individual's employer have work they can do on a temporary basis that involves minimal talking?
  • Has the individual experienced any associated complications such as dentoalveolar abscess that may impact recovery and prognosis?
  • Does the individual have any existing conditions such as diabetes mellitus or HIV of that may impact recovery and prognosis?

Source: Medical Disability Advisor



References

General

Martin, Michael, and Jacob W. Ufberg. "Dental Abscess." eMedicine Health. Eds. Ruben Olmedo, Francisco Talavera, and Steven L. Bernstein. 10 Aug. 2004. WebMD, LLC. 20 May 2005 <http://www.emedicinehealth.com/articles/20555-1.asp>.

Source: Medical Disability Advisor






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