For various inflammatory processes and infections oral cavity often fistulas or otherwise fistulas appear on the gums. They represent a void in the gum tissue that can be filled with pus.
This process is very dangerous and has serious consequences., so it’s better not to delay its treatment. A timely visit to a specialist will help save the tooth and prevent complications.
Features of therapy in a dental clinic
Many people are used to enduring toothache, putting off going to the dentist until later. But it is precisely these actions that lead to an advanced form of fistula. Best recommendation If a fistula is detected, a visit to the dental office is required.
Only high-quality diagnosis and treatment with elimination of the cause will help quickly get rid of gum lesions.
The presence of a fistula is determined visually, but how deep the infection has penetrated can only be determined by an x-ray. The doctor determines how much the granuloma has grown and whether it has touched the periosteum tissue.
The process of fistula formation is briefly presented in the following video:
Treatment of fistula in dental clinic begins with treatment of the affected tooth. It is opened, the canals are thoroughly cleaned of pus and treated with a disinfecting solution.
A visit to the dentist may not be enough if, in the doctor's opinion, a temporary filling is necessary. Then medicine is placed into the affected canals, and the tooth is closed with a soft filling material.
After a few days, the temporary filling is removed, the canals are thoroughly cleaned again, and the tooth is filled with a permanent filling.
If the affected tooth has already been filled before, the treatment process may take a little longer. After all, the tooth must first be unfilled, then treated, and only then closed.
When a pin is installed in the root of the tooth, the unfilling procedure is complicated by the fact that the pin must be removed. If for some reason this is not possible, then it would be safer to remove the tooth root along with the pin.
Antibiotic therapy program
In complicated cases, accompanied by extensive tissue damage and a serious inflammatory process, an additional course of antibiotics may be prescribed.
Typically, these are drugs in tablets or solutions for intramuscular injections. The antibiotic stops the inflammatory process and destroys bacteria in a short time.
The type of antibiotic should only be determined by a doctor. When selecting the most effective drug the cause of the fistula, the extent of inflammation, the rate of development of the disease and other parameters are taken into account.
Therefore, you should not prescribe antibiotics yourself. There may be no benefit, but harm will be done to the body.
Most often, preference is given to Gentamicin in ampoules and drugs that contain this component. The course of treatment with tablets ranges from seven to ten days, and Gentamicin may be sufficient with two ampoules administered within one week.
Here is a small list of antibiotics that are used in dentistry in the treatment of such inflammatory processes:
- Amoxiclav;
- Doxycycline;
- Trichopolum;
- Amoxicillin;
- Flemoxin solutab.
Each of these drugs has a number of side effects, including individual intolerance to the components of the drug. If the patient has previously had any allergic reaction to medications, you must inform the doctor about this before he makes an appointment.
Rehabilitation in the clinic
Photo: dental diathermocoagulator
If you delay treatment of the fistula, damage to neighboring tissues may begin. In severe cases, the fistula can spread to the adjacent tissues of the cheek.
After a course of treatment with antibiotics and antimicrobial drugs, as well as eliminating the cause of the fistula, rehabilitation measures aimed at tissue restoration may be required.
For more fast healing Laser tissue treatment is applied to the affected areas of the gums. During this procedure, wounds on the gums and cheeks are burned with a laser, which stops possible bleeding.
Cauterization of tissue areas with a diametric current or in another way has the same effect. diathermocoagulation. Some patients are very sensitive to the effects of current pulses and this method of rehabilitation cannot be applied to them.
One more modern method, used to restore tissue structure after a fistula, is ultrasonic influence. With its help, tissue regeneration is accelerated, and healing occurs much faster.
All these techniques are performed in a dental clinic or physical therapy office.
What can you do at home?
Some therapeutic actions, aimed at eliminating the fistula and the consequences of its occurrence, can be done at home. From medications antimicrobial and anti-inflammatory agents are effective.
Promotes faster tightening of the fistula passage regular rinses saline solution , prepared independently, or specially designed pharmaceutical solutions: Chlorhexidine or Betadine.
Special gels with antimicrobial and antiseptic effects can also have a positive effect on the healing of the fistula tract. Among them are used Solcoseryl, Asepta, Metrogyl Denta.
At severe pain you can sometimes use cooling gels designed to remove pain syndrome in children during teething or analgesics.
It must be remembered that it is impossible to cure a fistula at home without consulting a dentist. If the cause is not eliminated, the problem will return. Therefore, all treatment must be agreed with the attending physician.
Use of folk remedies
There are many recipes for the treatment of fistula in folk medicine. Some consider them safer, but you should always remember the possible allergic reactions on herbs.
In combination with traditional treatment successfully used:
- herbal infusions and decoctions for rinsing;
- medicinal ointments and balms;
- various lotions.
Can be used to relieve inflammation decoction. To prepare it, take in equal parts dandelion, yarrow, tansy and calendula. One tablespoon of the prepared mixture is brewed with boiling water, and when the broth has cooled to a comfortable temperature, you can rinse your mouth.
The herbs included in the decoction have a strong anti-inflammatory effect and healing effect.
Another popular remedy is considered to be a healing ointment, which contains many medicinal plants. To prepare an ointment for two parts of yarrow flowers and leaves, calendula flowers and dandelion root, take one part of tansy inflorescences and herbs, garden sorrel root, and sweet clover herb.
All plants need to be ground in a meat grinder or chopper, and then add one part to them ichthyol ointment or Vishnevsky liniment. If the resulting mass is not homogeneous, you can add a little calendula oil. The resulting ointment is infused for 12 hours and then spread on the affected gum.
Cooking with your own hands will help pull out pus from the fistula tract. eucalyptus ointment. About forty grams of eucalyptus should be combined with a tablespoon of sunflower oil and left for 24 hours. Then chopped onion is added to the mixture.
The mixture wrapped in a gauze bag is applied once a day to the damaged area. You should be careful, as eucalyptus can cause irritation and ulcers. In this case, the amount of eucalyptus in the mixture should be halved.
Another recipe for a medicinal lotion can speed up the healing of the fistula passage. To the crushed leaves of aloe and Kalanchoe (three pieces of each) add several cloves of finely chopped garlic.
The resulting pulp is wrapped in gauze or bandage and applied to the affected gum for ten minutes. If you leave the lotion on for too long, burning and irritation may occur.
For admirers traditional medicine It should be remembered that the listed recipes are effective only as aids to speed up recovery. But you shouldn't rely only on healing properties plants, because to cure you must first eliminate the cause of the fistula.
Features of therapy in a child
Fistula in a child is very dangerous dental problem. Therefore, untimely treatment or attempts to cope with the fistula on your own can lead to unpleasant complications.
At the first signs of fistula formation in a child, you should immediately contact pediatric dentist . There is no point in saving a baby tooth, so it is better to remove it immediately to save the baby from pain.
After removing a diseased tooth, you need to relieve the inflammatory process. For this, external agents are often used, for example, the affected part of the gum is lubricated with an ointment containing an antibiotic.
Internal antibiotics can only be prescribed for extensive lesions bacterial infection, which is confirmed only by laboratory tests.
If the child already knows how to brush his teeth on his own, then you can resort to saline rinses. But you should not leave the child alone during the procedure to avoid accidentally swallowing the solution along with the pus that gets into it.
You should not start the course of the disease either in children or adults, then the treatment will pass fast. Recurrence of a fistula can be avoided by following good oral hygiene and timely treatment problems with teeth and gums.
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From this article you will learn:
- why does a fistula appear on the gum,
- features of treatment in adults,
- how to treat a fistula on the gum of a child with baby teeth.
The article was written by a dental surgeon with more than 19 years of experience.
A fistula on the gum is always a symptom purulent inflammation flowing in the area of the root of one of the teeth (Fig. 1-2). Most often, fistulas form against the background of an exacerbation. This dental disease is most often a consequence of untreated caries and pulpitis, and when it occurs, a focus of chronic inflammation forms at the apex of the tooth root. Usually this chronic inflammation It is asymptomatic, but with hypothermia or decreased immunity, an exacerbation may occur - with the formation of pus at the site of inflammation.
The formation of pus in some cases leads to the formation of a fistula tract in the bone, which opens on the surface of the gum with a fistula opening. Accordingly, purulent exudate formed at the site of inflammation will be released from the fistula opening into the oral cavity. As a rule, the fistula opening is always located on the gum in the projection of the root of the causative tooth. In most patients, the appearance of a fistula is always preceded by pain when biting on one of the teeth. After the fistula has formed, the pain usually disappears immediately.
As we said above, a fistula on the gum is most often a companion to a focus of purulent inflammation at the apex of the tooth root. In dentistry, this disease is called “apical periodontitis.” The reasons for its development may be: 1) untreated caries and pulpitis in a timely manner, 2) poor-quality root canal filling, 3) trauma to the front teeth as a result of a blow or fall, which is more common in children. In the first two cases, you can always see caries, a filling or an artificial crown on the causative tooth (Fig. 1-2).
If the cause is an injury, you can usually see a chip on the tooth, or that the crown part of the tooth has acquired a bluish color. But a fistula can appear not only with periodontitis of the tooth. It can occur, for example, as a result of perforation, crack or fracture of the tooth root (allowed by the dentist during root canal treatment), and a fistula can also appear with such gum disease - both localized and generalized.
With periodontitis, periodontal pockets form along the surface of the roots of the teeth, from which purulent discharge drains during periods of exacerbation. If the periodontal pocket is very deep, then the outflow of pus from it may be impaired. In this case, an abscess forms in the projection of the periodontal pocket between the gum and the root of the tooth, which dentists call the term “periodontal abscess.” One of the outcomes of a periodontal abscess may be the formation of a fistula, through which pus will escape into the oral cavity (Fig. 3).
What does a fistula on the gum look like (video) –
Pay attention to video 1 - how the doctor inserts a thin gutta-percha pin into the fistula opening, used for filling root canals. Through the fistula tract, the pin can be advanced directly to the source of inflammation, i.e. get it right to the top of the tooth root. This clearly shows that the fistula tract connects the fistula opening on the gum - directly with the source of inflammation at the root of the tooth.
How does a fistula form on the gum?
Below we will tell you exactly how fistulas form during periodontitis and periodontitis (and gradually move on to treatment methods), but you need to take into account that fistulas can form not only with these diseases. For example, if the fistulas are multiple, with copious purulent discharge, then one can suspect cancer upper or lower jaw.
1) Formation of a fistula during periodontitis –
When a focus of purulent inflammation forms at the apex of the tooth root during periodontitis, the pus gradually formed in the focus of inflammation increases the pressure in it. Gradually, pus infiltrates the bone tissue around the tooth, and then, thanks to high blood pressure at the site of inflammation and heterogeneous structure bone tissue - pus spreads into the bones in the direction of least resistance. Thus, a fistula tract is formed in the bone tissue, through which pus penetrates under the periosteum of the jaw, forming an abscess there, which may look like a white lump on the gum (Fig. 5-6).
Further, the pus can break through the periosteum and mucous membrane of the gums, which will lead to the formation of a fistula. In this case, if the patient had an abscess on the gum in the form of a lump, then it sharply decreases in size, and in its place only a fistula opening remains. And in this case, patients usually complain that they have a pimple on the gum and white dot on the gums, from which pus or cloudy liquid is released. When the purulent inflammation at the root apex temporarily weakens, the fistula can close, but if the tooth is not treated, it will certainly appear again.
Let us remind you once again that acute or chronic periodontitis itself can be a consequence of either untreated caries, or the development of caries under a filling or artificial crown, or a consequence of poorly treated root canals (if the root canals are not filled to the apex, if the root is perforated, etc. .), or be a consequence of physical trauma to the tooth. All these causative factors can lead to the appearance of a fistula on the gum.
2) Formation of a fistula during periodontitis –
In the presence of a form of gum inflammation, called gingivitis, there is a gradual destruction of the attachment of the gums to the teeth + destruction of bone tissue, which leads to the formation of so-called periodontal pockets around the roots of the teeth (Fig. 7). They create good conditions for the proliferation of pathogenic bacteria and the formation of pus. If the pockets become deep enough, the drainage of pus along the surface of the tooth root may be impaired. In this case, a purulent periodontal abscess is first formed, in the projection of which a fistula on the gum can then form (Fig. 8).
Important : Please note that if a fistula occurs on the gum, treatment can only be carried out by a dentist. And here we will immediately disappoint patients who expect to be cured without visiting a doctor, using antiseptic rinses or antibiotics at home. Such remedies can only allow you to temporarily suppress the inflammatory process, without permanently reducing the severity of the symptoms of inflammation. In this case, the fistula may close temporarily (up to next period exacerbation of the inflammatory process).
Without professional treatment The causative tooth fistula can indeed close on its own, but do not indulge yourself in the illusion that the problem will disappear. Just acute form inflammation temporarily turned into chronic form with sluggish symptoms. In many patients, a fistula regularly forms in the same tooth for years; pus constantly flows into the oral cavity, worsening general health and giving breath. Many patients ignore this, not considering it a problem, and often seek help from a dentist only when the tooth needs to be removed.
How to treat a fistula on the gum (with periodontitis) -
The tactics for treating a fistula on the gum with dental periodontitis will depend on the initial situation, for example, on whether the tooth was previously treated, whether the root canals were filled, as well as on the degree of tooth destruction and the size of the inflammatory focus at the root apex. All this can be said after an analysis, which will show whether the tooth can be treated at all and in what way.
Below we have presented several options for the development of events, depending on what caused the development of periodontitis. In any case, the best prognosis will be for those patients who noticed the problem in time and did not delay visiting the doctor for months.
- Untimely treatment of caries and pulpitis
–
in this case, upon examination, you can always see the partially destroyed crown of the tooth, in the projection of which the fistula is located, but if the carious cavity is located in the interdental space, then you may not detect it. Patients usually do not complain of pain, but sometimes painful biting on the causative tooth may occur.Fistula on the gum: how to treat
V in this case The cause of the development of purulent inflammation at the root apex and the appearance of a fistula is an infection in the root canals. To remove the infection from them, you need to remove the infected inflamed dental pulp (nerve) from the tooth cavity and root canals, then, if necessary, treat the inflammatory focus at the apex of the tooth root. The treatment ends with the installation of a filling or an artificial crown.
- Poor quality root canal filling
–
Usually, root canals are filled in the treatment of pulpitis, periodontitis, or in preparing teeth for prosthetic crowns. Official statistics suggests that in 60-70% of cases, root canals are filled by dentists with poor quality (in most cases, not to the top of the tooth root). As a result, an infection always develops in the unfilled part of the canal, which leads to the formation of a focus of purulent inflammation at the apex of the tooth root.In Fig. 9-11 you can see radiographs of teeth in which the unfilled part of the canal will be marked with white arrows. In this case, the foci of purulent inflammation have the appearance of darkening at the apex of the root, and for convenience we have limited them to black arrows. In Fig. 11 you can see how well-sealed root canals look on an x-ray (black arrows mark the boundaries of the root apexes, up to which the canals should normally be sealed).
Fistula on the gum: treatment for periodontitis
As we said above, the appearance of a fistula during periodontitis is always associated with the formation of a deep periodontal pocket, from which the outflow of purulent discharge is disrupted. In this case, a periodontal abscess is first formed in the projection of the pocket, in the center of which a fistula with purulent discharge can then form. Treatment will begin with targeted or.
The first aid when a patient visits a dentist will be to create a good outflow of pus from the periodontal pocket. For this purpose, under local anesthesia pass with a special instrument along the root surface, or additionally make a small incision in the gums in the projection of the day of the periodontal pocket. Antibiotics and antiseptic rinses are prescribed. But this is only an emergency, and not the main part of treatment. The main treatment will depend on the form of periodontitis, which can be either localized or chronic generalized.
Treatment of localized periodontitis –
If periodontitis occurs in only a few teeth (from 1 to 3), then it is called localized. The reasons for its occurrence may be the overhanging edge of a filling or artificial crown, injuring the gums, or the presence of a traumatic bite between the upper and lower teeth in some part of the dentition. Most important point treatment is to eliminate the traumatic factor that caused the inflammation. This could be removing the overhanging edge of a filling, replacing a low-quality crown, grinding supercontacts between the upper and lower teeth, etc.
It may be necessary to remove the nerve from the tooth and fill its root canals. This is certainly necessary when the depth of the periodontal pocket reaches 2/3 of the length of the tooth root. The final stage treatment is carrying out a periodontal pocket and planting special materials for partial recovery level of bone tissue around the tooth.
Progress of open curettage operation –
Treatment of generalized periodontitis –
In the generalized form of periodontitis, periodontal pockets occur not in just a few teeth, but in almost all teeth. This form of periodontitis most often has chronic course with sluggish symptoms, manifested by bleeding and soreness of the gums when brushing, redness and swelling of the gingival margin, tooth mobility, as well as purulent discharge from periodontal pockets during periods of exacerbation of the inflammatory process.
It is during periods of exacerbations that abscess formation can occur, i.e. formation of purulent abscesses in the area of deep periodontal pockets. The cause of the development of generalized periodontitis is pathogenic bacteria of dental plaque and tartar, which accumulate at the necks of teeth and under the gum as a result of irregular and/or insufficient hygiene oral cavity. Treatment will begin with the removal of dental plaque and anti-inflammatory therapy, and then, according to indications, curettage, splinting of teeth, and prosthetics may be recommended.
Unfortunately, patients rarely consult a doctor at the very beginning of the disease, and come mainly with moderate and severe stages of periodontitis, the treatment of which is very labor-intensive and already requires significant financial costs. You can also read about treatment methods for this disease at the link above.
Fistula on the gum of a child: baby teeth
Most common cause The appearance of a fistula on the gums of a child is the development of a granulating form of periodontitis. It should be noted that with this form of periodontitis of primary teeth, there are practically no complaints from the child, and only upon examination can one detect characteristic symptoms– darkening of the color of the tooth crown, the presence of a fistula on the gum in the projection of the causative root baby tooth, slight pain when biting or tapping the tooth, and sometimes a slight degree of tooth mobility.
A feature of the course of granulating periodontitis of primary teeth is the rapid development of inflammation, which can spread to the roots of adjacent teeth and/or the bud permanent tooth(which is likely to lead to damage and death of the rudiment). If on x-ray there is a partial destruction of the cortical plate that surrounds each rudiment along the perimeter - this means that the latter is already involved in the inflammatory process. Additionally, this can be confirmed by a decrease in the degree of mineralization of the permanent tooth germ.
Due to the peculiarities child's body: immaturity immune system, close position of the primordia permanent teeth to foci of inflammation at the apexes of the roots of baby teeth (which gives rise to high risk death, developmental disorders and/or death of the rudiment), the presence of wide apical foramina and immature tooth roots - all this leads to the fact that conservative treatment Periodontitis of a baby tooth is in most cases simply dangerous and often threatens with complications, for example, sepsis.
Pay attention to how close the buds of permanent teeth are to the roots of baby teeth:
Milk teeth with a focus of granulating periodontitis at the apex of the tooth root are subject to mandatory removal in following cases –
- if there are less than 2 years left before the physiological change of the tooth,
- tooth mobility 2-3 degrees,
- if the tooth root is not formed or there are signs of root resorption,
- severe destruction of the tooth crown,
- large size of the inflammatory focus at the root apex,
- involvement of the permanent tooth germ in the inflammatory process or the threat of this,
- at the presence of a fistula tract,
- impossibility of performing high-quality root canal treatment due to the child’s behavior.
In this regard, it becomes clear that in the presence of a fistula against the background of periodontitis of a baby tooth, root canal treatment cannot be carried out in principle. But in the absence of a fistula and compliance with all the above conditions, in some cases, filling the root canals may be advisable (absorbable materials are used for this, for example, zinc oxide eugenol paste or pastes based on calcium hydroxide). We hope that our article on the topic: How to treat a fistula on the gums was useful to you!
Sources:
1. Higher prof. The author's education in therapeutic and surgical dentistry,
2. Based on personal experience work as a dentist,
3. National Library of Medicine (USA),
4. “Outpatient surgical dentistry"(Bezrukov V.),
5. " Therapeutic dentistry: Textbook" (Borovsky E.).
Dental fistula (fistula)- this is a hole between the gum and the tip of the tooth root (a channel for removing pus), which is formed due to inflammation of the tooth, for example or.
It is divided into external and internal. If pus accumulates at a distance of up to 3 mm from the surface, the suppuration quickly breaks through.
The result is a tubular formation. If pathogenic microorganisms have completely left the site of suppuration, such a canal will heal over time. But this happens in a few cases out of a hundred.
In the rest, either the suppuration does not go away, or a purulent formation deeper than 3 mm is an internal fistula that can burst in an unexpected place with unforeseen consequences. Therefore, it is better to adhere to the golden rule: “if something hurts and or swells in the oral cavity, then this is the time when you should contact the dentist.”
Causes
All causes can be divided into 4 groups:
- Complication of the underlying disease – periodontitis, caries, pulpitis.
- Mechanical: entry of pneumococci, gonococci, streptococci and other pyogenic bacteria into the pulp (soft tissue of the tooth); entry of foreign objects into the pulp, for example, food debris through damaged enamel; periodontal deformation due to the growth of wisdom teeth, due to which pathogenic microorganisms can enter the dentin.
- Poor quality treatment: poor quality filling, prosthetics, crowning, implant installation; root perforation; penetration of hydrophobic and toxic medications into the pulp, for example, arsenium (arsenic) after temporary filling.
- Failure to comply with oral hygiene standards and preventive measures after treatment of a particular dental disease.
Symptoms
All symptoms are classified by type:
Outer
Symptoms:
- Bad breath, even after proper oral care.
- Unpleasant constant taste and yellowish salivation, even after some time after eating.
- Changes in the structure of the gums - with the tongue you can feel the resulting hole or the thinnest partition behind which a void is felt if the suppuration moves into the periodontium or a hole in the tooth enamel if the suppuration moves towards it.
- Release of fluid unpleasant odor and taste when pressing on a sore spot.
Interior
The symptoms of an internal fistula are similar to those of other dental diseases, for example.
The symptoms of an internal fistula are quite varied: swelling of the gums; heat– in the evenings more than 38, and in the mornings not lower than 37.2 degrees, despite taking antipyretic drugs; headache; enlargement of the tooth and or gums, possibly the tongue; enlarged lymph nodes.
Depending on the type, a dental fistula is accompanied by redness on the gum, pain in the tooth if you press on it, and sometimes mobility of the tooth.
How to treat?
Before choosing one or another method of treating a dental fistula, like any other disease, the dentist conducts a diagnosis. To detect externally, a visual inspection is sufficient.
For internal diagnostics, a dental x-ray is needed. An X-ray is performed in any case, since a fistula may be a consequence of a concomitant disease.
In this case, the main attention is paid to treating the disease, then the main source of infection is removed, and treatment of the pus exit channel is either carried out in parallel with the main treatment, or is treated after eliminating another disease, or only the fistula as the main ailment is eliminated.
Methods
The method (method) depends on the type of effect on the fistula:
- Medication– carried out on early stage suppuration, or when due to the large depth of the formation it is not possible to use other methods. Medication method is basic. It is used as the only method of treatment or in combination with other methods, because only antiseptic drugs can completely destroy harmful microorganisms in the source of suppuration. The choice of drug is made by the attending physician depending on the effectiveness against microorganisms of a given class, the patient’s individual tolerance, and other factors.
- Laser and ultrasound therapy. This method is used for external fistula after passing drug therapy. The main task is to cauterize the dentin before filling.
- Surgery- at an advanced stage, when at the site of the main suppuration a - (benign solid formation) or granuloma (purulent bladder) has formed, the breakthrough of which can develop into a gingival fistula.
- Removal of a tooth– if it is impossible to perform an operation without complications or in order to save money for the patient at his request.
If a fistula is found in a child, it is better to remove this tooth. Firstly, baby teeth fly out sooner or later; secondly, there is a risk of pus getting into the stomach or soft tissues, and these are additional complications, and pain negatively affects the child’s psyche.
Possible consequences
If the fistula is not treated in a timely manner, there is a high probability of developing periodontal disease
Where is it easier for pus to make its way? Naturally, not through hard enamel, but through soft periodontal tissue.
In 80% or more cases, a dental fistula develops into a gingival fistula, and this is:
- The occurrence of periodontal disease.
- Periodontal destruction.
- Destruction of bone tissue in the jaw.
- Pus entering the lymphatic or circulatory system.
- Breakthrough fistula on the cheek.
Folk remedies
Treatment of dental fistula folk remedies Without prior consultation with a dentist, it is not advisable and sometimes dangerous for the following reasons:
- It may not be a fistula at all.
- The antiseptic effect of plants is much weaker and slower than that of antibiotics.
- You can be allergic to many plants.
- Symptoms may dull for a while, and the drainage channel of pus may become delayed without removing toxins.
It is advisable to use folk remedies only for preventive purposes.
This treatment (prevention) mainly comes down to decoctions of herbs that have an anti-inflammatory effect - sage, yarrow, calendula flowers, eucalyptus leaves, etc.
These plants not only relieve inflammation, but also draw out pus. Calendula, yarrow and eucalyptus are good antiseptics.
Important:
- Do not rinse your mouth with alcohol tinctures under any circumstances! Alcohol puts most bacteria into suspended animation, which significantly prolongs their existence.
- It is better to buy herbs in special herbal pharmacies with detailed instructions and dosages, otherwise you can burn your mouth or reduce the effectiveness of the plants.
Prevention
- Maintain oral hygiene: brush your teeth 2 times a day; rinse the mouth with herbal infusions and or dental elixirs
- The diet should contain foods that contain calcium, for example, cottage cheese.
- Reduce chewing load, e.g. chewing gum, replace frequent cleaning teeth and sucking on mints.
- Avoid sharp changes temperature in the oral cavity, this has a detrimental effect on the integrity of dental enamel.
- Be examined by a dentist 2 times a year and carry out professional cleaning teeth from plaque and stones (hard salt formations on tooth enamel).
A fistula is a hole in the gum associated with the source of inflammation, a kind of channel, the purpose of which is to remove pus from the site of the lesion. The inflammatory process is localized at the upper part of the root of one of the teeth. The hole is mainly formed at the projection point of the tooth apex.
Another name for a fistula is a gingival fistula.. This is the most common complication chronic periodontitis. His treatment takes enough long time, and therapy should begin by finding out the cause of the fistula.
Causes
The appearance of a fistula is evidence of the presence of soft tissues oral cavity or bone abscess. The accumulation of pus or a mixture of blood and pus at the site of inflammation entails the formation of a channel and outlet for their removal, resulting in the formation of a fistula.
There may be several reasons:
- Incorrect or incomplete treatment or tooth pulpitis.
- Inflammation of the cyst.
- Complication of granulating periodontitis.
- Difficulty or delay in the eruption of wisdom teeth.
- Poor quality filling.
- Perforation of the tooth root.
Poorly treated caries can cause inflammation of the dental nerve, i.e. go into pulpitis. Untreated pulpitis leads to periodontitis. With pulpitis, the site of infection is the pulp - the nervous tissue of the tooth. As pulpitis progresses, the nerve completely dies, and the infection from the nerve canal spreads to the apex of the tooth root. A focus of inflammation (purulent abscess) develops in this part, i.e. periodontitis begins.
After this, a channel is formed to get rid of purulent contents and a fistula.
The described processes are accompanied by the following symptoms:
- immediately before the onset of fistula formation, moderate or sharp pain in the area of the affected tooth;
- swelling of the gums is observed;
- the formation of a fistula leads to the disappearance of pain and swelling, since the pus already has an outlet;
- Pain in the tooth persists when biting or touching.
Since in most cases the formation of a cyst not accompanied by discomfort or painful sensations, in many cases it is ignored. The consequence is that in the presence of certain favorable circumstances (decreased immunity, exacerbation of chronic disease) an abscess develops and, as a result, an exit channel appears, and then a fistula.
When periodontitis passes into granulating form soft and bone tissue gums begin to decay. This occurs due to the proliferation of granulation tissues, which gradually destroy nearby healthy cells. The result is the appearance of a fistula on the oral mucosa.
If for some reason the process of wisdom tooth eruption prolongs or becomes complicated, the gums in this area become swollen and inflamed. Its increase in size causes constant injury to the tooth located opposite from the outside and the tooth trying to grow from the inside. At the site of inflammation, pus often accumulates and forms fistula channel, then a fistula.
In the presence of pulpitis or periodontitis, and also during preparation for putting on a crown, the root canals of the tooth are filled. If the process is carried out incorrectly (i.e. insufficient depth), the filling cannot reach the top of the tooth. Pores or voids often remain in the canal, in which favorable conditions are created for the development of the inflammatory process. As it spreads, the infection goes beyond the tooth and reaches the root apex, where purulent discharge is produced.
There is no pain when biting or touching the affected tooth.
During channel cleaning as a result of an error, a non-physiological hole can form, which in the future often becomes inflamed and begins to fester. The result is the occurrence of a fistula. This can be avoided by timely application of a special filling to the perforated area. The process is carried out through a tooth canal or through a surgical incision. An unsealed perforation can cause extensive inflammation.
The development of fistulas is also facilitated by factors such as:
- weakening of the body's defenses;
- past infectious diseases;
- hypothermia;
- overheat;
- overwork.
Symptoms of a fistula on the gum
The main sign of a fistula is the opening of a fistulous tract in the gum, through which an abscess located in the thickness of the jaw or periodontium communicates with the oral cavity.
The occurrence of a fistula, which in some cases is covered with a fabric bag, is accompanied by some characteristic symptoms:
- Appears toothache moderate to high intensity, aggravated by biting or touching the tooth. The affected tooth that caused the development of the fistula is identified by tapping with a metal instrument.
- Excessive tooth mobility may occur.
- Redness and inflammation of the gums are observed around the affected tooth and in the area of the fistula opening.
- Pus is released from the fistula tract.
- Body temperature may rise to 37.5 degrees or more.
A simple visual examination is sufficient to make a diagnosis. As additional measure may be assigned X-ray examination. It makes it possible to determine the depth of gum damage, the degree of granuloma growth under the tooth and the presence of inflammation in the periosteum area.
Treatment of fistula using traditional methods
For effective treatment fistula, first of all, its cause should be eliminated - in particular, the tooth that stimulated its development should be cured.
The specialist thoroughly cleans the canals of the diseased tooth, removes pus and carious deposits. Then the tooth is treated with a disinfectant solution and filled.
When a fistula forms due to an already filled tooth, the process becomes much more complicated, since this requires unsealing the dental canals. After the filling is removed, the tooth is treated with anti-inflammatory drugs. They are placed in cleaned canals for a long time. Re-filling is carried out only after complete elimination of infection and inflammation. In the presence of a crown or pin, the unfilling process turns out to be so difficult that in many cases it is prescribed surgical intervention: removal (resection) of the apex of the tooth root.
To completely cure the fistula, a course of rehabilitation must be carried out. The affected part of the gum is subjected to ultrasound irradiation or treated with a laser. Sometimes a diametric current is used to cauterize the fistula. The inflammatory process is eliminated through the use of antibiotics, as well as treatment of the oral cavity with special medicinal solutions.
The healing of the fistula and the prevention of possible infection is facilitated by the use of professional series toothpastes and gels.
If necessary, additionally prescribe antihistamines: tavegil or suprastin.
Salt baths help relieve swelling on the gums.
If there are complications, such as spread pathological process to the periosteum - removal of the fistula is carried out exclusively surgically. Timely contact with a specialist will help avoid complications and subsequent surgery.
What does traditional medicine offer?
Traditional medicine recipes cannot cure fistula or eliminate the causes of its occurrence. However, they help to significantly speed up the rehabilitation process.
- In equal parts, take calendula flowers, yarrow grass and flowers, dandelion root, sweet clover herb, tansy inflorescences, garden sorrel root, mix, grind in a meat grinder, add to the resulting mixture ichthyol ointment and calendula oil, stir thoroughly. Apply the resulting cream to the affected areas of the gums.
- Prepare chamomile infusion. To do this, pour a tablespoon of flowers into 400 ml of boiling water, leave for about 2 hours, strain. Wash affected areas several times a day. Chamomile can be replaced with calendula or a mixture of two plants in a 1:1 ratio.
- Finely chop the onion, add crushed mummy tablets (10 pcs.), a tablespoon olive oil, mix. Place the composition on sterile gauze and apply to the affected gum. Hold for 5 minutes. Repeat 2-3 times a day.
- Take three leaves of aloe and Kalanchoe, a clove of garlic, mince and mix. Wrap the mixture in a bandage or gauze and apply to the inflamed area three times a day. The duration of the procedure is 10 minutes.
Post date: 14.05.2011 12:00
Pauline
Good afternoon
I kindly ask you to advise me! Thank you in advance! At the end of January 2011, I once again visited the dentist, who suggested that after taking a picture, I should put crowns on the 5th and 6th teeth (top left) - the so-called. "bridge". Note: the 5th tooth was on a pin (a visible boundary was formed between the filling and the rest of the tooth - it looked ugly from the outside), and the 6th tooth had a filling over more than half of it - both teeth had long been “dead”. Naturally, I chose the material - metal ceramics. The crowns were placed in early February 2011. Literally immediately, a lump appeared under the 6th tooth, then a “sac” of liquid appeared. I thought it would pass, because... there was no pain. I rinsed it. This week I went to the surgeon and took a picture, he looked, said it was a fistula, and sent me to where they treated me. Where I treated them, they said that this was not a warranty case - your crowns are intact! But we didn’t treat the canals! Live like this. I went to another surgeon with the pictures. He told me that out of 3 canals on 6, only the palatal canal was cured, and why weren’t you offered to thoroughly treat all the canals before installing such expensive crowns?! I believe that the doctors are partly to blame, but they refuse to treat under warranty! The crowns were installed perfectly - no complaints! It's such a shame to take it off! Is it possible to re-install crowns again after treatment as carefully? I'm afraid that when they remove the crowns, they may break my teeth, because... They placed it very firmly - on special cement (like relatives, they don’t even interfere). I am tormented by the question of whether to take it off or just live for now, as the doctor advises where I placed it? Or don’t delay it and go to them urgently?!!! And another question, do you think this is a warranty case? Should I try to defend my rights? What if they would at least give a discount on the removal and re-installation of crowns? THANK YOU!
Post date: 15.05.2011 17:10
Hello, Polina!
The metal ceramics should be removed and the teeth treated properly. New crowns will have to be made.
The surgeon you went to is right. As part of the guarantee, you should have been warned about problems with your teeth and required to treat them before getting dentures.
Post date: 01.06.2011 19:10
Pauline
Alexander Alexandrovich, hello! Thanks for the consultation! The crowns were removed. I treated the canals. A control x-ray of the tooth was taken. I walked for 10 days with a temporary filling (I was under observation). The fistula went away within 7 days, after treatment of the canals (I often rinsed my mouth with Rotokan). Removed crowns The technician restored it (he did not make new ones). They installed it yesterday. I paid money for root canal treatment, and the crowns were reinstalled under warranty. I hope they last a long time.
Post date: 03.06.2011 07:07
Pauline
THANK YOU!!!
Post date: 23.04.2012 04:23
Elena
The tooth under the crown had been “dead” for a long time, but a fistula had formed, I went to the dentist, they gave me some kind of injection, the fistula went away, and a month later it returned. Now the lump “sticks out” all the time. how to cure?
Post date: 23.04.2012 07:02
Hello, Elena!
Before treating, you should figure out what to treat. First you need to take a photo. Subsequently, it may be necessary to remove the crown.
ps: I cannot make a diagnosis based solely on the presence of a fistula tract, and therefore cannot recommend treatment. Try to find qualified doctor and ask all your questions to him.
Post date: 20.05.2012 22:02
Alisher
Hello! I want to ask you... I have a fistula on my front biting tooth. Already 2 months ago, but as soon as the swelling went away, I thought that the fistula had gone away. But as it turned out, it came back out now and is tormenting me. The pain is severe, even my tooth hurts, it’s impossible to eat. I haven’t gone to the dentist. What is the option? Tell me...
Post date: 01.12.2012 00:13
Irina
Hello! I, too, had a purulent sac forming under the crown on my gum: I kept rinsing with water and salt, then it went away, then it all came back again. In the end, they took a picture, it turns out the doctor placed a pin obliquely, and this pin pressed on the gum, i.e. They explained to me in medical terms that there was a perforation of the tooth. As a result, I lost the tooth because it rotted and I had to remove the rotten tooth.
The question is, when the crowns are removed, what should be used to strengthen the remaining teeth while the new crowns are installed?
Post date: 01.12.2012 07:37
Teeth, if they are severely damaged, are strengthened with pins.
In general, I didn’t understand the question - what kind of teeth? from those who removed the crowns? Why strengthen them at all?
Post date: 27.01.2013 13:43
Guest
About 7 years ago I had metal ceramics done on my front (right) tooth. Everything was fine. And six months ago it became painful to press on the gum. Just under the nostril. Go to the doctor, cat. I made this metal ceramics, I got it only a week ago. He said. that there is no cure, I prescribed lincomycin, 2 capsules once a day. Drink for only 10 days. And one suprastin tablet at night. and rinse with water with soda, salt and iodine. Nothing hurts, but above this tooth on the gum on both sides there are 2 small pimples, one with some kind of white content. It's probably pus. The tooth has become mobile. I’m very worried, it’s the very front tooth! Why didn’t he do anything? This correct treatment? What is my perspective?
Post date: 28.01.2013 08:23
I think that antibiotics will not solve the problem, or they will solve it for the period of taking them, and then all over again. It is necessary to take a picture and remove the crown. Only then will it be possible to make a diagnosis and plan treatment.
Post date: 29.01.2013 20:01
Tatiana
After installing the bridge on upper jaw my cheeks began to rise lower eyelids wrinkles, upper lip stretched and two wrinkles appeared under the nose. Am I correct in thinking that the bridge is very raised and placed incorrectly and there are similar bags on the gums on one side. Should I first take a picture, and then contact the person who inserted it?
