Fistula under the crown. Dental fistula: treatment methods in adults and children. Fistula in the gum: what is it?

A fistula on the gum is a common symptom of inflammatory diseases of the periodontal tissues. How to treat a fistula in a child and an adult depends on the cause, duration of the disease, the tooth, individual characteristics and the clinical situation in the oral cavity. Only a dentist can provide qualified and complete treatment. You can treat the symptoms of the disease yourself, but only a doctor can eliminate the root cause.

Experts often call the disease a fistula, which means “tube” in Latin.. After all, a fistula is a kind of channel that connects the epicenter of inflammation with the oral cavity. This occurs when purulent exudate presses on surrounding tissues, increases pressure and breaks out. A fistula on the gum has the appearance of a round inflammatory formation, which patients characterize as a pimple, gumboil, abscess, lump, protrusion of the mucous membrane. The fistula canal comes from the apex of the tooth root and opens as an opening in the mucous membrane of the gums. The formation is always localized in the area of ​​a large tooth, most often in the projection of the root.

Causes

There are two main reasons for the occurrence of a fistulous tract on the gum.

1. The most common cause is the accumulation of purulent exudate at the root apex. Children often experience the formation of a fistula precisely because of this. Pathology appears when caries and nerve inflammation are not treated in a timely manner, since diseases in baby teeth quickly progress and turn into periodontitis.
2. The second reason for the fistulous tract may be the presence of a deep periodontal pocket due to diseases. Gum diseases occur more and more often in older people, so fistula for this reason practically does not occur in children and young people.

The following factors can be identified that contribute to the disease:

Types of disease

Clinical picture of non-standard formation of a fistula, which opens in the submandibular region

The fistula canal, as a pathological formation, can occur in any organ of the body in the presence of a source of infection and suitable conditions. Pathology occurs in people with decreased immune defense and the presence of chronic diseases. A fistula tract is formed in the absence of timely or correct treatment, during the transition from the acute to the chronic stage. The fistula opening opens in the projection of the epicenter of the inflammation and can be localized in the oral cavity, on the face or chin area.

Dental fistula most often occurs in the maxillofacial area, but there are other types of disease:

1. After tooth extraction. It occurs quite rarely and manifests itself when an infection occurs, difficult removal, lack of timely treatment and a decrease in human immunity.
2. At . This is a serious disease that is characterized by inflammation of the jaw bone, accumulation of pus and can cause the formation of a fistula.
3. In case of improper treatment of acute inflammatory processes -,. If you do not open the abscess, the inflammation can become a sluggish process and, during an exacerbation, come out in the form of a fistula.
4. After implantation. One of the complications of implantation is inflammation of the tissue around the implant -. A long-term inflammatory process can provoke the formation of a fistula on the gum or face.

Pathogenesis or how does a fistula occur?

The formation of a fistula during periodontitis is characterized by the presence of a purulent focus of inflammation near the root of the tooth. If there is no or difficulty in the outflow of exudate through the root canals, it accumulates. The pressure at the site of the disease gradually increases, and the pus spreads into the bone tissue and gums that surround the diseased tooth. The contents move in the direction of less resistance and form a channel. The purulent contents seek a way out, pass through the tissues and break through the mucous membrane of the gums.

The formation of a fistula can be considered a favorable outcome of periodontitis, because the disease is quite dangerous. In some cases, purulent contents can spread into the periosteum and even bone, which can lead to osteomyelitis and other complications. When the molars of the upper jaw are diseased, pus can spread to the maxillary sinus and cause odontogenic sinusitis.

With a slightly different mechanism for the development of the disease. It is characterized by inflammation of the gums, destruction of the periodontal junction, disruption of bone tissue and mobility of teeth. In this case, periodontal pockets of varying depths appear. Food debris, microorganisms and their breakdown products accumulate in the pockets, and during exacerbation, purulent contents form. In most cases, the outflow of pus occurs through the pockets themselves, that is, the pus exits along the surface of the root through the gums. If the pockets are deep enough, a violation of the outflow of contents may occur due to various reasons - the presence of dental plaque, the ingress of food debris, etc. In this case, a problem occurs that will provoke the formation of a fistula in the area of ​​the diseased tooth.

Course of the disease

Chronic periodontitis and its main symptom, fistula, are characterized by an undulating course. Symptoms of the disease will always depend on the stage of development of the disease. For some period of time, the disease can exist practically asymptomatically or cause minor symptoms (discomfort, tingling, discomfort in the tooth). When the pathology worsens, a canal is formed and pus is released.

In this case, an abscess forms on the gum, which will burst over time. After this, there will be no pressure in the source of inflammation near the apex of the tooth and the fistula will heal on its own. But if the epicenter of inflammation is not eliminated, the fistula can appear and disappear on its own many times until it provokes more serious complications.

Symptoms

Schematic representation of the development of the disease

Symptoms of the disease during exacerbation may be as follows:

• The formation of an inflammatory abscess on the gum.
• Painful redness of the gums in the projection of the roots of the causative tooth.
• Pain, discomfort, discomfort when biting on the causative tooth.
• A person complains that a limited area of ​​the gum hurts.
• Tooth mobility.
• Unpleasant smell.
• General symptoms: slight increase in temperature, malaise, swollen lymph nodes.

Appearance of the fistula after the release of purulent contents, healing stage

The formation occurs on the mucous membrane of the gums in the area of ​​the diseased tooth and its roots. On the mucous membrane of the gums in the projection of the epicenter of periodontitis there will be a formation of a round or oval shape, red in color with white contents. After a breakthrough in the mucous membrane above the fistula, purulent or turbid contents are released. The formation decreases in size, disappears, and the gums heal. A small scar or scar may form at the site of the fistula. The diseased tooth will have a deep carious cavity, a filling or an artificial crown. In addition, the diseased tooth may be discolored, destroyed or mobile.

In children, the disease can occur in completely healthy-looking teeth. This occurs when a tooth is injured, which leads to nerve death and the development of inflammation in the canals and periodontal tissues. At the same time, children rarely report painful sensations, and the fistula is discovered by chance during examination or hygienic cleaning.

Diagnostics

X-ray of chronic granulating periodontitis, in which a fistula is most often formed

Diagnosis of the pathology is simple. The specialist examines the oral cavity and collects an anamnesis of the disease. Examines the diseased tooth in detail using methods such as zoning, thermal diagnostics, percussion, and palpation. The main additional diagnostic method is radiography. From the image, you can identify a diseased tooth, estimate the size of the inflammation, and determine the exact location of the pathology. Also, the dentist uses X-rays to conduct differential diagnostics, which will help distinguish the fistula from other pathologies.

It is important to distinguish a fistula during periodontitis from a cyst. In the picture, these diseases may look similar - a rounded focus of inflammation. An important difference is that the cyst is more than 1 cm in size and has a capsule with clear edges, does not provoke the appearance of a fistula, and can have different contents, not just purulent. A fistula is formed during chronic granulating periodontitis, which in the picture looks like a lesion of bone tissue in the form of flames and does not have clear edges.

Treatment methods

Treatment of a fistula is quite complex and requires several visits to a specialist. Treatment must be comprehensive, complete, etiological and individual. Only a specialist - a dentist - can carry out therapy and eliminate the root cause.

Therapeutic treatment

The main and most effective method of eliminating pathology is treating the diseased tooth. The procedure is painless, since the nerve of the tooth has already died. The doctor performs the following manipulations:

• Removing fillings, caries or destroyed tissues using a drill;
• Creation of access to root canals;
• Removing pulp decay and cleaning canals using special tools;
• Mechanical and antiseptic treatment of canals;
• Application of a special paste based on medications into the canals for several weeks;
• After eliminating the inflammation at the top of the tooth, the canals are filled;
• Installation of a permanent filling.

Ancillary methods for treating fistula include:

1. Antibiotic therapy is the use of antibacterial agents to eliminate pathological microorganisms and the inflammatory process. The use of antibiotics will only be effective in combination with therapeutic treatment at the dentist. Otherwise, the fistula will disappear, but after a while it will worsen and appear again. Antibacterial drugs should be prescribed only by a specialist, taking into account sensitivity to them.
2. – this is the removal of all dental plaque using special dental devices: ultrasonic, sandblasting, etc. Cleaning is necessary if the cause of the disease is periodontitis. With the help of professional hygiene, all pathological microbes that are found in dental plaque and the oral cavity are also eliminated.
3. Physiotherapeutic procedures. Such manipulations as ultrasound, electrophoresis, UHF have a positive therapeutic effect. Blood flow is restored, the flow of nutrients and tissue healing are stimulated;
4. dental diseases - treatment of caries, pulpitis, periodontitis is necessary to maintain health and prevent further complications;
5. Treatment of chronic diseases of the body, taking multivitamins, and a balanced diet are recommended to increase the body's immune defense.

Surgery

If it is impossible to eliminate the source of infection therapeutically, when the fistula does not go away, tooth-preserving operations are performed:

• Resection of the root apex is a minor surgical intervention in which access is made through the gum, a window is formed in the bone and the root apex is cut off along with the source of inflammation;
• Hemisection is an operation to remove a root on which a cyst, granuloma or fistula is present;
• Coronary-radicular separation is performed in multi-rooted teeth. It involves removing the root with the epicenter of inflammation along with part of the crown; in fact, half of the tooth is removed.

If tooth-preserving operations are not advisable, then the diseased tooth is removed. This procedure is radical, but eliminating a chronic source of infection that spreads throughout the body is a higher priority than saving the tooth.

Features of treatment in children

Clinical picture of the formation of a fistula with purulent contents in a child

In primary dentition, the formation of a fistula tract is very common. Even if there is a small cavity in the tooth, the infection quickly penetrates deep into the tooth and through the root canals causes the formation of a fistula. The dentist can puncture the purulent blister on the gum and allow the pus to drain, which is absolutely painless. Such manipulation will alleviate the condition of the diseased tooth and the child, but will not eliminate the cause. The most common method of treating fistula in children is the removal of the baby tooth, which is the cause of the disease. If in adults they try to preserve the tooth as long as possible, then in children it is important to prevent damage to the permanent tooth germ. Since the source of inflammation is located close to the bud, the most appropriate method is removal.

Treatment of fistula of permanent teeth in children does not differ from the procedure in adults. The dentist cleanses the root canals, treats them and leaves a calcium-based drug for a period of 1-3 months. Under X-ray control, the medication is replaced until complete recovery and elimination of the source of inflammation at the apex. After this, the root canals are filled with a special material and a permanent filling is installed.

Treatment during pregnancy

Ideally, sanitation of all oral diseases should be carried out at the stage of preparation for pregnancy. But if a pregnant woman is faced with the need for treatment, then it is safest to visit a specialist in the second trimester of pregnancy. This period of time will be the safest for the baby and calmest for the woman. Fistula treatment is carried out therapeutically, without the use of anesthetics and antibiotics. The specialist uses only safe and effective products.

Therapy at home

The disease after the release of pus during the healing stage

The question of how to treat a fistula on the gum interests everyone who has encountered this problem. Correct therapy at home consists only of following all the doctor’s recommendations and prescriptions. The use of any traditional medicine methods without endodontic canal treatment will be ineffective. The fistulous tract is characterized by the fact that its external manifestations on the gums may disappear after applying ointment, gel or rinses. But without eliminating the root cause, the fistula will arise again.

After visiting a doctor, the following folk remedies can be used in complex treatment:

• Rinsing the mouth with decoctions of medicinal herbs;
• Salt and soda rinses;
• Medicinal applications;
• Wound healing ointments.

It should be noted that homeopathic remedies will also be ineffective. With their help, there is no way to affect the source of inflammation at the apex of the root. In addition, the World Health Organization does not recommend the use of homeopathic medicines to treat any disease. Scientists argue that homeopathy does not have any evidence base, and its minor therapeutic effect is nothing more than a placebo effect.

Complications

Lack of timely and qualified treatment can lead to complications. With exacerbations of periodontitis and accumulation of pus, the fistula tract will open and close, causing pain. The lesion near the apex of the tooth will increase in size and the tooth will become mobile. Over time, such a tooth must be removed, since it will no longer be possible to treat it.

A negative consequence is the constant intake of purulent contents into the body, which comes out of the fistula. Decomposition products and toxic substances in the composition of purulent exudate, along with saliva, enter the digestive tract. They cause gastrointestinal diseases, exacerbation of chronic pathologies, and worsen the general and local immunity of the body.

Forecast

The prognosis of the disease is good with timely treatment. In just a few visits, the dentist can completely eliminate chronic granulating periodontitis and its most unpleasant symptom – fistula.

Prevention

What to do to avoid fistula formation? The main preventive measure is regular and thorough hygienic care of the oral cavity. To maintain healthy teeth and gums, dentists recommend:

• Brush your teeth twice a day: in the morning after breakfast and in the evening after dinner.
• Use only hygiene products selected by your doctor - toothpaste and brush.
• Use mouthwash or rinse your mouth with water after meals throughout the day.
• If it is impossible to clean, eat an apple or carrot, which provide mechanical cleansing of plaque from the teeth.
• Clean the interdental spaces with floss.
• If there are crowns, dentures, braces or any other structures in the oral cavity, it is necessary additionally.
• You should visit a specialist twice a year for preventive examination and professional hygiene.
• If diseases are present, it is recommended that they be eliminated in a timely manner.
• You should not self-medicate, as most pathologies require qualified intervention.

We can conclude that fistula is a common pathology, which is the main symptom of chronic granulating periodontitis. The disease can occur with periodontitis and other lesions of the oral cavity. It is impossible to eliminate a fistula on your own; at home you can only influence the healing of the gums, but cannot remove the epicenter of inflammation. To maintain the health of the oral cavity and the body as a whole, it is necessary to carry out qualified treatment from a dentist.

A fistula or gum fistula is a neoplasm that looks like an abscess, which is a complication of advanced infectious diseases of the oral cavity. It is most often localized on the gums in the upper part of the tooth root. If you seek medical help in a timely manner, a fistula can be cured without consequences.

A fistula is formed in the soft tissues of the oral cavity during the life of pathogenic microorganisms, which include pneumococci, staphylococci, gonococci and others. The causes of pathology vary depending on the route of infection.

Most often, infection occurs as a result of a number of diseases:

Additional Information. A fistula can form after tooth extraction, as well as as a result of soft tissue trauma, damage to the root walls and improper filling of the canals with filling material.

Often accompanied by inflammation and swelling of tissues. If the process is complicated by the addition of a coccal infection, pus accumulates in the gum, which comes out through the fistula canal.

How to recognize a dental fistula?

Often the patient is not aware of the presence of purulent inflammation until it manifests itself with characteristic signs in the form of the opening of a fistula near the tooth on the gum. Symptoms The ones that should alert you first of all are the following:

• throbbing toothache;
• swelling and redness of the gum area;
• painful sensations when pressing on the swollen area;
• loosening of the tooth;
• in rare cases, increased body temperature.

A complete diagnosis can be carried out by a doctor. However, it is not limited to a visual examination, since identifying the nature and depth of the purulent process in most cases is possible only with the use of x-rays.

Fistula on the gums: treatment

The depth of surgical intervention depends on the location of the inflammation.

The maturation of the fistula is accompanied by an increase in symptoms, especially pain. Therefore, when the abscess opens and the pain becomes less, the patient may think that the problem has been resolved. However, without proper treatment, the fistula near the tooth will not resolve on its own.

How to cure a gum fistula? At the initial stage of development of the pathology, manifested in the form of redness and swelling, the treatment of the fistula occurs by opening the channel to remove fluid. The depth of surgical intervention depends on the location of the focus of inflammation.

If it is located outside, the procedure will be limited to a superficial incision. When located in deep layers, it is necessary to remove the dental filling, and in some cases, drill additional channels.

Important! Sometimes, to get to the abscess, it is necessary to remove the tooth completely.

The next stage of treatment is the removal of inflammation from the soft tissues and the complete removal of pus. To do this, the surgical site, which remains open, must be regularly rinsed with antiseptic solutions, and swollen areas of the gums must be treated with gels and ointments. Antihistamines are prescribed as prescribed to help relieve severe swelling.

Physiotherapeutic procedures, including ultrasound and laser irradiation of tissue, also contribute to faster healing. As part of complex therapy and anti-inflammatory drugs, the use of which is necessary to remove the infectious agent from the body.

After a certain period, the duration of which is determined in each specific case, the patient must come for an appointment, at which the doctor will examine the oral cavity. Elimination of the source of infection is indicated by the removal of swelling, redness, absence of pus and discomfort in the area of ​​the former fistula.

In this case, a temporary filling is placed on the tooth, which is replaced with a permanent one after a week, but only if there is no re-infection.

Note! If you do not seek help in time, the infection may spread to the periosteum. In this case, treatment consists of surgically cutting out the fistula, which is fraught with additional complications.

Treatment with traditional methods

Traditional medicine recipes can be used at home to help.

Traditional medicine recipes can be used at home to help. To fully treat a fistula on the gums, non-traditional remedies cannot be used. But they are highly effective in relieving inflammation and speeding up healing during the rehabilitation period.

1. Chamomile infusion. Dried chamomile flowers (1 tbsp) are crushed in a mortar and 400 ml of boiling water is poured. After steeping for two hours, the mixture is filtered through a clean piece of gauze. While rinsing, the liquid must be retained in the mouth. The procedure is carried out up to four times a day.
2. Aloe and Kalanchoe lotion. Two leaves from each plant are grated or chopped in some other way, and a paste of one garlic clove is added to them. The mixture is placed in a piece of clean gauze, and the excess juice is squeezed out. To get results, you need to apply the lotion to the inflamed gum for at least 10 minutes after eating.
3. Soda-salt solution. Mix soda and salt in equal parts (1 tsp each) in warm water (250 ml); you can add a few drops of iodine to the solution. Apply as follows. Take a small amount of liquid into your mouth and, tilting your head towards the painful area, hold it without spitting for several minutes.
4. Bulbous lotion. A peeled medium-sized onion is crushed into a pulp, mixed with mummy tablets (10 pcs.), which must be crushed, and olive oil (1 tbsp.). The mixture, placed in gauze, is applied to the inflamed gum for five minutes. The manipulation should be repeated up to three times a day.

Seeking qualified help is mandatory, even if the opening of the fistula occurred before visiting the doctor. Using folk remedies without eliminating the cause of the disease will worsen the situation.

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:

1. Complication of the underlying disease – periodontitis, caries, pulpitis.
2. 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.
3. 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.
4. Failure to comply with oral hygiene standards and failure to take preventive measures after treatment of a particular dental disease.

Symptoms

All symptoms are classified by type:

Outer

Symptoms:

1. Bad breath, even after proper oral care.
2. Unpleasant constant taste and yellowish salivation, even after some time after eating.
3. 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.
4. Release of liquid with an 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; high temperature - in the evenings more than 38, and in the mornings not lower than 37.2 degrees, despite taking antipyretic drugs; headache; an increase in 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:

1. medical– carried out at an early stage of suppuration, or when, due to the large depth of the formation, it is not possible to use other methods. The medicinal method is the main one. 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.
2. Laser and ultrasound therapy. This method is used for external fistula after undergoing drug therapy. The main task is to cauterize the dentin before filling.
3. 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.
4. 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:

1. The occurrence of periodontal disease.
2. Periodontal destruction.
3. Destruction of bone tissue in the jaw.
4. Pus entering the lymphatic or circulatory system.
5. Breakthrough fistula on the cheek.

Folk remedies

Treatment of a dental fistula with folk remedies without prior consultation with a dentist is not advisable and sometimes dangerous for the following reasons:

1. It may not be a fistula at all.
2. The antiseptic effect of plants is much weaker and slower than that of antibiotics.
3. You can be allergic to many plants.
4. 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:

1. Do not rinse your mouth with alcohol tinctures under any circumstances! Alcohol puts most bacteria into suspended animation, which significantly prolongs their existence.
2. 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

1. Maintain oral hygiene: brush your teeth 2 times a day; rinse the mouth with herbal infusions and or dental elixirs
2. The diet should contain foods that contain calcium, for example, cottage cheese.
3. Reduce chewing activities, such as chewing gum, and replace them with frequent brushing and sucking on mints.
4. Avoid sudden changes in temperature in the oral cavity, this has a detrimental effect on the integrity of dental enamel.
5. 2 times a year, be examined by a dentist and have your teeth professionally cleaned to remove plaque and stones (hard salt formations on tooth enamel).

Perhaps many can say what a dental fistula is, since they have experienced it at least once. Usually, due to improper dental treatment or simply lack of hygiene, a cavity forms in the gum, which is filled with pus. Some try to squeeze out the suppuration on their own, without even thinking about what all this can lead to. The resulting tubercle on the gum is only an external manifestation of a rather serious disease, which has to be fought for quite a long time.

If a dental fistula appears, this disease is called periodontitis. This term comes from a similar word - periodontium. Periodontium, a kind of apparatus that attaches the tooth to bone tissue. Periodontitis in the process of its development can lead to the destruction of the periodontium at the root of the tooth, and then the formation of an abscess in this area, i.e. dental fistula.

Fistulas, according to dentists, are a common and very dangerous disease, which is not so easy to cure and will take a lot of time. And if we talk about the causes of this disease, it is not so easy to establish them. But, as practice shows, there are 3 main reasons for the formation of a gum fistula.

Symptoms

The symptoms are quite pronounced, which are simply impossible to pay attention to.

At the first manifestations of this disease, you should immediately visit the dentist in order to avoid more serious consequences.

Treatment

Before starting treatment, the doctor takes an X-ray to fully determine and assess the extent of the disease and determine the size of the fistula in the gum. There is no way to delay treatment, as the infection will spread deeper and deeper.

Initially, the diseased tooth is treated, the tooth cavity is completely cleaned and it is filled. Then drug treatment with antibiotics (gentamicin or its analogs) is started, 2 ampoules per day are prescribed intramuscularly for up to 2 weeks.

Antibiotics are combined with antihistamines, usually Tavegil, Suprastin or Cetrin, since it is necessary to get rid of pathogenic microbes in the mouth. In case of pronounced pain, the dentist prescribes an analgesic, for example, Ketorol.

In addition, the doctor prescribes salt baths to the fistula area, as well as antibacterial ointments and gels. A dental fistula takes a long time to heal, so you will have to be patient and visit the dentist regularly. This is a necessary measure that should prevent further spread of the infection, since it is completely possible.

It is much more difficult to treat a fistula when the tooth is filled. Initially, the doctor removes the filling, cleans the tooth canal, treating it with anti-inflammatory and disinfectant solutions, and only then fills the tooth again. After filling, it is treated with a special paste that will not allow the development of pathogenic bacteria that contribute to the formation of ulcers on the gums.

If the disease is advanced, the doctor decides on surgical intervention. The operation will be inevitable if the inflammation has touched the periosteum. A qualified specialist, during the operation, will try his best to save the tooth and injure the gum as little as possible. It is also impossible to do without surgical intervention if it is noticeable, in other words, this is inflammation at the root of the tooth. For this treatment, local anesthesia is usually used; general anesthesia is used extremely rarely.

Ultrasound treatment is often used in the treatment of dental fistula. Ultrasound affects the affected area of ​​the gum, and sometimes laser tissue treatment can be used. Such methods are very effective and are used already in the rehabilitation process.

Prevention

If the treatment is carried out correctly, the fistula will heal quite quickly and will no longer bother you. But you must always be on guard, since everyone who has developed a fistula at least once is at risk of a recurrence of the fistula, only in a different place. Therefore, it is necessary to pay great attention to prevention, and we clearly know that it is always easier to prevent a disease than to cure it, so it is enough to know and follow a few rules and you don’t have to think about fistula anymore.

• Get regular check-ups with your dentist.
• Maintain good oral hygiene.
• Seek medical attention promptly at the first signs of illness.
• Choose a reliable and experienced dentist.

Only by following the rules in this way can the occurrence of a dental fistula, which causes many problems for a person, be avoided. In addition to prevention, do not forget to clean plaque and remove tartar once every six months. Eat right by eating foods containing calcium, which not only strengthens the immune system, but also helps prevent the formation of pathogenic microorganisms.

Be attentive to yourself and your health!

Often the gums of children and adults are affected by a disease called fistula, the treatment of which should be carried out under the guidance and careful supervision of dentists.

What does it look like, symptoms?

The lesion looks like a sac or hole filled with pus, blood and other fluid

A fistula is an inflammatory disease in the gums and serves as a kind of channel for removing pus from the lesion.

The lesion looks like a sac or hole filled with pus, blood and other fluid.

This canal drains the contents away from the inflamed tooth root. A fistula can be seen during a routine examination of the oral cavity.

Other symptoms of fistula formation include:

• severe or mild toothache;
• mobility of the problematic tooth;
• inflammation with redness of the gums in the area of ​​the affected tooth;
• outflow of pus from the resulting fistula;
• high body temperature of the patient.

Sometimes x-rays are taken for an accurate diagnosis, but a simple examination by a dentist is usually sufficient.

Reasons for development

The fistula is formed due to the work of pyogenic microorganisms, such as staphylococci, pneumococci and others. They get to the roots of the tooth as a result of various infections.

The following diseases lead to similar problems:

• Caries- in a neglected form, cavities are formed under the shell of the tooth, where putrefactive bacteria destroy it.
• Pulpitis– if caries is not treated, the tooth rots down to the pulp – its core. Through the infected pulp, pathogenic microorganisms go further and infect the bone tissue of the jaw and gums around.
• Periodontitis– infection of tissues in the tooth area. This happens as a result of the development of caries or sinusitis.
• Cyst- it is formed at the top of the tooth root due to untreated pulpitis or poor canal filling. A cyst is a bubble filled with pus.
• Granuloma- This is a small, up to 5 mm in diameter, formation similar to a cyst, but without a shell. They are formed after inflammation of the tissues in the tooth area.
• Teething. Often, a severe exit of wisdom teeth in adults and milk teeth in children is diagnosed. The tissues next to them become inflamed, receiving injury from the opposite tooth. Then there is infection with harmful microorganisms that are always in the mouth.
• Osteomyelitis. After the transferred incisions on the gums and complex extraction of teeth, foci of inflammation on the gums come out, resulting in a fistula.

Granuloma Caries
Cyst Osteomyelitis
Periodontitis Teething Pulpitis

Sometimes a fistula is obtained with swelling and inflammation of the gums, which is commonly called a flux.

Kinds

There are only two forms of fistula - external and internal. The outer one is located on the outside of the gum, it is easy to find it on your own. The internal one cannot be visually seen, it can only be detected on an x-ray.

Before the formation of a fistula tube, the inflamed focus is difficult to detect, because the inflammation with purulent contents is located inside the gum at the root of the tooth. Pay attention to the condition of your gums more often, because inflammation can be felt by pain in the teeth.

Where can they be located?

It is impossible to determine the place where the fistula most often occurs.

The canal independently chooses its exit direction, and a purulent sac can appear anywhere:

It is important: Symptoms of its appearance are pain and discomfort in the area of ​​the affected tooth, redness of the tissue. The initial stage is easier to cure, so you should not start the inflammation so as not to lose the tooth.

Treatment methods for gum fistula in adults

Treatment in a dental clinic consists of stopping the activity of pathogenic microflora, cleaning the tissues from pus and filling the canals of diseased teeth.

Treatment methods depend on the stage of the disease and the affected area:

• Opening of the external fistula. It is used if its formation is at an early stage, which can be determined by pressing on the gums. At the same time, it fills with pus and hurts a lot. To identify the cause of the fistula, X-rays are taken. Then the abscess is opened, the pus is cleaned out and left open. For better drainage of pus and quick healing, irrigate with an antiseptic solution. Next, physiotherapeutic procedures and treatment of the autopsy site with antibacterial ointments are prescribed. Antiviral, anti-inflammatory drugs and antibiotics may be prescribed.
• Treatment of internal fistula. The filling is removed to allow purulent masses to come out. The wound is left open, and to allow the pus to drain, it must be rinsed with an antiseptic and treated with antibacterial ointment. Once the inflammation and swelling have passed and the pus has stopped oozing, a permanent filling can be placed.
• Tooth extraction in the treatment of a fistula occurs due to the fact that the tooth cannot be restored in the future. The tooth can be removed in budget dentistry, because cleaning and treatment of the tooth takes a long time and it is problematic to do it efficiently. After tooth extraction, doctors carefully clean the tissues lining the fistulous entrance. Such a solution helps to cure a fistula in one visit to the dentist.
• Rehabilitation. In complex cases, when there has been no treatment for a long time, the fistula spreads to neighboring tissues, for example, to the cheeks. After surgery and a course of antibiotic and antimicrobial therapy, rehabilitation is required to restore damaged tissue in the clinic. To heal wounds on the cheek and gums, laser tissue treatment is performed to prevent bleeding. Ultrasound or electric cauterization also contributes to tissue restoration. This is carried out within the walls of the clinic in the physiotherapy room.

The sooner you start therapy, the easier and easier it will pass. Often, treatment and recovery is delayed for several months.

The process of removing a tooth cyst

How to treat at home?

At home, it is impossible to completely cure a fistula on your own. You can stop inflammation and relieve pain, but you can only be completely cured through a complex effect on the entire body.

Before visiting a doctor, you can take the following medicines:

At home you can use folk recipes:

• Pharmaceutical camomile. For 2 spoons of flowers you will need a glass of boiling water, leave the solution in a sealed container for 30 minutes and let it cool until warm. Rinse every couple of hours until severe symptoms subside.
• Walnut. You need to take several unripe nuts and chop them finely. Boil the chopped nuts in water and let cool. Then pour vegetable oil over everything and leave to infuse for 10-12 days. Then keep the mixture in a steam bath for 3 hours and let it cool, strain and add natural wax to it. Lubricate the gums with the resulting ointment every day.
• St. John's wort. Make a decoction of 10 g of herb and ½ glass of water. Let the herb brew, strain and add a little honey to reduce the bitterness. Rinse 3 times a day.
• Propolis. Pharmacy tincture of propolis can be used for rinsing the mouth, making solutions from it. Pure propolis disinfects the oral cavity; a piece of it needs to be placed under the tongue or absorbed.
• Eucalyptus. An ointment is prepared from its leaves: chop them and pour in the oil, after a day add finely chopped onion, take everything in equal volumes. Wrap a small amount of the mixture in a sterile bandage and apply to the affected gum. This remedy draws out pus well and heals the fistula canal.

It is important: Is it possible to puncture a purulent sac yourself? Doctors strictly prohibit doing this, because the infection can spread to neighboring teeth and tissues.

If the fistula ruptures on its own, you must also consult a dentist and undergo antibacterial treatment. Otherwise, sepsis may develop, which can be fatal.

If the fistula bursts, the constant entry of rotting products into the gastrointestinal tract leads to the development of pancreatitis, inflammation of the gallbladder and its ducts. It is dangerous for pus to enter the digestive organs by the development of gastroenterocolitis with vomiting and diarrhea.

In the event that the fistulous passage does not break through on its own, and there is no treatment, then such a complication as osteomyelitis may occur, which destroys the jaw bones and leads to blood poisoning.

Features of treatment

Features of treatment in adults are presented above. But medical care for children and pregnant women is somewhat different.

Treatment of children

Gingival fistula in children is not uncommon. A child should not be left without the help of a dentist.

The causes of this problem in children are as follows:

Treatment of a fistula in children is carried out by a dentist if it is just forming. In advanced cases, the tooth is simply pulled out, this is safer and there are no complications.

The replacement of a tooth does not occur immediately and this prevents infection of the new one. When the fistula comes out due to poor treatment, the filling is opened and therapy is given as for an adult.

Fistula in a pregnant woman

A pregnant woman's body undergoes dramatic changes, and her teeth also suffer. But they can be treated at a certain period of pregnancy. The dentist must be warned about your situation, then they will be prescribed surgical therapy using herbal ointments.

Under no circumstances should you take antibiotics. Fistula can be treated with other methods: you can rinse with decoctions of eucalyptus and chamomile - this will help stop inflammation and avoid surgical intervention.

Fistula at the wisdom tooth

Unlike a fistula on a front tooth, a fistula caused by a wisdom tooth coming out is usually treated with surgical removal. Then the area of ​​inflammation is rinsed and treated with antibacterial agents.

Fistula location diagram

Possible complications

An untreated or neglected fistula is dangerous due to its complications:

• The most common complication is tooth loss.
• A diseased tooth can infect others through the periosteum. It is possible to lose several teeth and, having undergone degenerative changes, the periosteum can be partially removed surgically.
• A large accumulation of pus affects facial tissues, which also have to be removed surgically.

Other consequences of untreated treatment were described in the treatment section.

Preventive measures

Treatment of a fistula is quite difficult and painful, so it is better to prevent its occurrence.

Experts have developed the necessary preventive measures for this:

• Take measures to prevent tooth decay.
• Brush your teeth thoroughly in the morning and at night.
• Remove tartar.
• Eat in the right way.
• Go to the dentist 2 times a year.

A generalization to all that has been said is correct and wise advice: you should lead a healthy lifestyle and monitor the condition of your oral cavity.

To get rid of a fistula once and for all, you need to eliminate the cause of its appearance. And this cannot be done without the help of a specialist. Therefore, you should not delay the visit to the doctor, without his help, the fistula itself will not go away.