Dental fistula. Symptomatology. Treatment

The acute infectious complications concerning the pulp chamber hold an important place among dental pathologies. One of these complications is the dental fistula, a marker of the chronicity of a dental abscess. With the appearance of the fistula, drainage, the evacuation of the purulent content inside the abscess, is achieved. This moment coincides with the cessation of pain.

Dental abscess – the precursor to fistula

This pathology is a purulent infection, occurring in the oral cavity when the health of the teeth is disturbed by processes that expose the dental pulp. The signs in identifying dental abscess are characteristic, easily suggesting the diagnosis, and are as follows:

  • Inflammation: the tegument will be more stretched and shinier, suggesting an incipient or advanced inflammatory status, depending on the intensity of the pathological process; the gingiva around the tooth with a focus of infection is also inflamed;

  • redness: along with inflammation, the gums and gingiva will be intensely reddish in color;

  • purulent collection: when pressure is applied to the gums, a yellowish liquid, equivalent to pus, may be excreted;

  • pain: this is perhaps the most important symptom, which sends the patient to the dentist. The pain is throbbing, often occurs at night and rarely subsides when pain killers are administered. Pain is the first symptom to appear in the manifestation of a dental abscess, and is excruciating. The absence or delay of treatment at this time leads to the appearance or accentuation of the symptoms and signs described above.

Fistulization of a dental abscess means migration, evacuation of purulent contents. This can be external, when the passage is at the level of the skin, or internal, when the communication is with the oral mucosa or gingiva.

Following the fistulization process, the pain decreases in intensity or even disappears and the purulent collection can be incised. Most of the time, dental fistula is accompanied by halitosis (unpleasant smell) or can alter the taste of food perceived by the patient.

Treatment of dental fistula

In the treatment of dental fistula, there are two therapeutic options, depending on the stage of the pathology. The first is preventive treatment, in which we clean the oral cavity to prevent possible infection, or the second is curative treatment, when the infectious process is already established.

Preventive treatment

The best way to avoid a dental abscess and therefore a dental fistula is to maintain good oral health. Your dentist will analyze your oral hygiene status and the factors that can compromise it. Tooth decay is the main factor that can destabilize the balance in the oral cavity.

Other pathologies with the potential to cause abscesses are oral inflammations such as cellulitis. Oral hygiene methods should be applied strictly and include brushing after each meal, the use of hygiene aids and regular check-ups by the dentist.

Curative treatment

It consists of antibiotics and anti-inflammatories, prescribed by the dentist. Once the fistula is formed, surgical treatment can be continued to evacuate the purulent collection.

When the patient’s condition improves, the possibilities of recovering the tooth that caused the infection can be explored.

Good oral hygiene is the foundation of good health. Infectious processes initially develop without pain, the patient being unaware of the onset of pathology. Therefore, regular check-ups by the dentist are an aspect that should not be neglected by the patient.

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