SWELLING OF ORAL AND PERIORAL SOFT TISSUES: CAUSES, SYMPTOMS AND TREATMENT


Along with gingival bleeding, trauma, tooth mobility and loosening of prosthetic work, oral and perioral soft tissue inflammation is an emergency in the dental office.

Inflammation is often the result of the externalization of periapical processes from the dental roots to the soft spaces.

In its evolution, a periapical process, by extension, deforms the bone plate, especially in areas where the bone is more spongy, less resistant. Later, the process is confined to the oral mucosa or even the integumentary level.

Causes

The causes of oral and perioral soft tissue inflammation can be diverse and include:

  1. Infection: One of the most common causes of oral inflammation is bacterial or fungal infection. Gingivitis, an inflammatory condition of the gums, is a common example. Also, stomatitis, an inflammation of the oral mucosa, can be caused by viral or bacterial infections.

  2. Allergies: Allergenic substances, such as certain foods, cosmetics or medicines applied topically to the perioral area, can trigger an inflammatory reaction in the soft tissues.

  3. Trauma: Bumps or other trauma to the mouth or perioral area can cause inflammation and swelling.

  4. Autoimmune diseases: Conditions such as systemic lupus erythematosus or pemphigus vulgaris can cause persistent inflammation in and around the oral cavities.

  5. Irritant factors: Aggressive use of toothbrush, floss or an oral irrigator can cause inflammation of the gums or other soft tissues.

  6. Systemic diseases: Certain systemic diseases, such as diabetes or kidney disease, may have oral manifestations, including inflammation of soft tissues

Symptoms

Pain – inflammatory processes sum up to three stages. In the first of these, the bony stage, the pain becomes more pronounced and in the second stage, the periosteal stage, the pain is of maximum intensity. On the other hand, in the third stage, i.e. the externalizing soft tissue stage, although the inflammation is much more visible, the pain may reduce dramatically and even disappear.

Congestion and swelling of the teguments – the mucous membranes in the area of the inflammatory processes become red, swollen and will have a circumscribed outline. The covering teguments also become stretched, smooth and, on compression, depressed and acquire a whiter color.

Fistulae – If the processes represent a reactivation of a chronic periodontal inflammation, fistulae may be present, most often in the gingiva adjacent to the vestibular mucosa of the pathological process. These are intended to facilitate drainage of the existing purulent collection.

Alteration of the general state of health – most often, pathological processes in the soft tissues alter the state of health. Manifestations include fever (usually not more than 38 degrees Celsius), lack of appetite, apathy and asthenia.

Symptoms of oral and perioral soft tissue inflammation may vary depending on the cause and severity. The most common symptoms include:

Redness and swelling in the affected area.

Pain or tenderness in the soft tissues.

Ulcerations or sores in the oral cavity or perioral area.

Gingival bleeding or itching.

Burning sensation or discomfort in the lips.

Worry or avoidance of hot, cold or spicy foods or drinks.

A severe manifestation of infection of the periodontal spaces externalized to the tegumentary level is cellulitis, an entity that represents, by the severity of its complications, a medical emergency.

Cellulitis is localized inflammation of the skin characterized by constant pain.

Most commonly, if the inflammation is extensive in the mandibular tegumentary area, the patient can no longer open the mouth within normal limits, sometimes not at all. The skin is warmer, rough to the touch and reddened.

Patients who present with cellulitis as a complication of dental pathologies often have an altered state of health, against a background of generally affecting diseases.

In patients with chills and severe health impairment, blood tests are also required to detect the substrate of the disease.

In most cases, enlarged, hard and painful lymph nodes can also be detected by palpation.

The body’s defenses are unable to cope with the existing bacteremia and antibiotic treatment is therefore urgently required.

In patients with known underlying general illnesses, such as those with diabetes, alcohol dependence or those undergoing immunosuppressive treatments, it is recommended that the antibiotic be administered in a hospital unit, by the intravenous route.

Treatment

The treatment to be given initially will be broad-spectrum, and once the pathogens in the outbreak have been identified, antibiotics will be replaced by those that act specifically.

Inflammation of oral and perioral soft tissues is a common problem in dental and dermatological practice.

This condition can affect the lips, gums, cheeks, tongue and other soft parts of the oral cavity, causing discomfort and, in some cases, severe pain.

It is important to understand the causes of this inflammation, associated symptoms and treatment options in order to provide patients with appropriate care and effective management of this condition.

Depending on the cause and severity of the inflammation, there are several treatment options.

In the case of bacterial infections, treatment with antibiotics may be necessary to control the inflammation and fight the infection. For autoimmune conditions, treatment may involve taking immunosuppressive drugs to reduce the inflammatory response of the immune system.

To manage inflammation caused by allergies or irritants, patients should avoid contact with triggers and adopt gentle oral hygiene measures. In the case of trauma, cold compresses should be applied and food and drink that may irritate the affected area should be avoided until healing.

In addition to cause-specific treatment, proper oral hygiene and regular visits to the dentist are essential to maintain oral soft tissue health and prevent inflammation. Regular brushing, flossing and visits to the dentist for professional cleaning help prevent plaque build-up and therefore gum inflammation.

In summary, oral and perioral soft tissue inflammation can be caused by multiple factors and can manifest various symptoms. Correct diagnosis and identification of the cause of inflammation is essential to establish an appropriate treatment plan. Adopting a proper oral hygiene regime and regular visits to the dentist are important preventive measures to maintain the health of the oral cavity and prevent inflammation from developing.

If oral and perioral soft tissue inflammation persists or worsens, it is essential to seek medical attention. An experienced dentist or dermatologist can assess the patient’s symptoms and medical history to identify the cause and prescribe appropriate treatment. Self-medication or ignoring symptoms can lead to complications and worsening of the patient’s condition.

Prevention

In addition to drug treatment, it is important to pay special attention to lifestyle and take certain measures to prevent oral and perioral soft tissue inflammation:

Rigorous oral hygiene: Regular brushing of the teeth at least twice a day, flossing and using a salt water gargle can help maintain healthy gums and reduce the risk of oral inflammation.

Avoid irritants: If you are prone to allergic reactions or soft tissue inflammation, avoid cosmetics or medications that may irritate the perioral area. Also avoid eating foods and drinking drinks that may aggravate symptoms.

Adequate hydration: Make sure you are well hydrated, as dehydration can worsen oral inflammation.

Balanced diet: A healthy, balanced diet rich in vitamins and minerals helps maintain a healthy immune system and soft tissues.

Quit smoking: Smoking can worsen soft tissue inflammation and increase the risk of oral and perioral diseases.

In summary, oral and perioral soft tissue inflammation can be a troublesome and sometimes painful problem. However, with correct diagnosis and appropriate treatment, most cases can be managed successfully.

In addition, preventive measures such as proper oral hygiene and adopting a healthy lifestyle can help prevent recurrences and maintain long-term oral health.

It is important to pay attention to signs of inflammation and not hesitate to seek medical advice when you experience oral or perioral problems. Following a proper oral care regime and following your doctor’s recommendations will help you enjoy optimal oral health and a healthy, bright smile.