A dental or tooth fistula can form in the upper and lower jaw and usually arises only on a single tooth. The tooth root is the center of origin. The term fistula comes from Latin and means tube. This word also describes the shape of the fistula, because it is always tubular and connects an internal hollow organ with another organ. A fistula can occur anywhere on the body, but is particularly common in the mouth. It consists of fistula opening, fistula canal and the fistula base. It is the germ cell from which the fistula develops.
How is a tooth fistula formed?
It arises from an inflammation of the tooth root or root tip, which can have various causes. The inflammation often occurs due to poor oral hygiene or as a result of pressure points from badly fitting dentures. Sometimes a tooth fistula forms after implantation, sometimes it is caused by a viral infection. The predisposition also plays a certain role. In some families, tooth fistulae frequently accumulate. Tooth fistulas emanating from the tooth are called odontogenic fistulas. If they are located in the jaw area, it is called non-odontogenic fistulas.
The Fistula as a sign of Infection
The formation of the oral fistula is a natural reaction of the body to a focal point of an inflammation at the tooth root. Left untreated, the inflammation spreads rapidly and becomes chronic. As the inflammation increases, so does the amount of pus. The accumulation of pus exerts great pressure on the jaw, causing the pus to make its way into the oral cavity. This creates a small tube, the so-called fistula tract. Now the pus has spread, but has not yet drained. At this point, the dentist is needed for medication or a surgical procedure.
What kind of complaints does a tooth fistula cause?
In the initial stage, the fistula is noticeable, but not very painful. The inflammation creates a feeling of warmth and worsens each day of non-treatment. The pain increases, begins to throb and knock, and is always accompanied by a state of tension. The symptoms can last for many weeks until the pain is so great that you desperately need to do something about it. In the area of the diseased tooth, the face swells, with an advanced inflammation you can even see a pus in the oral cavity. At this point, the pain is strongest.
Treatment of a tooth fistula
Not all fistulas are so close under the skin that you can see them with the naked eye. Only in the x-ray image, they are clearly diagnosed. If the pus has poured into the fistula, the pressure will decrease and the pain will decrease, but the inflammation is not eliminated. Bacteria and pus continue to work to destroy the jawbone. The dentist treats the inflammation with a locally acting antibiotic. Only when it has subsided, the tooth root can be treated.
Home remedies help with an inflamed tooth root only in the initial stages. Often, this method is not successful. Furthermore, the risk of meningitis caused by migrating bacteria is very high. To make sure that the inflammation at the root of the tooth heals completely, you should leave the treatment to an experienced doctor.
An unambiguous diagnosis always requires an X-ray. In the picture, the site of inflammation can be located very precisely. Its size can also be determined, from which the next steps result. There are two ways to derive the pus from the tooth root:
- Either the doctor drills a hole in the tooth and tooth root, so that the pus can flow away invisibly from the outside.
- The second possibility: It cuts the gums sideways, which is much more painful and leads to a longer healing process. If the fistula is large, it must be cut open.
After the pus has drained, the healing process begins. If the cause of the fistula is eliminated, it disappears on its own. Rarely, a fistula heals without treatment, but it does happen. If the focus of inflammation is prolonged, the fistula becomes chronic, can spread further within the oral cavity and cause nerve damage.
Tooth root inflammation is treated with medication and a root tip resection is not always necessary. If the inflammation can not be contained in this way, a laser treatment can also help. It is used for root tip resection, but an affected tooth can not always be saved. If a diseased root is removed, the cavity in which it was located must be filled. To do this, the dentist uses a mini-implant that resembles a pin.
Risk factors for the development of tooth fistulas
The most common fistula in the mouth is the tooth root fistula. It is almost always triggered by an inflammation of the root tip, which has led to the death of the tissue located in the tooth. Sometimes, jaw fistula are also formed from leftover teeth that have not completely broken through into the mouth during their natural development. Significantly less common are keratocysts. These are fast-growing, benign tumors that displace and treat other tissues. The formation of fistulas is favored by germs. With poor oral hygiene, the risk of developing it is much higher than with regular dental care.
Prevention of tooth fistulas
Since dental fistulas can barely cause discomfort for months and often lie deeper in the jaw, they are rarely discovered in the early stages. Brushing teeth several times a day reduces the risk of illness as well as abstaining from nicotine and alcohol. Even hard-to-reach areas have to be cleaned well, for example with dental floss and dental brushes. A weakened immune system is always a risk factor. Those who eat well, exercise regularly and spend a lot of time in the fresh air generally have a lower risk of inflammatory processes in the body. If possible, take care of the half-yearly check-ups at your dentist.
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