There are certain ailments that scare patients more. One of those that we could categorize as the one that causes the most alarm is the dental fistula.
In fact, when I tell a patient that this is the cause of his discomfort, his worried face is usually a poem.
For this reason, in this article, I want to explain what a dental fistula is, its possible causes, and whether or not you should worry after its appearance.
What is a dental fistula?
A dental fistula is a small lump that appears on the gum. In it, we find an opening through which pus oozes – a liquid consisting of white or yellow tones.
Fistulas respond, therefore, to infectious processes of various causes. Among its origins, which we will detail later, are extensive cavities or wisdom teeth eruption.
Although the introduction explained that the appearance of the fistula —as well as its name— used to cause alarm in almost all patients who suffer from it, there is also a small percentage of “easygoing” or reckless.
They think that the dental fistula is a natural way to fight the infection and that, therefore, it is not necessary to go to the dentist.
This belief is absolutely wrong and can have serious consequences for your general health. Therefore, we recommend you visit your trusted dentist to stop and eliminate the infectious process if this is your case.
Main causes of the appearance of dental fistulas
Dental fistulas should be understood as an external sign of an infection in the gums. But before stopping it, the dentist must know the reason for this infectious process.
Among the most common causes, it is worth highlighting:
- Caries: In the case of very extensive caries -whether in the molars or in other dental pieces-an infection can occur in the root of the piece. At this time, the accumulation of pus tends to try to drain through the soft area of the gum. A fistula emerges -generally in the gingival area next to the injured tooth-.
- Poorly executed endodontics: Sometimes, poorly performed endodontics can cause an infection that manifests itself through the formation of a dental fistula.
- Periodontitis: Periodontal diseases in an advanced stage can generate infectious processes in the gums. In this way, the formation of fistulas or abscesses in the area is common.
- Wisdom teeth: If infection occurs in the wisdom teeth, usually due to a complex eruption, it may manifest itself with the appearance of a fistula next to the infected tooth.
- Trauma to a baby tooth: Children have a tendency to bump their mouths accidentally. These traumas in the teeth can cause the appearance of infections several days after the impact. And that infection will cause the fistula to appear in the gum. In addition, it should be noted that strong blows to the teeth are also a frequent cause of the appearance of a fistula in adult patients.
Differences between fistula and Phlegmon
Before explaining in which areas fistulas appear most frequently, I want you to know the difference between a fistula and a phlegmon:
The fistula is distinguished by having an outlet for pus. In this way, the abscess can be drained properly and, therefore, it does not usually manifest with much pain or discomfort.
On the other hand, Phlegmon is a fistula that has not found an escape route, so the patient does experience inflammation and swelling in the area and pain.
In what areas of the mouth do fistulas come out?
A fistula most often arises in the gum, very close to the place where the infection exists.
But this is not an absolute rule, as sometimes the fistula has formed in a part of the soft tissue far from the real source of the infection.
This means that dentists must deeply explore —even at the radiological level— to determine where the infection is sprouting.
Another area where fistulas are not uncommon to appear is on the palate. When the tooth’s root is tilted toward the tooth, the abscess is likely to open on the palate rather than the gum.
What is the treatment for a dental fistula?
To know the exact path of a fistula, an instrument called gutta-percha is used. The gutta-percha is an extremely fine cone inserted into the fistula duct so that we can easily find both its origin and morphology.
In addition, the radiological examination can also be useful to understand exactly what is the cause of the infection and prescribe a treatment aimed at eliminating it properly.
However, before eradicating said origin, it is necessary to stop the unleashed infectious process. For this reason, it is common for the dentist to prescribe a treatment based on antibiotics with which to attack the infection.
However, if the cause of the infection is not eradicated, antibiotic treatment will be useless.
Therefore, once the infection subsides and the fistula subsides, it will be necessary to attack the underlying problem – extensive caries, poorly performed endodontics, periodontal diseases in an advanced state, etc.
Further treatment, therefore, depends on its cause. And for this reason, the procedure can be very varied:
If this abscess is the result of extensive caries, it will have to be addressed through root canal treatment -or endodontics-.
In the event that the fistula has occurred as a result of failed endodontics, the dentist will proceed to perform re-endodontics. This way, an attempt is made to save the damaged natural tooth and prevent its extraction.
However, in some cases, this conservative procedure is ineffective in restoring the piece. It is then that the extraction -or extraction- of the work becomes necessary.
Lastly, if advanced periodontal disease is behind the origin of the fistula, it will be necessary to perform periodontal treatment aimed at slowing down the infectious process. The dentist will effectively eliminate all the accumulations of bacteria present in the mouth, eradicating the infection and restoring health to the patient’s mouth.
As we have revealed to you in the previous section, the treatment can be very varied depending on the cause of the fistula.
Therefore, the cost of the treatment will also depend on its cause and the complexity of the procedure that the dentist who oversees the case must undertake.
Fistulas can be avoided with preventive visits to the dentist.
As I always say, prevention is essential to avoid many pathologies.
And it is that in periodic preventive check-ups, we can detect any latent infection before it shows its worst face in the form of a dental fistula.
For this reason, dentists do not tire of saying it: you should at least make one visit to your dentist a year to avoid greater evils.