A dental fistula is an abnormal passage that forms between a tooth and the gum. It can cause symptoms such as throbbing tooth pain, a lump on the gum, or pus draining from the area.
A dental fistula usually develops as part of the body’s natural response to clear pus and infection from the site. It may happen because of a dental abscess, an infection in the root of the tooth, or chronic periodontal disease.
Treatment for a dental fistula is done by a dentist or an oral and maxillofacial surgeon. Depending on the cause, treatment usually includes antibiotics, drainage of the abscess, a root canal, or surgery.
Main symptoms
The main symptoms of a dental fistula are:
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Redness or swollen gums.
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Throbbing tooth pain.
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A lump on the gum.
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Pus draining from the area.
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Swollen lymph nodes in the neck or jaw.
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Fever.
A bad taste in the mouth, bad breath, and pain that spreads to the neck or ear may also occur.
It is important to see a dentist or oral and maxillofacial surgeon whenever symptoms of a dental fistula appear so the diagnosis can be confirmed and the most appropriate treatment can be started.
Potential complications
A dental fistula can cause infection in the dental pulp, called pulpitis, which is the living tissue inside the tooth. It can also lead to dental necrosis, which is the death of that tissue.
According to the American Dental Association, if a dental abscess is not treated, it can lead to a serious infection in the jaw bone, teeth, and surrounding tissues.
Confirming a diagnosis
A dental fistula is diagnosed by a dentist or oral and maxillofacial surgeon based on symptoms and a physical exam of the tooth and gums.
A cold sensitivity test may also be done to evaluate the health of the dental pulp. A panoramic X-ray may be ordered to check whether the jawbone has been affected.
Possible causes
The main causes of a dental fistula are:
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Dental abscess.
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Deep tooth decay.
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Infection at the root of the tooth.
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Trauma or a deep injury to the tooth.
A dental fistula may also be caused by poor oral hygiene or chronic periodontal disease, for example.
Treatment options
Treatment for a dental fistula should be guided by a dentist or oral and maxillofacial surgeon. It varies depending on how severe the condition is.
The main treatments for a dental fistula are:
1. Antibiotics
Antibiotics may be prescribed by the dentist or oral and maxillofacial surgeon to eliminate the bacteria causing the dental infection or gum abscess.
The type of antibiotic can vary depending on the bacteria causing the infection. It should be taken for the full length of time prescribed by the dentist or oral and maxillofacial surgeon, even if symptoms improve quickly.
2. Drainage of the abscess
The dentist or oral and maxillofacial surgeon may drain the abscess to remove excess pus from the lump on the gum.
3. Root canal
A root canal may be done by the dentist to remove the infected dental pulp.
If needed, the dentist may also remove the affected tooth, especially if it cannot be saved.
4. Surgery
Surgery for a dental fistula may be done by the dentist or oral and maxillofacial surgeon to open the fistula and allow it to heal from the inside out.
This type of treatment is usually done after antibiotics have been used.
Home care
Some home care measures for a dental fistula include:
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Applying cold compresses to the cheek on the side of the face where the fistula is located.
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Rinsing with warm salt water.
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Taking pain relievers, such as acetaminophen, if recommended by the dentist.
According to the American Dental Association, good oral hygiene includes brushing twice a day and cleaning between the teeth (flossing) once a day.