A dental fistula, often appearing as a small bump or pimple-like lesion on the gum, signals an underlying infection that has created a drainage pathway. While the fistula itself provides a temporary release of pressure from this infection, it is a symptom of a more serious problem. Leaving the root cause of a dental fistula unaddressed can lead to significant complications, affecting not only oral health but potentially overall well-being. Understanding the nature of a fistula and the dangers associated with its underlying infection is important.
What is a Dental Fistula?
A dental fistula, also known as a sinus tract, represents a channel formed by the body to drain pus from an internal infection to an external surface. This opening typically appears on the gum tissue near the affected tooth, though it can sometimes emerge on the face or neck. The appearance is often described as a raised, red bump that may periodically discharge pus, blood, or a combination of both.
Individuals with a dental fistula might notice a persistent bad taste in their mouth or an unpleasant odor. The area around the fistula can also feel swollen or tender to the touch, though the drainage itself often temporarily relieves the intense pain associated with the pressure buildup from the infection. This temporary relief can sometimes lead individuals to mistakenly believe the problem is resolving. The presence of a fistula indicates that the body is attempting to manage an active infection, but it cannot resolve the issue on its own.
Common Causes of Dental Fistulas
Dental fistulas primarily develop as a consequence of persistent bacterial infections within the oral cavity. The most frequent cause is a periapical abscess, which forms at the tip of a tooth root due to an infection of the pulp, the soft tissue inside the tooth. This pulp infection commonly arises from deep tooth decay that has penetrated the enamel and dentin, or from a tooth injury that has damaged the pulp. Bacteria multiply within the pulp chamber, leading to inflammation and the accumulation of pus at the root end.
Another significant cause of dental fistulas is a periodontal abscess, which originates from severe gum disease affecting the tissues supporting the teeth. Periodontal disease creates deep pockets between the teeth and gums where bacteria can thrive and cause infection. When these pockets become infected, pus can accumulate, and if left untreated, it can form a fistula to drain the infection.
Why Untreated Dental Fistulas Are Dangerous
Leaving a dental fistula untreated means the underlying infection continues to fester, posing several serious health risks. The infection, initially localized around the tooth or gum, can spread to surrounding bone and soft tissues within the jaw and face. This localized spread can lead to significant destruction of the alveolar bone that supports the teeth, potentially resulting in tooth loosening or even tooth loss. The continuous presence of infection also weakens the affected tooth, making it more susceptible to further damage and eventual extraction.
Beyond localized damage, the infection can enter the bloodstream, leading to a systemic infection known as sepsis, which can be life-threatening. Bacteria from the oral infection can travel through the blood to other parts of the body, potentially affecting distant organs such as the heart, brain, or kidneys. In rare but severe cases, untreated dental infections can lead to conditions like Ludwig’s angina, a rapidly spreading bacterial infection of the floor of the mouth and neck that can compromise the airway.
Treatment for a Dental Fistula
Treating a dental fistula requires addressing the primary source of the infection. For fistulas originating from an infected tooth pulp, root canal therapy is the standard procedure. This involves removing the infected pulp tissue, thoroughly cleaning and disinfecting the inside of the tooth, and then filling and sealing the root canals to prevent re-infection. This procedure aims to preserve the natural tooth structure while eliminating the infection.
In cases where the tooth is beyond repair due to extensive damage or infection, extraction of the affected tooth may be necessary. If the fistula is due to a periodontal abscess, treatment typically involves deep cleaning procedures like scaling and root planing to remove bacteria and calculus from below the gum line. Sometimes, surgical intervention may be required to access and clean deeper infected areas. Antibiotics may be prescribed as an adjunct to these procedures to help control the infection, but they are generally not a standalone cure as they do not remove the source of the infection. Seeking prompt professional dental care is important to prevent the infection from spreading and causing further complications.