A dental cyst is a closed, fluid-filled sac of tissue that can form in the jawbone or soft tissues of the mouth, often near a tooth’s root. These sacs are slow-growing and benign, meaning they are not cancerous. Their development is often linked to issues with the teeth or surrounding structures.
What Causes a Dental Cyst?
The formation of a dental cyst is the body’s response to a stimulus, such as an infection or trauma. One of the most frequent types is the periapical cyst, which forms at the tip of a tooth’s root. This occurs when the nerve, or pulp, inside a tooth dies from deep decay or injury. This leads to an infection that spreads to the root tip and stimulates cyst development.
Another common type is the dentigerous cyst, which develops around the crown of a tooth that has not yet erupted, such as a wisdom tooth. The pressure from an erupting tooth can obstruct blood flow, causing fluid to accumulate and form a cyst. Less frequently, cysts can arise from the remnants of tissue involved in tooth development or due to genetic conditions like Gorlin syndrome.
Identifying a Dental Cyst
Many dental cysts are asymptomatic, especially in their early stages, and are often discovered incidentally during routine dental X-rays. When symptoms do appear, they can be subtle and may include localized swelling, a feeling of pressure in the tooth, or a small bump on the gums. The affected tooth might also become sensitive or feel loose.
Pain is not always a reliable indicator, as many cysts are painless unless they become large or infected. An infected cyst can cause more pronounced symptoms like pain, redness, and bad breath or a bad taste in the mouth. To confirm a diagnosis, a dentist uses imaging tests. Dental X-rays are standard, but a CBCT scan may be used for a detailed, three-dimensional view of the cyst’s size and location relative to other structures.
Treatment for Dental Cysts
The approach to treating a dental cyst depends on its type, size, and location, but the primary goal is its complete removal to prevent recurrence. For many cysts, a surgical procedure called enucleation is performed to remove the entire cyst sac under local anesthesia. The removed tissue is then sent to a laboratory for a biopsy to confirm that it is benign.
When a cyst is linked to an infected tooth root, the treatment must also address the source of the infection. This often involves a root canal to clean out the infected pulp and save the natural tooth. Following the root canal, a surgical procedure called an apicoectomy might be necessary to remove the tip of the root and the associated cystic tissue.
If a tooth is severely damaged or the cyst is very large, extracting the affected tooth may be the most viable option. After the tooth is removed, the surgeon will scrape out the cystic lining from the jawbone.
For very large cysts, a technique called marsupialization may be used first. This involves creating a small window in the cyst to allow it to drain and shrink over several weeks or months before it is surgically removed.
Complications from Untreated Cysts
Leaving a dental cyst untreated can lead to oral health problems. As the cyst slowly expands, it creates pressure that can weaken the surrounding jawbone, making it more susceptible to fracture. This bone destruction is a silent process that can occur without pain. The growing cyst can also put pressure on the roots of adjacent teeth, causing them to shift or become damaged.
There is also a risk of the cyst becoming infected, which can transform it into a painful abscess. A severe infection can spread from the jaw to other areas of the face and neck, leading to more serious health issues. In rare instances, certain types of cysts have the potential to develop into more aggressive tumors that require extensive surgical intervention.