Fistula on the gum: what does it look like, what to do at home?

A fistula on the gum can appear for various reasons, but most often it is a complication of the inflammatory process in the gum, in the area of the oral cavity, the tooth. Often a fistula occurs when a wisdom tooth is erupting, or with neglected caries. In essence, a fistula is a cavity with pus accumulated in it. More and more often dentists have to face such a problem, and this is due to a number of reasons. Let's take a closer look.

The first, natural, and very natural question that patients ask at the dentist's office is: "What is the danger of a fistula on the gum, and is it dangerous at all?". It turns out that it is dangerous. And first of all, its consequences and complications are dangerous. Fistula is always a cavity in which there is an inflammatory process and, accordingly, accumulates exudate. It can be purulent, serous, bloody, mixed exudate. In any case, it is a mixture of dead gingival cells, inflamed particles of damaged tissue, possibly necrotized parts of the gingiva, or components of a destroyed tooth (dentin, pulp).

In addition, it includes leukocytes, lymphocytes, basophils, macrophages, and other elements of the human blood and vascular bed. Is the first line of immune defense, which is immediately activated by any damage and inflammatory process. When a signal of gingival damage is received, these elements migrate en masse to the focus of inflammation, where they fulfill their function and eventually die off. Their accumulation occurs in the gingiva, as a result of which an exudate, pus is formed, the fistula begins to grow. It should also be taken into account that in the oral cavity is always present microflora, primarily bacterial. Any inflammatory process is accompanied by the parallel development of an infectious (bacterial) process. Thus, the fistula contains the products of bacterial metabolism, dead bacteria, exotoxins that are released during the destruction of the bacterial cell.

All this contributes not only to the maintenance of the inflammatory-infectious process, but also to its spread throughout the oral cavity, with the gradual involvement of more and more fragments of healthy tissue in the pathological process. This is the main danger. It should also be taken into account that the spread of pus, infection, inflammation can go both vertically and horizontally. In the first case, the pathological process spreads along the nerves, blood vessels, ascending pathways. Infection can penetrate into any part of the body, and form a new focus of infection there (like metastasis in a cancerous tumor).

A special danger arises when pus enters the brain, resulting in infectious inflammation of the brain, such as meningitis, osteomyelitis, poliomyelitis, or other inflammatory processes, which is often difficult to treat, and sometimes not at all. It is also worth noting that the purulent-inflammatory process can spread along the nerves, which entails severe damage to the peripheral nerves, basal ganglia, brain and spinal cord, and the corresponding irreversible consequences for the body.

Epidemiology

According to statistics, in about 52.5% of cases, the appearance of a fistula on the gum is accompanied by such diseases of the oral cavity and teeth, such as dental caries, pulpitis. Also fistula can appear as a result of the development of stomatitis, violation of the integrity of the mucous membranes of the oral cavity (about 32% of pathology). In 12-15% of cases, fistula develops in response to orthodontic or dental intervention. In 65% of cases of fistula development, concomitant factors were hormonal disorders, immunity imbalance, increased reactivity, sensitization of the organism. In about 5-10% of cases, the cause is poisoning, general intoxication of the body, violation of oral microflora. About 15-20% of cases are due to hormonal and immune changes, failures, including those that occur in connection with pregnancy, breastfeeding, menopause, age-related changes.

Causes of the gingival fistula

The main reason why a fistula begins to develop is damage to the gum tissue, in which the damaged area becomes inflamed, subject to inflammation and infection. The causes of damage can be many. The gum can become inflamed and damaged as a result of an inflammatory process that affects the tooth, and its various structures. For example, inflammation often develops against the background of caries, pulpitis, other inflammatory, infectious and necrotic processes in the area of the tooth. At the same time, many people know such a phenomenon, in which toothache is accompanied by pain in the gum. Gradually a fistula is formed, filled with pus. Sometimes fistula is formed against the background of other inflammatory and infectious processes, including angina, various forms of pharyngitis, laryngitis, bronchitis, inflammatory and infectious processes of the oral cavity, upper and lower respiratory tract. Often fistula occurs in general somatic disorders, against the background of reduced immunity, severe infectious, viral diseases, in the postoperative period, in certain conditions of the body (violation of hormonal background, immunodeficiencies, restructuring of the body, adaptation, increased workload).

It is also worth noting that the bacterial microflora of the oral cavity indirectly contributes to the maintenance of the inflammatory process and fistula. As a rule, the normal microflora directly in the area of the fistula, and then throughout the gingiva, is quickly transformed into pathogenic microflora, as a result of which the inflammatory process does not subside, but continues to be maintained.

The causes of gum damage can be many. It can be mechanical damage. For example, while eating, a person simply damaged the gum with hard, sharp, cutting particles (crumbs, bone, etc.). Often the cause is the impact on the gum of heavy chemicals. For example, the gum can become inflamed when exposed to caustic chemicals, vapors. Often such damage occurs in chemical poisonings, fires, accidents, as a result of prolonged stay in smoke, chemical exposure zone.

It is worth noting that a fistula can occur as a result of damage to the gingiva by some medicinal components, after dental procedures and any other manipulations, in which there is a risk of damage to the gingiva and soft tissues, mucous membranes of the oral cavity. After anesthesia, various forms of general and local anesthesia, after exposure of the body to radiation, gingival damage can occur. Sometimes this pattern is a consequence of radiation therapy, which is used to treat cancer patients. One of the complications is radiation damage to the mucous membranes, which is accompanied by the development of inflammation and infection, micro-damage, accumulation of exudate. Development of ulcers and erosions.

Fistula on the gum after tooth extraction, after implantation

After implantation or after tooth extraction, a fistula can form on the gum. This is primarily due to the presence of trauma, with damage to the gum, which inevitably occurs during such manipulations. In fact, the gum is a continuous wound, which gradually heals. This process is accompanied by active regeneration, restoration of the integrity of the disturbed structures. It is also worth noting that in the oral cavity there is always a large amount of bacterial microflora, which is activated against the background of weakening the body, violation of the integrity of its anatomical structures. Multiplication of bacterial microflora, involvement of pathogenic and fungal flora, can entail the development of infectious and inflammatory process. In the focus of inflammation, in addition to microflora, migrate cells of the immune system, defense proteins. Gradually, there is their dying off, and accumulation. In the process of accumulation of these pathological structures, and a fistula is formed. Accordingly, it can be called a complication of the manipulations performed.

Fistula on the gum under the crown

If you have a fistula on the gum, under the crown, you should consult a doctor. There may be many reasons - from incorrect placement of the crown, and ending with an individual reaction, intolerance to the crown. In addition, you should not forget that under the crown can always get under the infection. Failure to comply with the rules of asepsis, violation of basic sanitary and hygienic requirements, peculiarities of oral care, may entail inflammation, infection, fistula formation, up to necrosis.

Risk factors

The risk group includes people who have undergone various dental procedures, manipulations, as well as those who have an inflammatory process, or a chronic focus of infection in the oral cavity. Also, the risk increases if a person damaged the gum mechanically. If a person has been exposed to chemicals, caustic and poisonous components, the risk of damage to the gum increases dramatically. It is also worth noting that people who have been exposed to increased levels of radiation, various types of radiation, the risk of developing pathology is significantly higher than in persons who do not experience such a load on the body.

Risk factors may include taking certain medications, particularly those with severe toxic effects on the body. For example, it may be isoniazid, which is used to treat tuberculosis, various forms of antitumor and antiparasitic drugs, strong painkillers, anesthesia, anesthesia. People after radiation therapy, chemotherapy also fall into the risk group. In some cases, risk factors may include severe forms of antibiotic therapy, antifungal (antifungal) treatment.

Pathogenesis

The pathogenesis is based on the development of inflammation in the area of the damaged gingiva. Gradually, the inflammatory process involves pathogenic microflora, infection develops. Inflammation is accompanied by the active release of mediators, inflammatory factors, cytokines, interleukins, which support the inflammatory process. There is also a gradual involvement of cellular structures, in particular, cells of the immune system (lymphocytes, monocytes, macrophages). The inflammatory process involves basophils and mast cells, which release large amounts of histamine, other inflammatory factors. All this contributes to the fact that inflammation increases, a fistula is formed in the form of a cavity. Gradually it fills with purulent, rarely serous exudate. In addition, other structures located nearby are also involved in the inflammatory process.

Symptoms of the gingival fistula

The main symptom is swelling of the gum, the development of inflammation and infection in it, the formation of a fistulous cavity with a fistulous passage in which pus or other exudate accumulates. For example, it can be serous, purulent content. As a rule, the process is accompanied by pain, irritation, redness. Pain increases with palpation. Over time, there is a rupture of the fistula, and its contents can come out directly into the oral cavity. This entails the risk of spreading the infection throughout the gum, to other teeth. However, the rupture of the fistula is considered a positive sign, because otherwise, without an exit, pus can spread through blood vessels, nerves, pass into adjacent cavities, including the brain, resulting in the development of a progressive purulent-septic process with the formation of new foci of infection.

Fistula formation can begin in different ways, but most often, the first signs are increased local sensitivity of the gums, pain in the gum area. It can be both local and disseminated, which spreads throughout the gum. Local temperature rises, with a severe inflammatory process, there may be a systemic increase in temperature, weakening of the body, general deterioration of well-being. A characteristic feature is that, as a rule, the fistula does not develop on the first day. It appears about 1-2 days later in the form of a small bump, a thickening on the gum, which develops into a cavity filled with exudate of different origin.

Psychosomatics

It is now a proven position that any mental state, psychological disturbance, or emotional block is projected in a certain way on the somatic state of the body. This is explained by the fact that any mental or emotional reaction entails certain changes and processes at the level of physiology. They manifest themselves in the form of corresponding somatic reactions, including diseases, inflammations, disorders of structure and function.

As a number of studies show, a fistula on the gum appears in people who often experience greed, jealousy, envy. Such phenomena are often observed in people who are always afraid of losing something, have increased frugality (up to stinginess). Such a problem often bothers calculating and meticulous people who tend to accumulate everything, collect. Psychological greed and tendency to accumulate as if projected onto the body level, and manifests itself in the form of pus and pathological exudate, which accumulates in the body, forming a fistula. Fistula can be in people who have been deprived of anything since childhood, experiencing a lack of food, toys, things. The same problem bothers persons who in childhood or in the current moment of time are forced to deny themselves something all the time, persons who do not fully satisfy their basic needs, desires. Fear of loss, fear of remaining in poverty, fear of not getting the deserved reward - all these are psychological problems that at the level of the body can manifest themselves in the form of fistulas, including on the gum.

Fistula on the upper or lower gingiva

In this case, there are several variants: the fistula can be located only on the upper gingiva, or only on the lower gingiva. There is also a situation in which the fistula is localized simultaneously on both the upper and lower gingiva. As a rule, at the initial stage, the fistula is localized on one side. If you do not take timely action, do not treat, fistula, and the accompanying inflammatory and infectious process, can spread, gradually covering other areas of the gum. This is how a bilateral fistula appears. Therefore, if the first signs of pathology appear, you should consult a doctor as soon as possible to take the necessary measures and prevent complications.

Gum pain, a lump on the gum.

If you have a bump on the gum, the gum itself hurts, it is sore, it indicates that you develop a fistula, which in the middle is filled with pus, or other pathological content. Accompanying pathologies are inflammatory and infectious process. There may be an increase in temperature. There is a risk of progression of pathology and coverage of more and more areas.

In order to prevent serious complications and worsening of the situation, it is necessary to visit a dentist. It is not worth delaying a visit to the doctor. On the same day you need to go to the doctor, and be examined (as a rule, formalized as an emergency situation). If necessary, if there is a risk of spreading pus to other areas, or if there is a possibility of involvement of other tissues in the pathological process, the doctor makes drainage of the cavity. The purulent contents are pumped out, the fistula cavity is sanitized (treated with special antiseptic agents and anti-inflammatory drugs). This will avoid inflammation, progression of infection, accelerate recovery. Then additional treatment will be required to relieve inflammation, restore the gingiva and prevent recurrence.

Gingival inflammation

Inflammation of the gum is almost always accompanied by pain, redness. Quite often a fistula is formed on the gum. Thus, it may not manifest itself on the first and second day. But, as a rule, no later than the third day, inflammation is accompanied by the formation of a fistula. It is logical that this can be prevented. So, if you take timely measures aimed at relieving the inflammatory process in the gum, the fistula will not develop. It goes without saying that the correct treatment can only prescribe a doctor, so if the first signs appear, indicating the development of inflammation in the gum, you should immediately contact a doctor. In addition to what the doctor prescribes, you can additionally apply mouth rinses with the use of anti-inflammatory and antiseptic agents that quickly control inflammation and stop the development of infection.

Temperature

Fever most often develops in severe inflammation and infection. Fistula is rarely accompanied by fever. But this is possible if the body is weakened, or the process has a protracted character. If pus spreads through the body, if new foci of infection appear, or new tissues are involved in the inflammatory process, the body temperature may rise. Some people have an increased reactivity of the body, increased sensitization, in which even a minor inflammatory process is accompanied by an increase in temperature.

Usually, a dentist alone is no longer enough; other doctors, such as a general practitioner, may need to be consulted.

A small, white fistula on the gum

Even a minor, small fistula on the gum, especially a white fistula, can have very unfavorable consequences. As a rule, inside it is filled with purulent content. Its development is accompanied by an inflammatory and infectious process. For treatment, you need to visit a doctor. He will prescribe the necessary treatment and carry out all the necessary manipulations.

Fistula on an adult gum

As a rule, in adults fistulas on the gingiva are formed much less often than in children. In adults, the system of nonspecific resistance, local immunity, colonization resistance of microflora functions well enough. But if these conditions are violated, a fistula can appear. As a rule, it accompanies inflammatory and infectious processes of the oral cavity, often appears with dental caries, chronic gum pathologies. To avoid complications, you need to see a doctor as soon as possible. The doctor will prescribe appropriate treatment, or conduct drainage of the cavity and sanitation of the oral cavity.

A fistula on a child's gum

In a child, a fistula on the gum is not an uncommon phenomenon. This is due, first of all, to the fact that children have insufficiently formed microflora, as well as insufficiently developed immunity, there is often instability of the hormonal background. This significantly increases the risk of infection, inflammatory processes, increases the sensitivity and susceptibility of the body. Also an important role is played by the fact that the dentoalveolar system of the child is still at the stage of formation. Children's teeth are growing, milk teeth are changing into molars. All this entails a number of transformations, a decrease in the protective properties of the oral cavity, reduces local immunity, colonization resistance. If you visit the doctor in time, adhere to all his recommendations, you can quite quickly and successfully cope with this problem. With properly selected treatment, the fistula goes away quite quickly. Also, supportive therapy allows you to prevent the development of recurrences.

Fistula on the gum in pregnancy

The main reason for the appearance of fistula on the gum in pregnancy is a sharp decrease in immunity, increased sensitization of the body, decreased colonization resistance of mucous membranes, dysbacteriosis, activation of chronic foci of infection. Intoxication of the body, as well as periodic release of histamine, progesterone synthesis, intensifies this process. In addition, in the body of a pregnant woman there are various restructuring, sharply changing hormonal background, changes in the normal microflora, increased sensitivity and reactivity, sensitization of the body.

Fistula on the gum of a baby tooth

In some children, the change of baby teeth is accompanied by fistulas on the gum and is quite severe. This may be due to the presence of chronic foci of infection in the child's mouth and nasopharynx (untreated caries, tonsillitis, pharyngitis, adenoids, maxillary sinusitis). It can also be a consequence of decreased immunity, weakened body. Sometimes fistula formation is associated with a lack of moisture in the body, as well as a lack of vitamins A, D and E.

It is important to take a comprehensive approach to solving the problem. It is worth visiting a doctor (orthodontist, dentist), determining the cause of the fistula, and taking measures to eliminate these causes. There may be many reasons, and they are not always related to the dentoalveolar system. It may be a systemic problem, at the level of the entire body - from a common irritation, allergic reaction to severe hormonal and immune disorders that lead to the development of inflammation and infection, the formation of a fistula. Consultation with a pediatrician may be required. Other specialists.

A purulent fistula on the gum

Purulent fistula indicates a complicated course of the inflammatory process, the accession of infection. The appearance of purulent fistula on the gingiva is an unfavorable sign, may indicate the development of purulent process, accumulation of exudate, inflammatory infiltrate in the fistula.

In addition to the actual inflammation of the gum, and the development of dental diseases, fistula can be a sign of many infectious diseases, such as chicken pox, rubella, measles, mumps. In any case, you should not delay a visit to the doctor. It is recommended to undergo a comprehensive examination, which will show the cause.

In essence, a purulent fistula is a cavity with liquid contents (pus). The peculiarity and danger is that pus accumulates in the cavity and can not go out. In this case, the inflammatory process progresses, the infection spreads.

Complications and consequences

The most dangerous consequences and complications associated with the development of a fistula are the progression of infection and inflammation, the involvement of more and more new tissues and structures in the pathological process, the formation of new foci of infection. The danger is that if there is no exit pus, it can spread to deeper layers - the retina, the respiratory tract, and can even get into the brain. The consequences are obvious - inflammation of the brain, disruption of innervation processes, up to disability, paralysis and even death.

Can a gum fistula itself go away?

Patients often ask: "Can a fistula on the gum itself go away?". It can, but in order for it to "pass", it needs to rupture, and the purulent content must go outside, into the oral cavity. Such a phenomenon is possible. A ruptured fistula is easy enough to diagnose on the basis of the clinical picture, visual inspection. The pathogenesis is based on the violation of the integrity of the fistula, rupture of its walls, damage to the tissue, rupture of the cavity itself. From this cavity flows pus, sometimes bloody discharge. There may be an increase in body temperature. In this case, too, it is necessary to consult a doctor, because it is important to timely and correctly sanitize the oral cavity, because after some time the infection can spread throughout the gum and oral cavity. Which will lead to the appearance of new fistulas. Angina, maxillary sinuses, respiratory tract diseases can also develop as a result of bacterial infection in the nasopharynx and pharynx

What should you do if a fistula on your gum does not go away?

Most often, if the fistula on the gum does not go away, it indicates the progression of inflammation and the presence of a focus of infection in the oral cavity. Usually, if the fistula does not go away for 3-5 days or more, antibiotic therapy is required. First prescribe broad-spectrum antibiotics that are active against a wide range of microorganisms, including protozoa. Quite well established themselves various ointments for topical application. It is recommended to conduct a bacteriological analysis (bacterial culture), which will isolate one or more pathogens that support the infectious process, and will be selected an effective drug and its dosage.

A fistula burst on my gum

If the fistula on the gum has ruptured - this is both a positive and negative symptom. On the one hand, pus goes out, sosotvetvetnogo, disappears the risk of its penetration into adjacent cavities, removes the risk of spread and progression of infection through blood vessels, nerve fibers. On the other hand, there is a risk of spreading the infection throughout the mouth, the entire gum, and even the nasopharynx, pharynx, if the pus was swallowed. It is necessary to stop the inflammatory and infectious process as soon as possible. It is necessary to rinse the mouth, in any case do not allow swallowing pus. You also need proper sanitation of the oral cavity, treatment with reliable antiseptics. Improper sanitation, or its absence, often accompanied by the fact that the pathological process involves the nearest lymph nodes, surrounding tissues, the infection spreads. Caries, sore throat may develop.

Chronic gingival fistula

If a single fistula may indicate an "accidental" inflammation or infection, damage to the gum, then a chronic fistula on the gum speaks of serious disorders in the body. There may be many reasons for this.

First of all, chronic fistula is a sign of bacterial infection. For example, enterococcal, staphylococcal, streptococcal, Escherichia coli are the main pathogens of infection in the oral cavity. Fistula can be a sign of dysbacteriosis, in which the main pathogen is E. Coli. It multiplies intensively, fills not only the intestine, but also other free niches, including the oral cavity, digestive tract. The cause may be numerous changes in the mucous membrane, violation of colonization resistance, nonspecific resistance system and immune defense, microcirculation, hemodynamics.

Sometimes fistulas of a chronic nature appear and with a high viral load, especially if the number of cytomegalovirus, herpes virus, hepatitis. The cause may be a violation of the hormonal background, biochemical parameters. To the emergence of chronic processes of various genesis and localization leads to changes in the indicators of immunity, microbiocenosis, bacterial microflora, viruses, protozoa.

Such problems can occur if a person suffers from gastrointestinal diseases, infectious diseases, persistent stool disorder. A related factor is dysbacteriosis, with bacterial and viral infections, poisoning with bacterial endotoxins and exotoxins is often observed, which leads to the development of fistulas. Often people with a history of maxillary sinusitis, sinusitis, adenoiditis, tonsillitis, pharyngitis, lymphadenitis develop fistulas.

Children are more prone to develop chronic fistulas (they have more risk factors: frequent parasitic infections, giardia, enterobiasis, worms, insufficient immunity, oral microbiocenosis).

Diagnostics of the gingival fistula

Diagnosis of fistula is based on the clinical picture, pathogenesis of pathology. Therefore, it is necessary to visit a doctor (dentist), who will conduct an examination and prescribe appropriate treatment. Fistula is quite easily noticeable during the usual visual examination by a dentist of the oral cavity, and sometimes it does not even require special tools in order to make a diagnosis. It is a specific cavity in the gum that is filled with pus. The gum in this case is often inflamed, an infectious-inflammatory process develops. Often such a fistula is localized on the gum near any diseased tooth (with caries, pulpitis). Often growing wisdom tooth is also accompanied by the formation of a fistula on the gum.

Pus accumulates in the cavity and can not get out. In this case, the inflammatory process progresses, the infection spreads throughout the mouth, throughout the body as a whole. The danger is that through the internal ducts, pus from the fistula can spread to other areas. Sometimes the fistula ruptures, and then the pus freely comes out into the oral cavity, and this is considered a more favorable sign than if it does not rupture, and the pus goes, for example, into the ear, or the brain.

A ruptured fistula is also quite easy to diagnose based on the clinical picture, visual inspection of the oral cavity, teeth, gums. At the heart of the pathogenesis of ruptured fistula, there is a violation of the integrity of the gum, tissue damage, rupture of the cavity itself, from which pus flows out, sometimes bloody discharge. Also, the pathological process is accompanied by increased gingival sensitivity, increased reaction of teeth to cold, hot food, sweets.

Often fistula on the gum is accompanied by concomitant swelling of soft tissues, inflammatory process, which significantly increases pain sensations. Often the pain spreads to the entire gum, to neighboring areas. The pathological process often involves the nearest lymph nodes, surrounding tissues, tonsils, which may entail associated pathologies, for example, tonsillitis, lymphadenitis. If the examination is not enough, the doctor will prescribe appropriate auxiliary methods of examination

When diagnosing a gingival fistula, no tests are prescribed. To make a diagnosis, it is usually enough to visit a dentist, who will conduct an examination and make the appropriate diagnosis. If it is necessary to obtain additional information, instrumental methods of research are used.

In extreme cases (rarely), bacteriologic methods are used (bacteriologic seeding), in which the contents of the fistula are taken and sown on selective nutrient media. Subsequently, the culture is incubated, a pure culture (inflammatory pathogen) is isolated, the species and genus name of the pathogen is determined, and further treatment aimed at eliminating this pathogen is selected.

Antibiotic susceptibility testing is also used in parallel, in which an appropriate antibiotic (other antiseptic, antibacterial agent) is selected for the pathogen isolated in a pure culture. It is possible to select not only the agent that will inhibit the growth of the microorganism, but also to determine its optimal dosage, which will achieve the optimal (required) effect. But the fact is that the need for such tests arises very rarely. In most cases, if there is a need to eliminate infection and relieve inflammation, it is enough to resort to the use of antibiotics of a broad spectrum of action, which have an effect on a wide range of microorganisms: on Gram-positive and Gram-negative, on fungus, protozoa, and even on anaerobic infection). If these antibiotics are ineffective, a specific treatment with the selection of an appropriate remedy is required.

Differential diagnosis

To make a differential diagnosis, it is usually sufficient to visit a dentist. The dentist will examine the oral cavity, assess the condition of the teeth and gum, and examine the fistula. If necessary, he will refer for additional consultation, for example, to a dental surgeon, orthopedic dentist. If necessary, additional examination methods may be prescribed: X-rays of the tooth, gum, computerized, magnetic resonance imaging of the gum, oral cavity.

The need for differential diagnosis arises due to the fact that a fistula in the gingiva can be a sign of many dental diseases. In addition, the applied methods of research allow to accurately predict the peculiarities of the course of pathology, assess the state of dentin, bone and cartilage tissue, the rest of the gingiva.

Treatment of the gingival fistula

Treatment is reduced to preventing further accumulation of pus in the fistula, removing the existing pus to the outside. That is, in fact, it is necessary that the fistula ruptured, and the contents came out. It is also important to prevent the spread of pus and inflammation to the entire gum, to neighboring teeth, to the oropharynx, nasopharynx, trachea. That is, the primary role acquires the need to stop the inflammatory-infectious, purulent-septic process. Treatment is also aimed at relieving pain, swelling, inflammation, hyperemia. For this purpose, both etiologic treatment (aimed at eliminating the cause of the fistula) and symptomatic treatment (aimed at eliminating the manifestations, symptoms) are used. Anti-inflammatory, analgesic, anti-edematous agents are used. That is, first, drug therapy is applied. An excellent and effective addition to drug therapy is phytotherapy. Many plant decoctions, infusions, used for rinsing, irrigation of the oral cavity, for ingestion to relieve inflammation, eliminate the infectious process, stimulate immunity.

Surgical methods are resorted to if drug therapy is ineffective, if the fistula is large enough, and if there is a risk of complications (if there is a risk of inflammatory, purulent-septic process). It may be necessary to cut the gum, drainage of the fistula, in which a hole will be made in the gum for the exit of pus. Sometimes the pus is pumped out in various ways.

Who do I contact?

As a rule, the first person to turn to when a fistula appears on the gum is a dentist. Often in a regular polyclinic, this is the only doctor who can help in this case and prescribe special treatment. If possible, it is better to apply to a specialized dental polyclinic, hospital, or private clinic. The first, as a rule, is examined by a dental therapist. If necessary, he will appoint consultations with the appropriate specialists. A fistula on the gum is a reason to turn to a paradontologist - a doctor who specializes in the treatment of gums. But not all clinics and hospitals have the opportunity to consult this doctor.

What to do for a fistula on the gum?

The first thing to do in case of a fistula on the gum is not to delay, and immediately go to the dentist. This is primarily due to the fact that the fistula is a cavity in which a large amount of pus accumulates. It can cause inflammation, infection, progression of purulent-septic process to the rest of the teeth, the entire gum and oral cavity. Fistula causes other diseases of the upper and lower respiratory tract, becomes a focus of infection in the body, requiring sanitation. Because of such foci, there is an increasing risk of complications, bacterial diseases of the respiratory tract, GI tract. Especially often because of such foci, children and adults fall into groups of frequently ill people, as the focus becomes the cause of inflammation of various organs and systems.

After the examination is done, the doctor will tell you what to do. Various methods are used for fistula on the gum. Often first try drug treatment, if it is not effective, resort to surgical methods. Operations are quite simple, done under local anesthesia. The fistula is simply punctured (cut through), and from it remove the accumulated pus. Then further treatment is prescribed, which can be carried out at home: anti-inflammatory, anti-infectious agents are prescribed. Almost always need antibiotic therapy to control inflammation, prevent the development of the infectious process. Prescribe herbal decoctions for rinsing, means for local irrigation of the oral cavity.

What to gargle with?

Usually, after you have visited a doctor, he diagnoses you, makes appropriate prescriptions, including telling you what to gargle the mouth and throat. If you are not told what to gargle, you can always resort to phytopreparations, means of folk medicine. Quite well-proven essential oils, which can be dissolved in water, and used for gargling. A glass of water is enough a few drops of essential oil. It should be borne in mind that oils should never be used in pure, undiluted form, as they can cause chemical burns (they are concentrated substances). Well relieve inflammation, anesthetize, stop the development of infection (have antiseptic properties).

1. Approximately 2-3 drops of orange oil dissolve in a glass of warm water, stir, use as a solution to rinse the mouth, throat (3-4 times a day).
2. Add 1-2 drops of geranium oil to a glass of warm water, dissolve, rinse up to 5 times a day.
3. Approximately 2-3 drops of cardamom oil + 1 drop of kewda per glass of water. Dissolve, gargle 3-4 times a day, after meals.
4. On a glass of warm water 2 drops of cedar oil and 1 drop of cinnamon oil, stir, gargle after each meal.
5. Approximately 2-3 drops of lavender and lemon oil per glass of boiling water, stir, rinse 3-4 times a day, alternating with recipe number 6.
6. Take 2-4 drops of fir oil (depending on the severity of pain, inflammation), dissolve in a glass of warm water, rinse 3-4 times, alternating with recipe number 5.
7. Add 2 drops of pine oil and 2 drops of thuja oil to a glass of warm water, dissolve, gargle 2-3 times a day.
8. Prepare "sea water": half a teaspoon of salt, half a teaspoon of baking soda, dissolve in a glass of warm water, add 2-3 drops of iodine solution, 2 drops of orchid essential oil. Gargle 3 times a day, after meals.
9. For a glass of water add a teaspoon of salt and soda, 2 drops of citronella oil, 1 drop of amber oil, mix thoroughly, rinse 3-4 times a day.
10. Dissolve 2 drops each of angelica, hyacinth and cypress oils in warm water. Use for rinsing the oral cavity, gorda, 2-3 times a day.

Ointments for a fistula on the gum

Some ointments for fistula in the gum can be purchased in the pharmacy in ready form, while others can be prepared independently. For example, ointments such as metrogil denta, ciprolet work well. But you can also prepare your own, using natural ingredients.

• Recipe #1.

As a base take about 30 grams of butter, 50 ml of clarified milk and 2-3 tablespoons of honey. Prepare a mass of homogeneous consistency. The mass should be uniform, should not contain lumps. When the mass is prepared, just before applying to the gum, add 2-3 drops of concentrated essential oil of queen of the night, lotus and marjoram. Apply in small amounts to the gum. If pain increases, larger amounts can be applied. This ointment can be applied up to 24 times a day (every hour).

• Recipe #2.

As a base take about 30 grams of bitter black chocolate, butter, bee royal jelly, mixed together. Immediately before applying to the gum, 2-3 drops of concentrated essential oil of pomerantz, rhododendron, anise and aphrodesia are added. Apply in small amounts to the gum, every 2-3 hours.

• Recipe #3.

Take about equal parts of honey, butter, mix with half a teaspoon of ground lemon zest powder, add a teaspoon of ground ginger. Mix well, so that no lumps remain. Before use, add 2-3 drops of essential oil of geranium, jasmine, sandalwood, once again mix thoroughly, apply to the gum. For the first three days apply every 2 hours, then on the 4th day - apply every 3 hours, on the 5th day - after 5 hours, further - use three times a day.

• Recipe #4.

Mix in equal parts lard and butter (about a cup of each component). Heat until warm, stirring constantly, add about 5 tablespoons of wheat germ oil, a teaspoon of ground cinnamon and 2 tablespoons of freshly squeezed aloe juice. All this is thoroughly mixed, bring to a boil. As soon as the remedy has boiled, immediately remove from the fire, insist for about an hour. Apply to the gum up to 5 times a day.

Metrogil Denta

It is an effective dental remedy, which is used to eliminate inflammation and infection, to prevent the risk of complications, and most importantly - to relieve pain. It has a mild anesthetic effect on the body. Metrogil denta is applied to the gum (directly on the fistula, as well as around it). Squeeze out the gel (pea-sized), rub thoroughly, evenly distributing it over the gum. It can be applied 5-7 times a day.

Antibiotics

There are two basic precautions for all antibiotics. The main thing is not to quit taking them, but to finish the entire course of treatment. Otherwise, the bacteria that caused the inflammatory process will not be completely killed, but will survive and undergo mutation. In this case, they will acquire new properties, and will be resistant not only to this antibiotic, but to the entire group of antibiotics. In addition, the surviving bacteria will be more resistant, requiring the use of stronger antibiotics. Bacteria show an increased tendency to biofilm formation, the ability to form new foci of infection.

The second precaution is not to combine antibiotics with alcohol. You also need to know how to choose the right antibiotic. Not all antibiotics work on the same bacteria. They may work on some, but not on others. Therefore, the most rational way of selection is to conduct a preliminary analysis of antibiotic sensitivity, in the process of which accurately determine which microorganism was the causative agent of inflammation, which antibiotics on it act, which will be the most effective, and what is its optimal concentration, so self-medication is better not to engage in, and consult a doctor. In addition, this will avoid many side effects of antibiotics (dysbacteriosis, stomach pain, digestive disorders, liver pathologies, general disorders of microbiocenosis, ineffectiveness and development of resistance).

For gum fistula, unless you know exactly what microorganism is causing and maintaining the inflammation, it is worth starting treatment with broad-spectrum antibiotics. The antibiotics below may be recommended.

• Amoxicillin - one tablet (500 mg) once a day, 3-5 days.
• Ciprofloxacin - one tablet (500 mg) once a day, 5-7 days.
• Biseptol - 480 mg per day (can be a single dose, can be divided into 2 doses). With a strong inflammatory process, you can double the dosage - allowed up to 960 mg per day.
• Co-trimoxazole - 80 mg per day, 10-14 days.

Precautions: has anticoagulant activity, blood thinner (should not be taken in combination with anticoagulants, because their activity is sharply reduced). The drug causes inhibition of hepatic metabolism (administered together with anticoagulants).

• Ampicillin - 500 mg per day, 3 days.

Treatment of gingival fistula at home

It should be borne in mind that referral to a doctor is mandatory. Treatment of fistula on the gum is not recommended to be carried out at home, at least because it is necessary to make a correct diagnosis, and this requires special tools, special lighting. Even an experienced doctor can not always diagnose only on the basis of examination, requires the use of auxiliary diagnostic tools, for example, X-rays.

At first glance, it may seem that the problem is not serious: to relieve the pain it is enough to take an anesthetic, rinse the mouth, or puncture the fistula, but this is not the case. You need to realize that this will not solve the problem, but only temporarily relieve the condition. Moreover, the danger of painkillers is that the pill blocks the pain signal, reduces the sensitivity of pain receptors. This means that the body simply stops perceiving pain, but the inflammatory and infectious process from this does not stop, but on the contrary, continues to progress. Painkillers can mask the symptoms, and as a result you will get numerous complications. Therefore, do not do it yourself, and at the first opportunity to consult a doctor.

Self-treatment is better not to engage in, because you can miss a serious pathology, which requires, for example, surgical intervention.

Vitamins

Usually a fistula on the gum is a contraindication to taking vitamins, because the fistula is a cavity in which pus accumulates. And pus is known to be an accumulation of dead cells, microorganisms. Here there are putrefactive processes, infection develops. And vitamins act as a nutrient substrate and growth factors for microflora. Therefore, if we take vitamins while the fistula is developing in the body, the infection will only progress, inflammatory and purulent-septic process will intensify.

The exception is vitamin C, because on the contrary, it prevents the growth and reproduction of microorganisms, stimulating the immune system, preventing the development of oxidative stress. It is recommended to take vitamin C (ascorbic acid) in double dosage - 1000 mg per day.

Physiotherapy treatment

At a time when a person has an actively developing fistula on the gum, inflammatory and infectious process, physiotherapeutic treatment is contraindicated. The only method that can be prescribed is CUF (ultraviolet light treatment), which has an antiseptic effect, preventing the inflammatory and infectious process. The other methods are used during the recovery phase or after surgical intervention (e.g. After a fistula incision).

Folk treatment

No matter what they say, folk treatment is not an alternative to traditional medication, and even more so, surgical treatment. It is necessary to visit a doctor, make a scheme of complex treatment. It may include many folk remedies.

• Recipe #1.

As a base take wheat germ oil and grape seed oil, approximately in equal parts (50 ml each). Mix, prepare a mass of homogeneous consistency. Just before applying to the gum, add 2-3 drops of concentrated essential oil of thuja, champa, orange, add half a teaspoon of vanilla, mix thoroughly. Apply in small amounts on the gum (use for lubrication, or with a turunda applied for some time directly on the fistula).

• Recipe #2.

As a basis take about 30 grams of birch tar and honey, mixed together. Just before applying to the gum add 2-3 drops of concentrated essential oil of valerian, geranium, frankincense and lily. Apply in small amounts to the gum, up to 5 times a day.

• Recipe #3.

Take about equal parts of sea buckthorn oil and glycerin, mix them together, add a teaspoon of myrrh oil. Mix well. Before use add 2-3 drops of essential oil of lotus, musk, tea rose and violet, mix again thoroughly, apply to the gum.

• Recipe #4.

Mix in equal parts apricot glue and oleoresin (about 2 tablespoons of each component). Heat until warm, stirring constantly, add about 5 tablespoons of coconut oil, a teaspoon of fresh lemongrass extract and the same amount of hawthorn syrup. All this is thoroughly mixed, heated on a steam bath. As soon as the remedy boils, immediately remove from the fire, insist for about an hour. Apply to the gum up to 5 times a day.

Propolis for a fistula on the gum

Propolis is an effective natural remedy to get rid of gum fistula quickly.

• Recipe #1.

For preparation take a tablespoon of pure water and birch juice, add about 50 grams of propolis, previously melted on a water bath. All this is mixed, heated without bringing to a boil, smear the resulting decoction on the gum several times a day.

• Recipe #2.

Take in equal parts aqueous salt solution (half a teaspoon per glass of water), melted propolis on a water bath (at least 150 grams). All this is poured 500 ml of alcohol, insist at least 5 days, used to rinse the mouth 2-3 times a day.

• Recipe #3.

As a base take vodka or pure alcohol, mixed with 50 ml of propolis, melted on low heat or on a water bath. Stir until the formation of a homogeneous consistency, and then set aside to insist for at least 24 hours. Used for gargling, irrigation of the oral cavity.

• Recipe #4.

In ordinary alcohol (500 ml) add a tablespoon of propolis and honey. Then add 2-3 drops of essential oil of orchid and lemon. It is used for rinsing the oral cavity.

• Recipe #5.

Take about 150 grams of pure propolis, melt it until completely dissolved, add 100 grams of cream (fatty clarified milk). With constant stirring, bring to a liquid state. This mixture is used as a base: a tablespoon of fresh extracts of bergamot, magnolia and musk, 1 drop of essential oil of opium, 2 drops of perfumed rose water are added. All this is boiled for about 5 minutes, remove from the fire, allow to infuse for at least 12 hours, apply to the fistula as an ointment, or use for gargling, dissolving in a glass of warm water.

• Recipe #6.

Melted propolis is used as a base. In it add 2-3 drops of essential oils: Pomerantz, sandalwood, juniper, almond. All this is mixed, kept for 24 hours, used to rinse the oral cavity.

• Prescription #7.

Melted propolis is mixed with alcohol in a ratio of 1:2. Add 2 drops of essential oils of sage, myrrh and rosemary. Use for gargling (3-5 times a day).

Herbal treatment

Treatment with various herbs, their mixtures, collections, have long been used to treat fistula on the gum. Mainly used in the form of decoctions, infusions, rinses and irrigation of the oral cavity.

Almonds have antiseptic and anti-inflammatory properties, relieves pain, resolves seals, abscesses, draws out pus. Used for rinsing the oral cavity.

Stevia increases local immunity, normalizes sensitivity, has antiviral, antibacterial properties. It is mainly used for gargling the mouth, throat. You can drink orally (a glass a day), which will significantly accelerate recovery.

Lily normalizes local immunity, the state of mucous membranes, promotes the elimination of pus, causes fistula breakthrough. Used as a decoction, infusion (for gargles, for ingestion).

How do I get the pus out?

In order to draw out the pus, you need to contact a dental surgeon who knows exactly how to draw out the pus correctly, without consequences and complications. To do this, the fistula is pierced in a special way, the cavity is drained. Technically, it is quite simple.

But there are many methods of folk treatment, which allow no less effectively draw out pus, without resorting to surgical methods. For this purpose, various recipes are used, including herbal decoctions, infusions, which are based on the absorbent properties of active substances. They bind pus (sorb), attract it and contribute to the fact that it gradually comes out (fistula bursts). Propolis, honey, sea buckthorn, plantain, aloe, kalanchoe, pine oleoresin have such properties.

Can a fistula on the gum be punctured?

One often hears the question: "Is it possible to puncture a fistula on the gum independently?". Let's understand. Indeed, technically it is possible, and it is not very difficult. But is it necessary to do it?

It turns out that it is impossible to pierce a fistula on your own, as you can only make things worse. First, you can get an infection, resulting in the development of a massive inflammatory process. Often it already affects the entire oral cavity, lymph nodes, tonsils, there are foci of chronic infection. Secondly, you can accidentally puncture a nerve or vessel, which will lead to bleeding, neuralgia, irradiation of pain, and at the same time, and the inflammatory process, to the entire gum.

Fistula removal on the gum

Methods of surgical treatment are the usual removal of the fistula on the gum, or rather, its opening, puncture. Then pus flows out of it quite quickly, the inflammatory process subsides. If the pus does not flow out through the puncture, it is pumped out with the help of special drainage systems. Then further reconstructive treatment is required. Removal is used if there is a risk of spreading infection, or there is a risk of complications, with severe pain, involvement in the pathological process of nerves, vessels, soft tissues. Also an indication for surgical intervention is the spread throughout the gum, a high risk of inflammatory, infectious, purulent-septic processes. It is obligatory to remove when the first signs of necrosis appear.

Prevention

Prevention is based on the elimination of all possible risk factors: compliance with oral and dental hygiene rules, timely sanitation of the oral cavity, visits to the dentist (preventive examinations). In addition, it is required to take vitamins, mineral components, proper nutrition.

Forecast

The course and prognosis depend on the timeliness of diagnosis and treatment. A fistula on the gum can be treated or removed. The main thing is to do everything in time and correctly. If you follow all the recommendations of the doctor, you can significantly reduce pain, prevent serious complications, prevent the progression of inflammation and infection.