Tooth cyst (radicular cyst) - symptoms and treatment

The problem occurs several weeks before the eruption of a baby or permanent tooth. The appearance of a cyst is indicated by a bluish-purple spot (hematoma). This is due to difficulty in tooth eruption.

An eruption cyst is a type of soft tissue benign tumor that appears when a tooth has already begun to erupt through the gum. Scientists and doctors have not agreed on why it occurs. The most likely causes: infection, trauma, improper development of teeth, which causes a lack of space for the “newbie”. In addition, it may be a consequence of caries and improper care.

Eruption cysts occur during the growth of baby teeth or, more often, at 6–9 years of age, when permanent teeth emerge. The fact is that, due to its anatomical structure and location, the chewing group of teeth is the most difficult to erupt.

If you notice a large formation in your baby’s mouth, in the place where a tooth should appear, consult a doctor. Do not resort to self-medication under any circumstances. Infusions, rinses and even strong antibiotics most likely will not help, but ruining a child’s health in this way will cause serious harm.

If you contact a specialist, treatment can follow one of two scenarios. In the most favorable option, the doctor will advise giving the child toys, special teethers, crackers - everything that the baby can chew. This will help break through the mucous membrane.

In difficult situations, surgery may be necessary. Then the surgeon will cut the gum under local anesthesia. This will make teething easier.

It is forbidden to try to cut or tear the mucous membrane on your own; you can cause a serious infection or injure your baby.

How does a tooth root cyst appear?

The causes of cysts are varied, and among them it is impossible to single out the prevailing ones. So, this may be the result of physical trauma to the maxillofacial bones, or a rare but common medical error, in which the tightness of the root canal was broken, which became the basis for the emergence of a source of infection. A similar situation occurs when a dental crown is installed incorrectly. But the reasons for cyst formation are not limited to this. Untreated infectious diseases (in particular, sinusitis or periodontitis) are no less a provoking factor.

When can you eat and drink after surgery?

You should not strictly limit yourself in nutrition, you will need strength to recover - you can eat as soon as the anesthesia wears off, namely after 2-3 hours. You can drink it immediately after you remove the cotton swab. Until this point, it is undesirable for food particles or bacteria to get into the open hole.

In the first 3-5 days, you need to take into account several nuances in nutrition so that further healing of the wound goes well:

  • food should be warm. Hot or cold food will irritate tissues and cause blood vessels to dilate or constrict, which can cause new bleeding,
  • It is better to exclude rough food to avoid mechanical damage to the wound. Soups, purees, baked and boiled foods, minced meat dishes,
  • Do not chew food on the side where the tooth was removed to keep the protective clot intact.

Carefully! Many people mistakenly believe that in the first days it is better to drink and eat liquid foods through a straw. But in fact, suction creates a vacuum in the mouth, which can displace the clot or disrupt its integrity. Should not be doing that. For the same reason, you should not spit or suck in your cheeks.

Classification of dental cysts

There are not many types of cysts, so understanding them is not difficult. Four main types are distinguished by location:

- wisdom tooth cyst;

— a cyst due to an illiterate (unprofessional) installed dental crown;

- a cyst that arose as a result of the influence of a third-party infectious disease (sinusitis);

- a cyst localized in the area of ​​the front teeth.

At the same time, a classification is used based on previous circumstances preceding the occurrence of the cyst:

- a disease caused by poor-quality removal of one or more teeth;

— periodontal type cyst, provoked by an inflammatory process in the gums;

- a cyst caused by the growth of a wisdom tooth (retromolar or paradental);

- a cyst that occurs in children, first during the period of the appearance of milk (follicular) teeth, and then molars (eruption cyst);

— a cyst that arose as a complication of periodontitis (radicular);

— a situation is also possible in which the tissue forming the tooth degenerates (keratocyst).

General recommendations after surgery

On the first or second day after tooth extraction, you want to lie down and sleep - this is the body’s natural reaction to the stress experienced. After the release of stress hormones - adrenaline and cortisol - stabilization and rest are needed. Don't deny yourself this.

However, there are recommendations regarding sleep: you should raise the pillow higher and sleep reclining so that your head is elevated. This will prevent unnecessary pressure on the jaw and cause bleeding. To increase the inclination of the bed, place a pillow under the mattress or use two pillows.

Otherwise, maintain a calm regime without physical overload, pressure surges and overheating. That is, for the first time it is better to refuse air travel, hard work, playing sports and lifting weights, visiting the pool, bathhouse or sauna. You should not take a hot bath (a short warm shower would be preferable) and stay in the sun for a long time or sunbathe in a solarium. All this increases blood pressure, which is fraught with new bleeding. It is ideal if you have a couple of days off to recover after your teeth are removed.

Diagnosis of symptoms of tooth root cyst

The appearance of a cyst implies the formation of a cavity, which gradually grows while simultaneously filling with pus. This condition can last for a long time, and the patient does not experience pain. A sign suggesting the presence of a cyst is slight pain that occurs when pressing on the gum. Such a symptom only in rare cases becomes a reason to visit a dentist. Basically, it occurs in later stages, when the pain intensifies and becomes nagging, continuous, cannot be relieved with analgesics, and inflammation begins to additionally manifest itself in the form of swelling and swelling of the gums in combination with a persistent unpleasant odor in the oral cavity. Finally, a situation cannot be ruled out in which a fistula occurs - that is, a channel through which the contents of the cavity independently come out.

An effective way to detect a cyst in a timely manner is to conduct an X-ray examination followed by its opening and removal.

It should be noted that at the very beginning the disease poses minimal danger to surrounding tissues, since the cavity itself is reliably isolated by thick walls. However, as pus accumulates, the pressure on the walls increases, creating the possibility of a breakthrough, which can lead to blood poisoning and, in the long term, damage to the structure of the jaw bones. At the same time, the dynamics of cyst development are unpredictable and strictly individual. However, in the presence of other inflammatory processes or infections, in a weakened body the transition to the acute stage can occur quickly.

Particular attention should be paid to early diagnosis of the disease in pregnant women. This is due to the complexity of treatment: during pregnancy, only stabilization of the cyst is possible. If the inflammatory process worsens, the choice of treatment methods is strictly limited. That is why, at the planning stage of pregnancy, it is necessary to undergo a full examination by a dentist.

A short checklist: a list of recommendations after tooth extraction

What can and should be done

  • hold the cotton swab applied by the doctor for 20-30 minutes,
  • within 2-3 hours after surgery, be sure to apply cold compresses to reduce tissue swelling,
  • carry out oral baths (not to be confused with rinsing) with antiseptic drugs for 3-5 days: “Miramistin”, “Chlorhexidine 0.5%” or other drugs prescribed by a doctor can be used as medicinal solutions,
  • after 3-5 days, start using a toothbrush - only a soft one for the operated area, as well as a new one, without bacteria on it. The teeth of the opposite jaw can be brushed immediately, the main thing is to avoid the area of ​​the extracted tooth,
  • chew food on the side opposite the injured area,
  • You can drink water immediately, preferably warm water,
  • You can eat only after the anesthesia wears off, that is, after 2-3 hours,
  • Lead a quiet lifestyle, try to avoid physical activity and heavy lifting for 5-7 days.

What you should absolutely not do

  • don't rinse your mouth! Mouth baths in the first 3-5 days are more than enough,
  • do not use hot compresses! This is fraught with the appearance of edema and the development of inflammation,
  • do not create a vacuum in your mouth: do not puff out your cheeks, sneeze, blow your nose and spit very carefully,
  • do not pick the wound, do not touch the clot with your tongue,
  • do not drink or eat hot or cold food, only warm food,
  • try to quit smoking for at least 2-3 days after surgery,
  • Do not drink alcohol for 2-3 days - it does not promote tissue repair. Also exclude it if the doctor has prescribed a course of antibiotics,
  • Do not overcool or overheat - give up sports exercises, swimming pools, saunas for 5-7 days.

Tooth root cyst in children

The disease has features and varieties that are characteristic strictly for children. First of all, we are talking about formations that arise and go away on their own, without complications: in the form of a rash that appears on the gums, as well as the so-called “Epstein’s pearl”. Both varieties do not pose a danger due to the absence of purulent masses, which means that the cavity is infected. In addition, they may not occur at all, being only some of the phenomena accompanying the development of the child.

The situation is different with the appearance of a cyst during the growth of teeth (both milk and molars). In this case, the resulting cavities are infected, and given the previously described asymptomatic nature of the disease in the early stages, the most reliable method of determining its presence is regular visits to the doctor. This allows for successful treatment at the very beginning of the development of the cyst, saving the tooth in almost 100 percent of cases.

Methods for treating dental cysts

As mentioned earlier, the only reliable and error-free method for diagnosing a cyst on the root of a tooth is an x-ray. In most cases, one x-ray is sufficient; however, due to individual tooth growth patterns, an additional x-ray of the root portion may be required.

Based on the analysis of X-ray data, the dentist determines and prescribes the type of treatment. Due to the difficulty of accessing the cavity, the process of getting rid of the cyst can take several sessions - however, only this method allows you to eliminate the pathology while keeping the tooth itself healthy.

There are two main directions of treatment: therapeutic and surgical.

— the sequence of actions during therapeutic treatment is as follows: the dentist gains access to the intradental canals (to do this, the tooth tissue is opened), expands them, cleans the cavity from pus, then disinfects it and installs a temporary filling. In the absence of relapse and a favorable outcome, the temporary filling is replaced with a permanent one. An alternative option may be the depophoresis method. Its difference is that the cleaning of the canals occurs due to the sequential introduction of a special substance into them, which, under the influence of an electric current, disinfects them. The common property of both methods is their applicability in the early stages of the disease;

— surgical intervention is used in most cases due to its reliability and high efficiency. There are three types of surgical treatment: cystectomy, hemisection and cystotomy. The first option involves opening the gum from the side and removing the cyst, followed by suturing. Rehabilitation takes place while taking antibiotics. Hemisection requires additional removal of the affected tooth root and crown fragment. If a cystotomy is prescribed, penetration into the cavity is carried out through the near wall. This method has a significant rehabilitation period.

In addition to the above methods, laser therapy is used. Its principle of operation is to insert a thin tube into the cyst, allowing complete disinfection using a laser, followed by vacuum cleaning. This progressive method is painless and effective, since it is guaranteed to preserve the tooth and protect against recurrence of pathology.

Rehabilitation period and prevention of dental cysts

Due to the fact that the cyst is an inflammatory infectious process, drug therapy necessarily includes taking antibiotics, which are selected by the attending physician. Vitamin complexes and immunomodulators act as compensating medications. Treatment of dental cysts with medications is carried out simultaneously with removal of the cyst.

The main ways to avoid the disease are to regularly visit the dentist and carefully monitor oral hygiene. For preventive purposes, you can periodically rinse with infusions and decoctions - for example, aloe, calendula, sage. Combined with strict adherence to the dentist’s recommendations and timely relief from chronic nasopharyngeal diseases, this will ensure dental health for years to come.

You also need to clearly understand that a cyst on the root of a tooth is one of the serious and complex diseases, the treatment of which requires time and highly qualified surgeons. Only this guarantees the absence of complications: re-infection, the occurrence of an abscess, pulpitis or fistula, damage to adjacent tissues and teeth.

The most complete reminder for patients after tooth extraction

So, you left the doctor's office - the surgeon asked you to tightly squeeze a gauze pad with your teeth, which will help stop the bleeding. You need to hold it for about 20-30 minutes, that is, while you fill out the necessary documents at the clinic or go home. Remove the tampon carefully, moving it slightly to the side, without sudden movements, so as not to damage the fresh blood clot.

Very important! A thrombus (usually called a “blood clot”) protects the wound from microbes and prevents pieces of food and saliva from accumulating in the hole during the first week of rehabilitation. This is a natural sterile dressing that starts the process of new tissue formation. The most important rule that will protect you from complications and severe inflammation of the wound is to never remove the clot, do not touch it with your tongue or fingers, do not touch it with a toothbrush and protect it from other influences. Gradually it will resolve on its own.

Do not keep the tampon in place for more than 30 minutes - gauze soaked in blood and saliva will quickly become a breeding ground for infection. In addition, a blood clot is forming in the hole - the presence of a foreign body and additional injury are of no use to it. You need to give the wound the opportunity to heal naturally.

“If you have a complex tooth extraction, especially if you had surgery to remove wisdom teeth, or if you have an underlying condition, such as diabetes, you may need to observe a doctor for a few more hours. For this purpose, we have our own hospital, where you can sit comfortably and relax while we monitor your condition to see if there are any complications. This will give us confidence that the operation will be successful and will reassure you as the patient.”

Vasiliev Alexander Alexandrovich, implant surgeon, more than 10 years of experience make an appointment

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Swelling after tooth extraction (especially if it was complicated) can be prevented by applying a cold compress - to do this, wrap an ice pack from the freezer in a towel and apply it to the cheek (that is, from the outside) for no more than 20 minutes. After 15 minutes the procedure can be repeated. If you don't have ice on hand, frozen vegetables or meat will do, but be sure to wrap them in a bag and a towel to avoid cold burns. Cold constricts blood vessels, reduces pain and swelling, although it does not completely remove swelling. Compresses are effective immediately after surgery for approximately 3-4 hours.

Do not warm up the injury site under any circumstances! A hot compress will only make the swelling worse by increasing blood flow to the area of ​​inflammation. This will lead to serious complications after surgery.

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