Symptoms of flux occur due to advanced caries or inadequate oral hygiene. In medicine, this disease is called odontogenic periostitis. This is an inflammatory process in the periosteum of the gums, accompanied by suppuration and severe swelling of the cheek. Often patients, faced with toothache, postpone a visit to the dentist until the last. It is important to remember that it is impossible to get rid of flux at home. Self-medication can only aggravate symptoms and complications. Only a specialist can carry out sanitation of a purulent-inflammatory focus.
What is flux?
Bacteria enter the area of the tooth root. Most often this is observed with an advanced form of caries. Reproduction of pathogenic microorganisms provokes inflammation, in which pus is formed. Exudate accumulates in the gum area over a diseased tooth and tends to go outside. However, the periosteum prevents the breakthrough of the abscess. As a result, a person has symptoms of tooth flux: swelling of the gums and cheeks, accompanied by bursting pain.
Periostitis can occur in acute and chronic form. In the first case, the clinical picture of the disease is pronounced, pain and swelling increase rapidly. In the chronic form of flux, the signs and symptoms of pathology develop slowly. There are periods of remission, when the patient is not concerned about the unpleasant manifestations of the disease. Exacerbation occurs after hypothermia or a drop in immunity.
Causes of pathology
Symptoms of flux in the cheek most often occur due to caries. Tooth enamel is destroyed and bacteria enter the pulp. There is inflammation of the root of the tooth - pulpitis. It is accompanied by acute pain. If the visit to the dentist is postponed, then the disease progresses. Inflammation spreads from the pulp to the periosteum. An abscess forms, the gums and cheek swell. The risk of flux increases if pulpitis was complicated by a tooth root cyst.
In addition to caries, the following pathologies can lead to periostitis:
- Gum and jaw injuries. In this case, the infection enters the periosteum through the wound.
- Diseases of the throat and oral cavity. Bacteria can enter the periosteum from nearby tissues through the blood and lymph. Flux often appears with angina, respiratory diseases, gingivitis, periodontitis, stomatitis. If the patient has advanced caries, then a cold can provoke periostitis.
In some cases, gum flux symptoms occur due to poor treatment of pulpitis. If the treatment of the root canals with their subsequent filling was carried out in violation of the rules, then soon the patient's cheek and gums swell.
Symptoms of acute periostitis
How does flux start? Symptoms of periosteum inflammation are usually preceded by a multi-day toothache. Shortly before the occurrence of suppuration and swelling, the discomfort in the causative tooth is reduced. However, this is a temporary and deceptive improvement. Soon, a person's gums swell and blush in the area of a diseased tooth. Then the swelling spreads to the cheek, because of this the face becomes asymmetric. It becomes difficult for a person to open his mouth and eat. Photos of flux symptoms can be seen below.
The pain in the causative tooth returns. It acquires a diffuse character, radiating to the cheek and chin. Due to the impossibility of exudate exiting, a sensation of pulsation in the gum appears. A swollen cheek becomes hot to the touch. The general state of health worsens, weakness and malaise appear. Body temperature rises to +38 degrees. If the inflammatory process is localized in the lower jaw, then an increase in lymph nodes is possible.
The clinical picture of chronic periostitis
In chronic periostitis, the symptoms and treatment of gum flux are somewhat different. This disease develops over a long period - several months, and sometimes even years. Its symptoms are less pronounced than in the acute form of the disease.
In chronic periostitis, remissions alternate with exacerbations. During periods of calm, the patient does not experience any unpleasant sensations. Under the influence of various provoking factors (hypothermia, colds, decreased immunity), the pathology exacerbates. Flux symptoms occur: swelling of the gums and cheeks, pain in the affected tooth. However, they proceed more easily than in acute form. The swelling of the cheek is less pronounced, but there is a thickening of the jaw in the area of the diseased tooth. Well-being is not significantly disturbed, body temperature remains normal.
Periostitis in children
The symptoms of flux on the gums in adults have been listed above. However, periostitis can occur in childhood, when the child has not yet formed permanent teeth. The causes of the disease are the same as in an adult. These are caries of milk or permanent teeth, poor oral care, stomatitis and gingivitis, which children are often exposed to.
The first symptom of a child's flux is pain in the area of the causative tooth and gums. She can be very intense. Kids often cry, become moody and restless, stop eating. If the inflammation is localized in the upper jaw, then there is swelling of the cheek, lower eyelid and parotid region. If the diseased tooth is located on the lower jaw, then there is a swelling of the cheek and chin, as well as an increase in lymph nodes. In severe cases, swelling extends to the neck.
Every parent needs to know about the symptoms and treatment of flux in children. When the first signs of the disease appear, you must immediately show the child to a pediatric dentist. This ailment should never be triggered. If the flux has arisen due to decay of deciduous teeth, then adentia can become a consequence of periostitis. This pathology manifests itself in the fact that the child does not form permanent teeth, and prosthetics may be required in the future.
Complications
With flux symptoms, a person needs emergency dental care. Treatment of periostitis is urgent. Purulent inflammation in the periosteum can cause the following dangerous complications:
- Abscess. Suppuration may extend beyond the periosteum. Inflammation becomes diffuse. In this case, the abscess often erupts on its own. A fistula forms on the gum. After pus comes out, a person feels relief, but this does not mean that the disease has receded. In the future, abscesses with fistulas constantly recur, and the pathology becomes chronic.
- Phlegmon. This is a purulent inflammation of the subcutaneous tissue. It occurs if an infection from the periosteum penetrates into the soft tissues of the face. This is a very dangerous complication that can lead to sepsis.
- Penetration of infection into the brain. This is one of the most dangerous complications with flux of the upper jaw. It can cause death.
- Penetration of infection in the neck and mediastinum. This complication occurs with lower jaw flux. Pus can enter the trachea, heart or esophagus, which often leads to the death of the patient.
- Tooth loss. In advanced cases of periostitis, the tooth must be removed.
In addition, bacteria from the purulent focus can spread throughout the body with blood flow. The result of this is inflammatory processes in various organs.
Diagnostics
A dentist is responsible for identifying symptoms and treating flux. The diagnosis is based on an examination of the oral cavity and patient complaints. Usually the definition of the disease is straightforward. However, flux in its manifestations may resemble other diseases: a tooth cyst, phlegmon, chronic periodontitis. If it is necessary to conduct differential diagnosis, then an x-ray is prescribed.
In order to identify the degree of inflammation, a general blood test is done. With periostitis, this study shows an increase in the number of white blood cells and ESR.
What is not recommended to do?
Often, patients, having discovered the symptoms of flux, try to self-medicate. In no case should this be done. Periostitis is a complex disease that cannot be cured by folk remedies. Rinsing with decoctions of medicinal herbs is not able to remove purulent inflammation of the periosteum.
Flux therapy should be carried out only in a dental clinic. Trying to get rid of pain and swelling at home, patients often commit the wrong actions, which only exacerbate the situation.
It is important to remember that with periostitis it is categorically contraindicated:
- Apply heat to the cheek from the affected tooth. This can lead to the spread of purulent-inflammatory process to nearby tissues.
- Take antibiotics without a doctor's prescription. With prolonged use, antibacterial drugs reduce the immunity, which is necessary to fight the infection.
- Take painkillers before a visit to the dentist. The use of such drugs can smear the clinical picture of the disease, and it will be difficult for the doctor to identify signs of pathology. If the pain becomes unbearable, then you can take an analgesic, but not less than 3 hours before visiting the dentist.
- To use "Aspirin". This remedy should not be taken before and after visiting a doctor. Treatment of periostitis is carried out surgically, the abscess has to be opened. Aspirin may cause increased bleeding during dental surgery.
The appearance of flux symptoms should be a signal for an immediate visit to the dentist. Only a specialist can conduct competent treatment of periostitis.
Surgery
Treatment of periostitis is carried out only surgically. The resulting abscess in the gum must be opened as soon as possible. Surgery consists of several stages:
- A local anesthetic for pain relief is injected into the gums.
- A scalpel is made an incision in the area of the bag with pus. If necessary, open the periosteum. The depth of incision depends on the degree of damage.
- The exudate is released through an incision. The inflamed cavity is washed with antiseptics.
- If the causative tooth is not subject to conservative treatment, then it is removed.
- A tube (drainage) is inserted into the incision for the outflow of exudate.
- After a few days, the drainage is removed. Usually the incision heals on its own. If necessary, stitches are placed on the postoperative wound.
It is important to remember that flux symptoms do not disappear immediately after opening the abscess. In the first time after surgery, even a slight increase in edema can be noted. This is a natural reaction of tissues to an anesthetic injection and to a gum incision. Already after 1 - 2 days, the swelling of the cheek will begin to decrease, and then completely disappear.
However, if after opening the abscess, the patient persists for 10-12 hours, then it is necessary to consult a dentist. It may be necessary to correct therapy.
Conservative treatment
Immediately after opening the gums, the patient is prescribed a course of antibiotics: Amoxiclav, Linkomycin, Tsifran, Ampioksa, Doxycycline, Tsiproleta. They have a wide spectrum of action and are able to inhibit the growth of many bacteria. The doctor selects the doses of drugs individually. To prevent an allergic reaction, antihistamines are prescribed at the same time: Cetirizine, Claritin.
At first, after a gum incision, the patient may be disturbed by pain. To reduce unpleasant sensations, anti-inflammatory drugs of non-steroidal action are used: Nise, Ketanov, Nimesil.
After surgery, it is very important to maintain oral hygiene. This will help prevent infection of the incision. Dentists recommend regular rinsing with a decoction of chamomile, oak bark or a composition with "Hydrogen Peroxide."
Forecast
If the flux proceeds without complications, and the treatment was carried out at an early stage, then the prognosis of the disease is favorable. After opening the abscess and conducting antibiotic therapy, the edema subsides and full recovery occurs. However, in most cases, it is possible to save the tooth.
If the patient delays the visit to the doctor, then the prognosis is complicated. Often you have to remove the causative tooth and perform prosthetics. Treatment of the inflammatory-purulent process with antibiotics can be lengthy.
With phlegmon, the forecast becomes very serious. This complication is fraught with blood poisoning. Urgent hospitalization in the Department of Oral and Maxillofacial Surgery is required. An autopsy of the purulent focus is performed with the installation of drainage. In this case, it is often necessary to make an incision from the outside of the cheek, after which a scar may remain.
When bacteria enter the brain and mediastinal region, the prognosis becomes unfavorable. Infection can affect vital organs and can be fatal.
Prevention
How to avoid periostitis? The main preventive measure of flux is the timely treatment of caries. You should contact your dentist as soon as a toothache occurs. You should also regularly undergo preventive examinations of the oral cavity. In most cases, flux is a complication of advanced caries.
It is also important to remove tartar in a timely manner. Such deposits are a favorable environment for the growth of bacteria and contribute to the appearance of pulpitis and periostitis.
Care should be taken in the care of teeth and oral cavity. Caries-prone people need to avoid hypothermia and strengthen immunity. This will help minimize the risk of flux.