Inflammatory processes in the oral cavity are fairly common conditions. A large amount of pus that accumulates in the tooth area is commonly called flux. Many people face this problem and understand exactly what it looks like. In medicine, this condition is called periostitis.
Purulent periostitis in acute form is an inflammatory disease in the periosteum. The lesion extends to the lower jaw from the outside, and in some cases appears on the upper. This condition is considered quite dangerous, requires mandatory consultation with a doctor and the appointment of the right treatment.
Development features
The following stages of the development of this disease are distinguished:
- Infection from a diseased tooth goes to the root and then to the bone tissue.
- Serous exudate is formed in the bone tissue.
- Through the vessels and nerves, the infection penetrates the periosteum, stratifying it.
- As the inflammatory process progresses, leukocytes appear in the serous exudate, and the process itself becomes purulent.
According to ICD 10, acute purulent periostitis of the lower or upper jaw has a code of K10.2. The number 10 denotes diseases of the jaw, and 2 - the inflammatory process in it, that is, periostitis in a purulent form.
The main causes of the disease
Periostitis in rare cases manifests itself as a separate ailment, most often it occurs against the background of other pathological processes in the oral cavity and larynx. Typically, the cause of this disease is chronic periodontitis in an advanced stage, as well as periodontitis, jaw cyst, alveolitis and inflammatory processes in the so-called wisdom teeth.
Leads to the accumulation of a large amount of pus, as a rule, and a bacterial lesion that occurs against otitis media, influenza, tonsillitis, acute viral disease, measles, and scarlet fever.
Another acute periostitis of the jaw may appear when exposed to negative factors, which include:
- problems encountered during tooth extraction;
- surgery in the oral cavity;
- mechanical damage to the jaw, resulting in wounds;
- the onset of the inflammatory process in the tissues of the face;
- hypothermia or, conversely, overheating, strong physical exertion;
- teething of the first teeth in a child;
- improper treatment of dental diseases;
- reduced immunity.
The cause of the appearance of acute purulent periostitis of the jaw can be pronounced, in this case it will be quite simple to diagnose it. But everything is much more complicated when there are no visible symptoms of a pathological condition.
The inflammatory process may occur as a result of exposure to negative factors. For example, after cured tooth decay, a wound formed near the root of the tooth, which, due to low immunity, was exposed to bacteria. As a result of this process, the development of acute purulent periostitis of the jaw begins. When visiting a doctor, the patient should give him all the information that will help determine the cause of the ailment. In this case, the treatment will be prescribed effective and comprehensive.
Symptoms of periostitis
The general clinical picture of the disease in each patient will differ depending on the form of the lesion, stage of development, course characteristics, as well as on the individual characteristics of the patient's body.
The chronic form of the disease proceeds, as a rule, sluggishly, without pronounced symptoms. The acute form of the disease cannot be overlooked, since it is most often accompanied by one or more pronounced symptoms that will not allow a person to work and relax normally.
Acute periostitis of the upper jaw can manifest itself as an independent disease or develop against the background of other diseases of the oral cavity. It is from this that the symptoms that will progress every day will depend.
The most common complaints about purulent periostitis of the upper jaw doctors include:
- severe and acute, in some cases, throbbing pain on one side, which radiates to the ear, temple, or neck;
- problems with jaw mobility, which provoke a strong pain syndrome when opening the oral cavity;
- puffiness and swelling of a part of the face, depending on the area of pain distribution, in some cases there are problems with facial expressions;
- purulent abscess next to the root of a diseased tooth, which leads to yellow and watery discharge, this condition occurs from time to time and may bring temporary relief;
- inflammatory processes of the oral mucosa, as a result of which redness is observed;
- fever in some patients to 38-39 degrees, general malaise, feeling tired, chills;
- an increase in the size of the submandibular lymph nodes, severe soreness in them.
What symptoms will accompany acute purulent periostitis of the upper jaw and lower jaw will directly depend on the stage of development of the disease and its progression. In most cases, suppuration of the periosteum extends to the lower lateral teeth, which provokes severe swelling of the submandibular region and cheek. Of course, the history of the disease of acute purulent periostitis of the lower jaw will be different in each patient.
If inflammation develops in the upper jaw, then tissue hyperemia occurs near the lips and eyes. The face acquires a pronounced uneven shape, there is a strong swelling and blue skin.
From the appearance of the first symptoms of the lesion to the formation of a large abscess, as a rule, several days pass. After this, the pain syndrome gradually intensifies, and overall well-being only worsens.
From time to time, a person’s condition may be alleviated, this is typical for those cases when the abscess is opened by itself. But this does not mean at all that you can not visit a doctor, if you do not start the correct treatment and do not clean, then pus will accumulate in the affected area of the oral cavity again.
Who suffers from the disease?
Purulent periostitis mainly affects adults, but during the eruption of the first teeth or when injured, the disease can develop even in childhood. Diagnosis in this case can be quite complicated for the reason that the symptoms of the disease are very similar to osteomyelitis.
Although, there are characteristic signs of the described illness: anxiety of a child, poor behavior, crying, sleep problems, gum redness, swelling on the one hand, severe pain at the moment of touching the affected area and a sharp rise in temperature.
In most cases, the disease is observed in children 3-4 years old and has a severe course. For help, a doctor should be consulted as soon as possible, without delaying the treatment of acute purulent odontogenic periostitis, as this can lead to rather dangerous pathologies.
The main types of disease
Diagnosis of acute periostitis is carried out by comparing the symptoms characteristic of all types of such a disease. Comparison helps to determine the form of pathology, to make a comprehensive and effective treatment for a particular case.
According to the genesis and distribution, the inflammatory process is divided into the following types:
- odontogenic - appears as a result of other diseases of the oral cavity;
- traumatic - provoked by mechanical damage to the jaw;
- lymphogenous - the infectious process captures the lymphatic system;
- hematogenous - infection spreads through the bloodstream.
The most common form of the disease appears in humans when exposed to odontogenic factors. But in rare cases, other types of diseases are also established, which are treated depending on the cause of their appearance.
Disease development
Depending on the symptomatology and severity of the lesion, dentists distinguish acute and chronic periostitis. Chronic develops for a long time, and its symptoms are poorly expressed. With this disease, a person has an increase in bone tissue in the affected jaw, accompanied by progressive ossification. Such a process is almost irreversible and very dangerous. Only timely detection of inflammation of the periosteum will help prevent complications.
Acute periostitis is characterized by severe symptoms, therefore, as already mentioned, it is simply impossible not to notice the disease. There is a purulent and serous form of the course of pathology. With serous periostitis, a certain amount of serous fluid accumulates in the affected area of the mouth . For a purulent type of lesion, an abscess under the periosteum is considered characteristic. These two forms of pathology, with improper or untimely treatment, can quickly become chronic.
Degrees of illness
Conventionally, a disease, depending on the area of distribution, in dentistry is divided into a diffuse and organic degree.
The latter is characterized by inflammation of 1-3 teeth, while with diffuse damage can extend to almost the entire jaw. In dentistry, a diffuse form of pathology is quite rare and is characterized by its unpredictability.
Such a classification of periostitis helps the specialist make an accurate diagnosis, and then prescribe an effective and comprehensive treatment of pathology.
Therapy Features
Treatment of the disease should be comprehensive. When the initial symptoms of inflammation of the jaw appear, it is important to immediately consult a doctor. He will conduct a visual inspection, which will reveal the area of distribution of the lesion. To clarify the diagnosis, it is important to conduct a blood test in the laboratory. With the development of a purulent process, the level of leukocytes and ESR will be high.
The most effective diagnosis is thermography, which uses infrared radiation. With his help, the specialist manages to identify the inflammatory process and the place of its spread. Additionally, the doctor conducts an x-ray of diseased teeth and determines all possible additional diseases.
Treatment of acute purulent periostitis is carried out through surgery. In any case, it is important to open the abscess without fail, and then remove all contents from it.
To do this, the doctor makes a small incision in the affected gum, eliminates diseased tissue and installs a special drainage for the outflow of accumulated pus. The operated area is preliminarily anesthetized with trimecaine or lidocaine.
At the initial stage of the development of the disease, it is customary to use gum irrigation, in more difficult situations, local anesthesia is used. Autopsy of the flux alone is strictly prohibited, as this can only worsen the situation.
Possible consequences
With timely contact with the dentist, the tooth can be saved. He is treated, and then filled. In advanced cases, the inflammatory process is so already widespread that the doctor has to remove the tooth.
Therapy may continue for several months. In some cases, due to severe pain in the patient, an abscess is first treated and only after that the dentist proceeds to treat the teeth themselves. The time of therapy will directly depend on the stage of the disease, the size of the affected area and the characteristics of the pathological process.
At the second stage of therapy, the doctor prescribes medications that help heal. To do this, use antiseptic and cleansing rinses with a warm solution of potassium permanganate or soda. Most often, the doctor prescribes antibiotics in order to eliminate a bacterial infection. For severe pain, analgesics are used. Also, a specialist can prescribe anti-inflammatory, antihistamines, vitamins and minerals.
During rehabilitation, the patient is prescribed physiotherapy: UHF, neon irradiation, laser therapy, as well as ultrasound. To improve the condition of the muscles of the face, you need to use special medical exercises.
Therapy of the acute form of periostitis at the initial stage of its development lasts only 3-5 days, including surgery and rehabilitation of the patient. Subject to all the advice of a doctor, a person completely gets rid of the problem and continues to live a full life.
With the advanced stage of the development of the disease, a longer and more comprehensive treatment is required. The transition of pathology into a chronic form provokes irreversible changes and regular relapses in the tissues of the periosteum. In this case, the doctor should constantly monitor the patient's condition and prescribe periodic treatment.
Patients in the reviews say that you do not need to be afraid to visit a doctor. A cured disease will help improve health without the high financial cost. But treating a lesion of the oral cavity yourself should not be, as this can only worsen the condition and lead to irreversible complications.
The outcome will depend on the individual case history of acute purulent periostitis of the upper jaw in the patient.
Patient reviews
Patients note that for the treatment of the disease at the first stage of its development, only about 660 rubles will be required (opening an abscess). Additional costs are needed to treat complications after periodontitis or pulpitis, which appeared with advanced periostitis. Removing a tooth will cost 1,500-2,000 rubles.
Additional expenses include x-rays, taken anesthetics and antibiotics, in some cases hormonal drugs. With complex treatment, the patient may need about 5,000 rubles, and sometimes more. Therefore, those who have suffered periostitis recommend not postponing a visit to the dentist.