Osteomyelitis photography

"Pustules grow on the gums. Can they be punctured? 」

"I won't feel uncomfortable, but I have pustules on my gums over and over again! 」

"I have a pimple on my face, and I haven't seen many dermatologists. The dermatologist suggested coming to you. 」

"Is it effective to put salt on your teeth? 」

Many people have the experience of pustules on the gums. How to deal with them correctly? Let's watch.

Two different requirements of gingival pustules

1. Don't poke it.

Never puncture the pustule with a sharp object yourself. Not only is the wound easy to be infected, even if you puncture it, as long as the root cause is not solved, it will grow pustules again and again.

2. Don't trust folk remedies

Don't trust folk remedies easily, but seek the help of a doctor. Remember, it's useless to teach people to put salt on their teeth.

Please act immediately and make an appointment with a doctor by phone or online.

Clean the mouth

Before the appointment time, all you can do is keep your mouth clean and clean your teeth correctly. What exactly is a gingival pustule?

Pustule is an opening of a passage, which we call "sinus". This opening can be on the gum in the mouth or outside the mouth (that is, on the skin around the face), and it is a hole for pressure discharge.

"Sinus" is the path and channel connecting the closed infected area (abscess) and epithelial surface.

Gingival pustules usually disappear naturally with the elimination of pathogenic factors by endodontic treatment and root canal treatment.

Why does pustule grow on gum?

These sources of infection can be roughly divided into those related to teeth and those unrelated to teeth.

Dental pulp inflammation, necrosis, apical abscess and periodontal problems are all related to teeth.

What has nothing to do with teeth is osteomyelitis, tumor, or some infections after tooth extraction and oral surgery.

Due to space reasons, we will focus on two related problems of teeth.

Gingival pustules caused by dental pulp diseases

If the following problems continue to develop, they may develop pustules on the gums or skin outside the mouth.

1. Deep tooth decay (dental caries) leads to the infection of the pulp dentin system inside the teeth. We can simplify the picture below.

2. Tooth fracture: Tooth fracture is a big problem, which can be roughly divided into trauma-related or unrelated, leading to pulp disease.

3. Severe periodontal disease: From the above knowledge, the tip of the root is an open channel, and severe periodontal disease can also indirectly cause pulp diseases. So we have a special term called "combined pulp and periodontal disease".

4. Trauma causes internal damage to teeth: Trauma not only causes cracked teeth in a broad sense, but also causes root resorption, blocking the operation of dental pulp and dentin composite system.

5. Root resorption: Root resorption is also one of the main reasons that may lead to diseases of pulp-dentin complex system.

When the above reasons lead to the infection and illness of the dental pulp dentin complex system inside the teeth; If not treated as soon as possible, the infection will continue to spread to the root tips of teeth and even to the bones outside the root tips.

The root of the tooth is buried in the closed alveolar bone, and a series of inflammatory reactions lead to inflammation around the apical part, and some of them will become apical abscess or even cyst.

Because the water polo in the closed space needs pressure release, it forms a channel, which opens on the gum or the skin outside the mouth. We call it pustules and sinuses. What are the symptoms of pulp disease?

1. At the initial stage, there was generally no discomfort or pain except pustules and sinuses on the skin above the gums or outside the mouth.

I often hear patients say, "My teeth don't hurt, but I have a pustule, sometimes good and sometimes bad. The pustule disappeared, but I couldn't sleep well and grew back under pressure. 」

"Tooth won't hurt" is mainly because the pulp nerve has been necrotic, that is, the wire that transmits pain inside the tooth is broken, and of course there will be no feeling of pulp pain.

2. In the middle and late stage, with the progress of the disease, the bone damage around the teeth is more serious, which may lead to the risk of cellulitis, and even drag down some nearby structures such as teeth, neural tubes, nasal cavity and sinus.

At this time, the teeth themselves may be painful, uncomfortable to bite, and the teeth will shake even more; Or symptoms of sinusitis and nerve paralysis may occur.

In severe cases, it hurts even if you don't touch your teeth. The risk of systemic infection is greatly increased; The alveolar bone was hollowed out due to invasion.

What kind of examination will the endodontist do?

1. X-ray photography of the root tip will find a black shadow around the root tip. By placing positioning materials in the pustule and taking X-rays, we can trace the problem of this tooth, which we call tracing back to the source.

Of course, most pustules caused by dental pulp diseases can be found in apical X-ray photography, but there are still some exceptions. At this time, cone-beam computed tomography of teeth is needed.

2. After dental pulp activity test and temperature test, it can be found that tooth activity is necrosis in most cases (note that there are exceptions). After pulp necrosis, just like the wire that transmits pain inside the tooth is broken, of course, there will be no pulp pain and hot acid feeling.

3. Other related examinations are as follows: percussion, palpation, pressing, shaking test, occlusal examination, oral cleaning, periodontal related examination, periodontal pocket depth, microscope-assisted examination, etc.

Gingival pustules caused by periodontal disease

Mainly because of inaccurate oral cleaning and tooth cleaning. For example, there are problems in habits, cognition and technology, or improper arrangement of teeth, which hinders fine hand movements, and may cause unclean teeth cleaning.

Many infectious sources and dental plaque accumulate around the teeth, which in turn destroys the alveolar bone (bone) around the teeth and forms periodontal disease.

Because the source of infection accumulates around the teeth, the gums around the teeth are red, swollen, suppurated and pustuled because of inflammation.

What are the symptoms of periodontal disease?

1. At first, it may just be inflammation of the gums, redness and swelling of the gums, bleeding when brushing teeth, or pain when touching the gums.

2. In the middle and late stage, at this time, the bones around the teeth are destroyed and become periodontal disease; Of course, there will be toothache, and at this time, you will find that the gums are shrinking, the teeth are longer, the teeth are bigger and easier to stuff with food, the teeth are shaking, the food bite is insufficient, the teeth are disordered, the gums are oozing, the gums are pustules, and the breath is bad.

More severe periodontal disease will destroy more alveolar bone, and nearby teeth will affect it, or other nearby tissues. It can even cause serious infection and cellulitis, which is life-threatening.

What tests will periodontists do?

1.x-ray photography will find that the alveolar bone around the root is obviously damaged. According to the situation, the doctor can trace the problem of this tooth by placing positioning materials in the abscess and cooperating with X-ray shooting, which is called tracing the source. However, there are some exceptions to X-ray photography, so dental cone-beam computed tomography is needed.

2. Other related examinations are as follows: percussion, palpation, pressing, shaking test, occlusal examination, oral cleanliness, periodontal related examination and periodontal pocket depth. Dental pulp vitality test, temperature test, microscope-assisted examination, etc.

To prevent gum pustules, you can do this.

The first trick: self-oral cleaning

1. Cleaning time, methods and tools are very important. Can reduce tooth decay, plaque accumulation, and reduce bacterial growth in the mouth.

2. It is suggested that the toothbrush head should not be too big. If the brush head is too big, you can't clean your teeth one by one. Don't be too stiff, brush your teeth with * * *, and don't "saw" your teeth hard. Finally, dental floss and interdental brush should be used instead of toothpicks.

3. At present, there are many teaching plans to promote tooth cleaning. Here, I quote the latest summary of the American Dental Association. Brush your teeth with fluoride toothpaste at least twice a day for more than two minutes each time, and carefully floss your teeth at least once a day.

Mouthwash helps to clean the mouth and keep the breath fresh, but mouthwash only plays an auxiliary role. Before using mouthwash, we need to determine the cause of bad breath and brush our teeth.

5. The tooth punching machine is always an aid, just an aid! Just an aid! I am often asked by patients, does the tooth cleaning function replace the oral cleaning principle of 1~3 above? I answered directly that the tooth punching machine is only an aid; Do you think it would be useful to just spray the water when we clean the floor? Is it necessary to clean it with a brush?

The second measure: pay a regular visit.

The purpose of follow-up is to prevent and delay the occurrence of diseases; And in the early stage of symptoms, early intervention.

Why do I emphasize regular follow-up visits? Because dental disease has its particularity, it will hardly happen "suddenly", but will advance with time (of course, dental trauma is an exception).

Dental pulp and root canal diseases, periodontal diseases, tooth decay, oral mucosa related diseases, etc. There are almost traces to follow in the early stage. Depending on the time of visit, doctors can help prevent the occurrence of diseases, or find and treat diseases early at the beginning.

What should I do if I have pustules?

1. Don't poke it.

Never puncture an abscess with a sharp object. Not only is the wound easy to be infected, even if you puncture it, as long as the root cause is not solved, it will grow pustules again and again.

2. Don't trust folk remedies

Don't trust folk remedies easily, but seek the help of a doctor. Remember, it's useless to teach people to put salt on their teeth. Please act immediately and make an appointment with a doctor by phone or online.

Clean the mouth

Before the appointment time, all you can do is keep your mouth clean and clean your teeth correctly. Don't underestimate gingival pustules

Pustules grow on the gums, and most people want to squeeze them out, just like acne. Squeezing them is very comfortable. But squeezing or puncturing the pustule with a sharp object will not only help, but may also cause more problems.

Besides, some people don't care about pustules on their gums. Because they often say: "The tooth is not painful, but a pustule, sometimes good and sometimes bad. The pustule disappeared, but I couldn't sleep well and grew back under pressure. 」

In fact, at this time, you have neglected that the disease has become more and more serious, and even the alveolar bone damage has become more and more serious, and the consequences are unimaginable. Seeking help as soon as possible is the way to save your teeth and keep healthy.