Diagnosis

The dentist can make the diagnosis “fistula” at first sight on the basis of the typical reddish-yellow bulging of the gums. However, further examinations follow the optical examination to identify the tooth causing the fistula. A percussion test and a sensitivity test are performed.

This means that first the teeth are tapped with a dental instrument and then a cold foam pellet is held against the teeth. The dentist wants to determine the reaction of the teeth to pressure and cold. An X-ray is taken to show the exact location and extent of the damage. This information can then be used to initiate appropriate treatment steps. This topic may also be of interest to you: X-ray of the teeth

Symptoms

In the initial stage, the fistula causes little or no discomfort. Mostly it feels like a slight inflammation, which is even rarely noticed. Over the course of a few weeks, a slight pricking or tapping is sometimes heard, which can be accompanied by a feeling of tension.

At first a swelling forms around the diseased tooth, which turns into a pustule. At this point, severe pain can also occur. Once the pressure in the bladder reaches its peak, the fistula empties into the oral cavity.

The pain then decreases for a short period of time while the bladder can fill again. Even when there are no symptoms, the pathological process continues within the bone. The inflammation progresses and the bone is damaged until the cause of the inflammation is found and eliminated.This topic might also be of interest to you: Fistula at the gum

Fistula treatment

The aim of the treatment of the fistula is a maximum reduction of bacteria as well as the complete healing of the resulting defect. This is the only way to achieve lasting freedom from symptoms. After the diagnosis is made, the trepanation, i.e. the opening of the tooth, takes place.

For this purpose a hole is drilled to the tooth cavity with a drill and the purulent secretion is sucked out. This drainage reduces the pressure on the tooth, and the pain is partially alleviated. A subsequent X-ray image then determines whether the tooth is retained.

If the damage is too advanced, the tooth must be extracted. If the tooth can still be saved, the dentist will perform a root canal treatment and remove the root tissue damaged by the bacteria. This should make the pain disappear completely.

If this is not the case, an additional apicoectomy can be performed to repair the damaged area. Oral antibiotics are often prescribed to eliminate the bacteria completely and accelerate the healing process. The administration of antibiotics is indicated in most cases of fistula.

The cause of fistula formation is a persistent inflammation. This inflammation destroys surrounding tissue and forms a kind of duct, a so-called fistula duct, towards a surface. This can be, for example, the oral cavity or the cheek.

Antibiotics must be used to combat this. Pus often forms, which is drained via the fistula tract. If the cyst is already very large and has to be opened and emptied surgically, antibiotics are also prescribed after the operation in order to accelerate healing and prevent a new inflammation.

An antibiotic is subsequently necessary for almost every fistula. For infections of the teeth and jaw area, broad-spectrum pumpicillins, i.e. penicillins that combat a wide range of pathogens, or clindamycin, the antibiotic of choice in the case of a penicillin allergy. Both antibiotics attack at different points in the metabolism of the bacteria.

If the fistula is surgically opened, a smear can be taken and a special antibiotic effective against the pathogens present can be taken. It is not recommended to treat the fistula itself. Although it can happen that the fistula heals on its own, the inflammation of the teeth inside the body does not.

Even if the fistula has healed, the tooth must still be treated to prevent it from reoccurring. A fistula should only be opened and treated by the dentist, as only the dentist has the necessary expertise about the cause. Furthermore, the same sterility is not required under domestic circumstances as in the practice.

The use of non-sterile objects for fistula treatment could further promote and advance the inflammatory reaction. Pain relief alone can push the disease into the subconscious. One would forget the problem and the inflammation could spread to an abscess.

An abscess in the head and neck area is extremely dangerous, because under unfavorable conditions it can even reach the brain and cause permanent damage. A fistula is an unnatural and in this case pathological connection between the root of the tooth and the oral cavity. It has formed due to an inflammation at the root of the tooth.

The pus of the inflammation finally empties into the oral cavity through a kind of tube as a drainage channel. From the moment it is emptied, the fistula in the mouth is usually no longer painful. It is recommended to consult a dentist who will remove the inflammation professionally.

The necessity of surgery depends on the location and size of the fistula. However, it is often unavoidable to operate. The dentist removes the causative purulent inflammation (usually an inflammation of the root) and disinfects the wound.

It is not recommended to open the fistula by yourself. In most cases, more bacteria can enter the wound than is already the case. A further risk is that the pus and thus the bacteria will pour into the surrounding tissue through the puncture and thus cause an extensive inflammation.

There are many homeopathic remedies. Among others, the remedies Silicea C4 and Hekla Lava C5, which can be used depending on the strength of an inflammation. In cases of fistulas and bone necrosis, they are said to improve the body’s ability to regenerate.By accelerating the inflammatory reaction, the self-healing rate should be increased.

This would allow the inflammation to heal easily and quickly. However, the principle applies: without mechanical opening of the tooth, no healing of the fistula can be expected in the long run! There are no home remedies that can fight the cause of a fistula.

Camomile, administered through tea or in gel form, can have a soothing effect due to its anti-inflammatory and antibacterial effects. Similarly, onions, garlic and clove oil can all be applied to the fistula with the hope of relief. Despite initial improvement of the symptoms at the beginning, the cause of the inflammation remains unaffected by these home remedies.

The bacteria can spread further and cause more serious damage. Therefore, no healing can take place. This is particularly worrying during pregnancy.

There household remedies should not be used under any circumstances. A prolonged inflammatory process could be harmful to the unborn child. A visit to the dentist should not be avoided!