Inflammation of the periosteum of the tooth - symptoms and treatment

Soldatova Lyudmila Nikolaevna

Candidate of Medical Sciences, Professor of the Department of Clinical Dentistry of the St. Petersburg Medical and Social Institute, Chief Physician of the Alfa-Dent Dental Clinic, St. Petersburg

Inflammation of the periosteum (periostitis) is a disease that brings many painful symptoms. As a rule, acute pain and severe swelling immediately bring the patient to the dentist, and rightly so: not only the condition of the oral cavity, but also health in general depends on the timeliness of treatment.

Typical symptoms

Symptoms of inflammation of the periosteum of the tooth are quite pronounced:

• redness and swelling of the gums;
• increasing severe pain radiating to the ear, temple and other areas, depending on the location of the inflammation;
• swelling of the face on one side (cheeks, lips, cheekbones);
• high body temperature;
• symptoms of general intoxication (headache, dizziness, dry mouth, fatigue and weakness, general loss of strength);
• white or gray plaque on the gums;
• change in tooth position, tooth mobility;
• in some cases, the appearance of purulent discharge.

With a prolonged inflammatory process, a fistula can form: pus finds its way into the oral cavity, which is accompanied by the appearance of blood, but the pain and fever temporarily subside. This is due to the fact that the contents stop accumulating in the tissues and begin to flow out, but you should definitely consult a doctor.

What is periostitis and how does it manifest in children?

The disease is usually a consequence of advanced dental problems, when inflammation descends, spreading to the bone. In children, this process can happen very quickly - sometimes the hours count.

In everyday life, periostitis of the jaw is called gumboil

. It is usually acute in nature and manifests itself with the following symptoms:

• complaints of jaw pain;
• asymmetrical swelling, puffy cheek;
• enlarged lymph nodes in this area;
• increase in general body temperature;
• weakness of the child, signs of general intoxication.

Please note that with periostitis, cooling the inflamed area reduces pain, and heating
increases discomfort.
Look at photos of children with periostitis - you will notice that the face is asymmetrical, the cheek or cheekbone area is swollen and looks painful.

The symptoms listed above (one or more) should be a guide to immediate action - it is necessary to urgently take the child to the dentist. It should be noted that in this case a prior appointment is not required - at the municipal clinic you will be seen immediately with a note of “acute pain”.

Why does inflammation of the periosteum occur?

There are three ways that pathogenic bacteria enter the periosteum:

• odontogenic factor - dental diseases become the source of inflammation: caries, cysts and granulomas of the tooth root, pulpitis. Bacteria penetrate deep into soft tissues. Quite often, periostitis is observed as a result of a long and complicated process of eruption of “eights”;
• hematogenous factor - infection occurs as a result of bacteria entering the tissues from the bloodstream or lymph flow. As a rule, this happens in connection with ENT diseases, furunculosis of the face, neck, abscesses, etc.;
• traumatic factor - mechanical damage to the periosteum during fractures, impacts, complex tooth extractions leads to inflammation.

Types of inflammation

Symptoms of inflammation of the periosteum of the tooth depend on the form of the process. In the acute form, pain and swelling are severe, difficulty swallowing, spreading of swelling to the face and neck, and enlarged lymph nodes may be observed. Acute inflammation occurs over several days.

The chronic form may bother the patient for several months. Symptoms are more moderate; a fistula may appear - an opening through which inflamed tissues get rid of purulent contents.

There are also two types of both acute and chronic inflammation:

• serous - more often provoked by traumatic injury, swelling forms quickly, but the pain is more moderate and tolerable, relief occurs, on average, after 5 days;
• purulent - more dangerous, characterized by severe throbbing pain, severe swelling and redness of soft tissues, and higher body temperature.

In both cases, you should definitely consult a doctor, since the risk of complications is very high.

Features of treatment

Treatment of inflammation of the periosteum of the tooth should only be carried out by a doctor. The specialist chooses tactics depending on the type and form of the disease.

Drug treatment is only advisable if you consult a doctor immediately at the first symptoms of the disease. Therapy includes:

• taking antibiotics prescribed by a specialist: this will stop inflammation and prevent the spread of infection;
• taking anti-inflammatory drugs, painkillers;
• local effect: use of antiseptic rinses, chlorhexidine baths, ointments and gels with an anti-inflammatory effect.

The course of treatment is at least 5-7 days. If relief does not occur, surgical methods are used.

Symptoms and treatment of inflammation of the periosteum of the tooth are individual. In case of advanced inflammation, ineffectiveness of conservative methods and other indications, the doctor performs a tissue opening - periostotomy. It is carried out in several stages:

1. anesthesia: local infiltration or conduction anesthesia is sufficient.
2. Making an incision in the gum in the projection of the source of inflammation.
3. Washing and cleaning tissues.
4. Treatment of the wound with antiseptic agents.
5. Installation of drainage - a small rubber band in order to prevent premature fusion of the mucous membrane and the re-formation of pus inside.

The drainage is removed by a doctor after a few days; you should not do this yourself. The specialist must make sure that the contents of the inflamed tissue are released and the wound can be allowed to heal. If the incision is small, no stitches will be required.

If the cause of the disease was a damaged tooth, it is treated: restoring its shape using filling materials, filling root canals. Sometimes removal is required; it is performed simultaneously with surgical treatment of periostitis.

Additionally, physiotherapeutic procedures may be recommended. They will speed up inflammation relief and healing. These include UHF, darsonval therapy, infrared radiation, and magnetic therapy. During the healing period, it is advisable to use vitamins and restorative medications.

Causes

Accurate diagnosis is important for a positive treatment outcome. It is this that allows you to determine why the tooth is inflamed. There are 3 diseases hidden under the general term.

Pulpitis

Microbes penetrate through the dentin layer to the neurovascular bundle - the pulp. People call it a nerve. Usually, this happens with deep caries. The pulp is penetrated by nerve endings. The pain is often acute and difficult to endure. But sometimes it is not strong, periodic. We ignore it and the inflammation becomes chronic, destroying the pulp. A small bun makes a huge difference:

• produces secondary dentin, therefore, although the height of the teeth changes throughout life, they do not disappear completely;
• participates in tissue metabolic processes;
• conducts nerve impulses.

When the pulp dies, the tooth is said to become “dead.” Such teeth are quickly destroyed.

To treat pulpitis in dentistry, therapeutic and surgical methods are used. In the first case, medications are placed into the tooth cavity and closed with a temporary filling. After some time, the tampon with the medicine is removed and the tooth is filled. This method does not always help relieve inflammation inside the tooth.

If the process has gone far, the pulp or part of it is removed and then a permanent filling is placed.

Periodontitis

Under the crown of the tooth there is connective tissue - periodontium. As a result of injury or poor treatment, microbes penetrate there, causing inflammation of the tooth root - periodontitis.

.

There is an apical form, when only the apex is affected, and a marginal form, when all the tissue around the root is infected.

Symptoms of periodontitis:

• pain while eating or when jaws touch;
• feeling that the tooth stands out from the row (has become taller);
• temperature increase;
• tissue redness;
• tooth mobility;
• discharge of pus.

Periodontitis is an insidious enemy. Often the disease occurs without symptoms. It can only be suspected when the signs of the disease become pronounced: roots are exposed, gums bleed, pus is released, bone tissue decreases.

Treatment depends on the type of periodontitis and severity:

• Therapeutic method

The doctor opens access to the root canals, removes part or all of the pulp, and installs drainage to drain the pus. After a few days, the drainage is removed, the canals and tooth are processed and filled. It is recommended to place a crown on such a tooth.

• Surgical method

They resort to it if fibrosis has developed or there are granulomas.

Dentist:

1. Cuts off the root tip
2. Removes 1 root in multi-rooted teeth
3. Amputates the root but leaves the crown intact
4. Removes a tooth
5. Performs separation (cuts the tooth in half, cleans it and puts it back together)

A course of antimicrobial tablets helps relieve inflammation inside the tooth.

Periodontitis

Periodontium is the fibers that hold the tooth in its socket. Plaque allows bacteria from it to penetrate into the periodontium and begin to rapidly multiply, forming a periodontal pocket. From the pocket, it is easy for them to get under the crown of the tooth and cause an inflammatory process there.

Before treating tooth inflammation under the crown, periodontal pockets are curetted, freeing the surface from tartar and plaque. Then they begin other manipulations: getting rid of caries, splinting teeth. Often, for periodontitis, a course of antibiotics is prescribed. The inflammation must be stopped so that the tooth does not have to be removed.

How to help yourself before visiting a doctor

If the periosteum of the jaw is inflamed, you should forget about such traditional methods as heating: any hot compresses will aggravate the situation. If you open the formation, take antibiotics without a doctor’s prescription, or remove the pus yourself, this can lead to dire consequences.

You can alleviate your condition by doing the following:

• rinse your mouth with a weak saline solution at room temperature or an antiseptic with an analgesic effect;
• apply a cool compress to the cheek on the side of the inflammation;
• Take an over-the-counter pain reliever.

These measures will help relieve pain and slightly reduce swelling, but you should contact a specialist as soon as possible. As an antiseptic rinse, you can use ACTIVE mouthwash. It does not contain alcohol, so there is no risk of burning inflamed tissues, and the chlorhexidine and benzydamine in the composition will help relieve the condition before you see a doctor.

Clinical researches

Repeated clinical studies have proven that the two-component mouth rinse ASEPTA ACTIVE more effectively combats the causes of inflammation and bleeding compared to single-component rinses - it reduces inflammation by 41% and reduces bleeding gums by 43%.

Sources:

1. The role of anti-inflammatory rinse in the treatment of periodontal diseases (L.Yu. Orekhova, A.A. Leontyev, S.B. Ulitovsky) L.Yu. OREKHOVA, Doctor of Medical Sciences, Prof., Head of Department; A.A. LEONTIEV, dentist; S.B. ULITOVSKY, Doctor of Medical Sciences, Prof. Department of Therapeutic Dentistry of St. Petersburg State Medical University named after. acad. I. P. Pavlova
2. The use of drugs from the Asepta line in the complex treatment of inflammatory periodontal diseases (N.V. Berezina E.N. Silantyeva S.M. Krivonos, Kazan State Medical Academy. Kazan.) N.V. BEREZINA, E.N. SILANTIEVA, S.M. KRIVONOS Kazan State Medical Academy
3. Report on determining/confirming the preventive properties of commercially produced personal oral hygiene products: Asepta toothpaste used in combination with Asepta mouthwash and Asepta gum balm Head. Department of PFS Doctor of Medical Sciences Professor S.B. Ulitovsky St. Petersburg State Medical University named after Academician I.P. Pavlova. Faculty of Dentistry. Department of Preventive Dentistry.

Diagnostics

Only an experienced dentist can accurately determine the form of the disease and prescribe competent treatment after a comprehensive examination.

1. Visual inspection.

The dentist will examine the oral cavity, paying special attention to severely damaged teeth.

2. X-ray of the jaw.

In order to differentiate periostitis from pathologies with similar symptoms (for example, from a dental cyst or acute periodontitis), the doctor may prescribe an X-ray examination.

X-ray allows not only to accurately diagnose periostitis, but also to determine the boundaries of the source of inflammation.

3. General blood test.

If purulent periostitis is suspected, a general blood test is required. An increase in leukocytes and ESR values ​​confirms the purulent form of periostitis.