Dental fistulas can range from a minor annoyance to a serious medical condition, depending on the severity of the situation. When left untreated, they can result in pain, infection, and a number of other issues.
Therefore, it’s important to be aware of what causes dental fistulas and how to properly treat them before they become too severe.
A dental fistula is an abnormal connection between two parts inside the mouth that should not be connected—for example, between a tooth root and the soft tissue surrounding it or between different teeth.
They are usually caused by trauma due to injury or bad oral hygiene habits such as brushing with too much force or using hard-bristled brushes. Smoking is another risk factor, as is infection.
A fistula in the mouth can not only be very painful, but is also an indication of deeper problems. Here you can learn everything about the causes & the course of treatment.
In this article, I first address why fistulas form in the mouth in the first place and who is most commonly affected.
After that, you’ll still learn all about treatment options – and how you can effectively avoid oral fistulas in the future.
What exactly are oral fistulas?
Fistulas are tube-like tissue ducts that are not present in healthy people.
Basically, the body uses fistulas to provide relief for the elimination of secretions (pus) from the body.
- They can occur anywhere in the body, but the intestines are most commonly affected.
- But fistulas also occur in the mouth – the so-called oral or dental fistulas.
They are mostly the result of local inflammation at the root of the tooth.
Fistulas serve to clear the body of bacterial foci – they are usually an indication of deeper inflammation.
The function of fistulas
Bacterial inflammation of the tooth root is extremely painful as the soft tissue is attacked and damaged.
The body reacts by forming a fistula in the mouth. It is intended to drain wound secretions and pus that have accumulated in internal body cavities to the outside.
Causes & Symptoms
The primary cause is tooth decay & bad teeth.
The bacteria penetrate through the pulp of the tooth to the root, where they cause painful pus formation (see the following diagram of the structure of a tooth for a better understanding)
The harmful bacteria with time reach the root & nerve of the tooth (if it becomes inflamed it leads to pulpitis)
- They provide there for an inflammation with abscess formation and the associated development of pus.
- This is collected in the small, underlying oral cavity.
- To allow the wound secretions to drain to the outside, the body forms a fistula.
So it is usually a sign of deeper problems.
Initially, there are no symptoms
As the inflammation progresses, dull, throbbing pain develops and worsens over time.
In most cases, the teeth are overly sensitive to external stimuli. Pain-sensitive or cold-sensitive teeth often occur.
Also redness and swelling of the gums occur in the affected area. This often manifests itself literally in a thick cheek.
The structure of an oral fistula
An oral fistula consists of three interconnected parts that connect the cavity just below the tooth root to the surface of the gums.
- Bottom of the fistula: It refers to the origin of the fistula directly at the abscess of the tooth root.
- Fistula canal: It is formed to conduct the purulent secretions from the base of the fistula to the fistula opening.
- Fistula opening: A point on the surface of the gum where a painful pus-filled vesicle forms.
The formation of a dental fistula can take weeks, sometimes even months.
Especially in the beginning, pain does not always occur – however, in the later course, most suffer from it.
What are the risk groups?
Adults are comparatively rarely affected by oral fistulas, but are not spared.
- A lack of oral hygiene, an unhealthy lifestyle, a weakened immune system or smoking promote tooth decay lead to bacterial inflammation of the gums & painful cavities.
- Chronic diseases such as diabetes, periodontal disease or inflammation of the oral mucosa are also known for their damaging influence on the teeth.
If you experience dental fistula, you should make an appointment with your dentist immediately.
Fistula in the mouth in children
Because the dentition and jaws in children are not fully developed and growth is not yet complete, oral fistulas are particularly common in children.
- Even babies & toddlers who have just got their first teeth can be affected by dental fistulas.
- For wearers of fixed braces, the risk increases further, as pressure points contribute to fistula formation.
However, a child’s body reacts in the same way as adults’ – it forms fistulas to drain pus (which forms inside the body) to the outside.
Where do fistulas occur in the mouth?
Mouth fistulas can occur in both the upper and lower jaws.
- A gum fistula close to the surface opens by itself in some cases – then the pus flows out without your intervention.
- However, if it is a deeper fistula, then it usually remains closed without intervention.
Untreated, it can form an abscess – this is a self-contained bacterial focus that can only be removed surgically.
Lancing fistulas yourself?
If you lance the oral fistula yourself, the risk of inflammation increases, which can spread to other teeth. Therefore,
CAUTION: Please always have a fistula opened by the dentist, absolutely refrain from laying hands on yourself.
Treatment at the dentist – The procedure
If you suffer from toothache and fistulas have formed, you should always visit the dentist as soon as possible.
Don’t be afraid of the dentist! The sooner you treat a dental fistula, the better.
- So it’s best to approach a specialist in a personal consultation – even if you only suspect you’re suffering from an oral fistula.
- He will first try to find out the cause of the inflammation – usually this is done by an assessment in the office & X-rays.
After the diagnosis, the dentist determines the exact method of treatment – depending on the severity of the inflammation.
Many times doctors prescribe various antibiotics to get the foci of inflammation in the mouth under control – because in many cases you can’t get rid of them any other way, even with perfect dental hygiene.
Does the doctor always lance the fistula?
This depends a lot on your symptoms. Sometimes the doctor will forego lancing, preferring to fight the bacterial focus with medication.
If, however, the pus does not recede & the formation of an abscess threatens, then the doctor often decides to open the fistula in the mouth.
When the wound secretion and pus can finally drain through the fistula after breaking through to the surface of the gums, the pain that is clearly felt subsides.
Home remedies for treating fistulas in the mouth
There are, however, a few natural home remedies that can help you relieve symptoms and promote healing
Garlic: The bulb is considered a natural antibiotic. For external use, chop a clove of garlic and place it on the abscess on your tooth.
Chamomile tincture: Chamomile is known for its soothing, healing properties. To take advantage of chamomile’s disinfecting properties, rinse your mouth several times a day
Cooled tea bags:To treat the causative abscess, you can place a cooled, moist tea bag on top to relieve swelling
However, these home remedies are not a complete substitute for a visit to the dentist.
Preventing fistulas in the tooth – The right precautions
As a reminder, the development of dental fistulas is a result of decayed teeth & inflammation of the gums.
- The main cause is harmful bacteria & plaque due to poor brushing technique.
- Therefore, your goal should be to take the best possible care of your teeth and strive for good oral hygiene.
Because with all-around healthy and well-maintained teeth, the risk of caries decreases – and with it, the risk of tooth root disease.
What helps against fistulas in the mouth: proper dental care represents the best means of prevention
How can I improve my oral hygiene?
Regular brushing (including flossing between teeth) represents one of the most important measures.
Likely there is an area you can improve here as well.
Browse this page to learn more about proper dental care & or the right actions to take for common dental problems.
- It can also make sense to purchase an Oral-B toothbrush or a sonic toothbrush – because they not only take work off your hands, but also make daily dental hygiene easier.
- If you have no problems with it, then a normal brush is also enough. According to experience, however, many neglect the proper brushing technique – especially early in the morning in stress
For this reason, many scientific studies see an electric device as a sensible purchase for healthy teeth. Read more about the different types & recommendable models here: Electric toothbrushes in the test.
Other measures for a bright smile
Apart from this, of course, there are other tips to improve your own dental care.
- If you are not yet flossing regularly, then you should definitely do so.
- Even the best brush does not reach the interdental spaces, which is why a particularly large number of bacteria form there.
For those who can not cope with flossing at all, there are also alternatives such as oral irrigators or interdental brushes.
Not least, you should also do everything right when choosing toothpaste & mouthwashes to round out your daily brushing routine
All of these measures are not only cheaper but also much more painless than costly treatments at the dentist.
Tip to finish: In addition to thorough oral hygiene, it is of course still a good idea to go for regular check-ups with your dentist to get white teeth (or maintain your bright smile).