A fistula on the gums, also known as an oral fistula, is a kind of canal that develops between two regions in the mouth. The canal connects with the tooth abscess and drains pus from it.
An abscess is a pocket of pus that forms after bacteria infect in a certain area inside the mouth, usually in the pulp of the tooth.
Bacteria present at the site thrive, and the surrounding tissue becomes soft, creating a pocket that fills with pus, bacteria, and dead tissue. If not identified, the infection spreads further, causing an even larger abscess.
Symptoms of an abscess include fever, toothache, and a sour or unpleasant taste in the mouth.
How does fistula on the gums form and what causes it?
Tooth fistula usually occurs when teeth or gums with an abscess cause infection. After some time, discharge from the infection accumulates, and increasing pressure causes a fistula that connects the abscess to the gums.
Abscesses form at the root of the tooth. The most common causes of abscesses are injuries to the mouth or teeth, poor oral hygiene and previous dental work. Dental treatments such as endodontic therapy can lead to abscesses and, eventually, fistulas.
Fistulas can also form in the mouth of a person who has chronic dry mouth or a continuously diet rich in sugar. A congenital defect can also cause a fistula, although it is rare as a cause.
Fistula on the gums is rarely painful. Even if you feel some pain, it is not constant.
Symptoms of dental fistula
Symptoms of dental fistula include:
- A small lump that forms on the gums (pimple on the gums)
- Pus discharged into the oral cavity, often accompanied by an unpleasant taste and odor
You may not always be able to recognize when a dental fistula is forming. However, the symptoms of an abscess will be easier to recognize:
- Sensitivity or pain at the site where the abscess forms
- Tooth hypersensitivity
- High temperature
- Enlarged lymph nodes from the jaws and neck
- Severe throbbing toothache
If you have difficulty breathing or swallowing, you must seek medical attention immediately.
Treatment of fistula on the gums
If your doctor or dentist determines that a fistula is present on your gums, you will need medical attention. Tooth fistulas almost never go away without treatment. Infections can spread uncontrollably if left untreated, in which case they can affect the jawbone and other parts of the mouth.
The dentist will make an X-ray of the affected area during the examination. They will then also perform intraoral and extraoral examination.
The dentist can clean the pocket of the infection and prescribe antibiotics to remove the bacteria that caused the infection. Depending on the severity of the tooth fistula, the dentist may recommend endodontic therapy (cleaning the root canals of the tooth) or tooth extraction.
Endodontic therapy is a dental treatment that includes treating an inflamed tooth, preventing re-infection, and saving a natural tooth. During this treatment, the dentist removes the infected nerve and pulp from the root of the tooth, disinfects and cleans the inside of the tooth, then fills and closes the tooth with filling.
Dentists perform this treatment under local anesthesia, which minimizes any immediate pain. But anyone who passes through root canal treatment should expect swelling and discomfort a day or two after the procedure. Your dentist may also recommend the placement of a dental crown (cover) to preserve and protect the aesthetics and function of the tooth.
Tooth extraction means complete removal of an infected or damaged tooth. Dentists use this procedure when endodontic therapy does not give results, and apicotomy is not possible. If you have an abscess, your dentist may first prescribe antibiotics to treat the infection before removing the tooth.
A dentist or oral surgeon will perform a tooth extraction procedure under local anesthesia. You may be swollen and feel pain a day or two after the procedure. After the gums heal in a few weeks, you can discuss the possibility of replacing your teeth with your dentist.
For less severe cases, antibiotics and drainage of pus is enough to get rid of the fistula on the gums.
When to seek help?
The best is to seek help as soon as you notice that a pimple is forming on your gums. Since it is rare for a fistula to go away on its own, you should seek professional help from a dentist. You may notice other symptoms such as fever, pain, and swelling before you discover the pimple.
If you do not seek treatment immediately, you may develop complications such as tooth or jaw bone loss. In rare cases, an infection from an oral abscess can penetrate your bloodstream, causing sepsis.
Also, seek medical attention immediately if you have difficulty swallowing or breathing.
If you can’t visit your dentist right away, you can take the following steps to alleviate the problem:
- Rinse mouth and gargle with lukewarm salty water. The water must be lukewarm, not hot, because overheated water will only worsen the fistula.
- Take medications against pain to help with fever and swelling.
- Apply a cold compress to the affected area several times a day to relieve pain and swelling.
- Apply a warm compress to increase blood circulation in the area, delivering nutrients and promoting healing.
- Continue with regular oral hygiene.
Even if you are sure that the bacteria are causing the infection, it is never a good idea to prescribe antibiotics for yourself. Only take them if your dentist or doctor prescribes them.
Natural treatment for fistula on the gums
Even though oral fistula cannot be solved without professional treatment in a dental office, there are several natural compounds for fistula on the gums to alleviate the feeling of discomfort and pain caused by infection.
- Rinse your mouth with sodium bicarbonate solution: put half a teaspoon of sodium bicarbonate in a half cup of water and add a little salt. Mix the ingredients and rinse your mouth. Keep the solution in your mouth for as long as possible (up to 5 minutes) and then spit it out. Do not repeat this procedure more than twice a day.
- Oregano essential oil: this oil is an antioxidant and has an antibacterial effect. Mix a few drops of oregano essential oil with 30 ml of vegetable oil of your choice. Using a dropper, drip a few drops on cotton wool. Place a cotton ball on the fistula area and let it work for a few minutes, then rinse your mouth. Repeat the procedure two to three times a day.
- Fenugreek Tea: Put a teaspoon of ground fenugreek seeds in a cup of hot water. Leave the tea to cool completely. Dip a cotton ball in tea and place on the affected area. Repeat the procedure two to three times a day.
- Clove essential oil: This oil has antibacterial and anti-inflammatory properties, but if you use essential oil it needs to be diluted. Drizzle a little diluted clove essential oil on the cotton wool and place on the affected area. Or mix a few drops of oil in a small glass of water and rinse your mouth with it.
- Hydrogen peroxide: mix an equal ratio of water and 3% hydrogen peroxide. Then rinse the solution in your mouth for about one minute, then spit it out and washmouth. Be careful not to swallow it.
- Garlic: Crush a few garlics and make a mixture to apply to the infected area. Leave on for a few minutes, then rinse your mouth. You can repeat the procedure several times, as needed.
Because fistulas are caused by a variety of factors such as poor oral hygiene, a diet high in sugar, and injury, there is no cure or specific treatment to prevent them. To reduce the chances of developing a dental fistula, practice regular and high-quality oral hygiene, maintain a healthy diet and visit the dentist at least twice a year.
Oral fistulas can be prevented as follows:
- Brush your teeth twice a day, for at least two minutes each time. Floss once a day.
- You can use fluoridated mouthwash and toothpaste.
- Limit your intake of sugar and acidic foods and increase your intake of fruits and vegetables. Eat calcium-rich foods such as dairy products, green leafy vegetables and beans.
- Chew sugar-free gum to increase saliva production and prevent dry mouth.
- Get regular dental checkups to maintain and improve your oral health.
If you suspect that you have a fistula on the gums, you must make an appointment with a dentist as soon as possible. If you have recently had a dental procedure, you should make sure that an abscess has not occurred. Even if you do not feel any pain, but feel the presence of a fistula or abscess, seek medical help.