Phlegmon. What it is, How to Treat it and How to Prevent it

Phlegmon is one of the most frequent dental emergencies in a dental clinic and if not treated in time it can lead to serious problems in the health of your mouth. boca.

From RASLAN, your family dental clinic in Barcelona, we want to send a message of the importance of regular check-ups to maintain a good level of oral hygiene and thus prevent the appearance of phlegmons or other types of oral pathologies, such as gingivitis.

If you have had any phlegmons, the pain you felt will surely come to mind. The main symptom of dental phlegmon is severe acute pain in the affected area as the infection grows and fills with pus over time.

Below we would like to explain what a dental phlegmon is, the types, causes, symptoms and how it is cured.

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What is a dental phlegmon?

A dental abscess, or more commonly known as a phlegmon, is an inflammatory oral condition of an infectious type that usually appears on the surface of the gum in less severe cases and in advanced cases, in the blood vessels and nerve inside the tooth.

Abscesses are spaces where pus and inflammatory tissue accumulate. The pus is generated due to a defense reaction of the immune system trying to fight the existing infection.

The openings in the tooth enamel allow bacteria to infect the center of the tooth or dental pulp. The infection can spread from the root of the tooth to the bones that support it, causing accumulation of pus and inflammation of the internal tissues of the tooth.

As the infection progresses, it expands radially, seeking the shortest exit route, generally towards the cortices that it perforates, but when it is retained in the periosteum, a subperiosteal abscess is formed.

The duration of a dental phlegmon is very variable. The time varies greatly depending on the severity of the infection, but we can say that the average duration is about four days, being noticeable after 48 hours.

What types of phlegmon are there?

Dental phlegmon can be subclassified according to its location into different types:

Gingival phlegmon (gum): It is an infection that has only reached the gum.
Periodontal phlegmon: Infection caused by periodontal diseases that reach the bone around the tooth and can produce destruction of the tooth-bone junction and the periodontal ligament. If the periodontal abscess is advanced, the tooth may have to be extracted.
Periapical Phlegmon: A periapical phlegmon is an infection that has reached the blood vessels, nerve and connective tissue. We are talking about an infection of the nerve cavity of the tooth, the dental pulp, and in most patients it causes intense throbbing pain.
Endodontic – Periodontal Phlegmon: This type of phlegmon is a combination of 2 types of periodontal and periapical locations. Here we find a tooth that has a nerve problem (tooth pulp) and periodontal disease. It is important to be clear about the difference between the two in order to understand the correct diagnosis and treatment for each case.

What is the cause of dental phlegmons?

As we have seen before, dental phlegmon is a bacterial infection, but what has caused this bacterial infection?

One of the main stimulators of dental phlegmons is a bad oral hygiene habit that allows the accumulation of bacterial plaque and tartar on the teeth and not having regular dental check-ups to prevent the most common causes of a phlegmon: caries, periodontal pathologies, previous dental treatments or dental trauma.

Caries associated with dental phlegmon:

This type of abscess appears in teeth with advanced caries. A carious lesion wears away the tooth, from the outermost surface (enamel) to the inner surface of the tooth (the pulp cavity or dental pulp), the area where the nerve of the tooth is located. Periapical phlegmon is caused by caries.

It is important to emphasize that not all cavities cause a dental phlegmon. If the caries is on the surface of the enamel or dentin, in most cases, only restorative treatment: resin fillings, inlays or crowns will be sufficient without the need to treat the nerve of the tooth.

Periodontal pathologies:

Bacteria act by entering the periodontium of the tooth: the gum, root cementum, alveolar bone and periodontal ligament mostly caused by an accumulation of dental plaque due to poor oral hygiene that causes gingivitis or periodontitis (periodontal disease or pyorrhea).

Dental treatments performed in the past:

Several scientific articles show a treatment failure ratio (low success rate) in poor dentures due to improper sealing of the restoration on top of the tooth leaving exposed spaces for bacteria to re-enter the tooth causing infection of the tooth.

Dental Trauma:

Accidents to the teeth can cause internal injuries inside the tooth such as fissures that are not visible to the human eye. It is important to visit a dental clinic when you have suffered a dental trauma to control the affected area and monitor its evolution over time. Upon impact, fractures can form in the tooth enamel creating enamel openings that allow bacteria to enter the inner layers of the tooth (dentin and dental pulp). On other occasions the tooth after receiving a blow becomes dark with time.

Symptoms of a phlegmon

From RASLAN Dental Clinic in Barcelona we insist on the importance of making an appointment as soon as possible to your trusted dentist when you think you have a phlegmon to solve the causes as soon as possible.

The swollen face due to phlegmon is usually the most striking sign of this condition. When phlegmon appears, swelling occurs in the affected area due to the accumulation of pus. Symptoms may vary according to the characteristics of the person and the severity of the process.

. The symptomatology of phlegmon is usually:

Constant and intense pain with dental hypersensitivity when you take something cold or hot. Toothache can reach the ear or throat.
Swelling due to inflammation that may affect the nerves of the face.
Fever
Weakness and feeling of being tired
Redness and bleeding of the gums
Oral trismus. Difficulty opening the mouth
Halitosis. Bad breath or taste in the mouth due to bacterial plaque, stored food debris or cavities in the mouth.

What is the treatment to cure a phlegmon?

In order to cure, or as many patients call it “lower a phlegmon” quickly, an early intervention by the dentist is essential to know what type of phlegmon you have and the causes that provoked it.

Before starting any treatment it is necessary:

Elimination of infection by antibiotics
Removing accumulated pus by means of drains to reduce inflammation.
Removing accumulated pus by means of drains to reduce inflammation.

After eliminating the infection and reducing the inflammation, the treatment you need will depend on the type of phlegmon and its condition:

Endodontic treatment known as root canal treatment or commonly as nerve killing. Reconstruction of the tooth and in certain cases when the tooth loss is extensive we will recommend an inlay or dental crown.
In cases of periodontal phlegmon or endoperiodontal periodontal treatment approach when its cause has been periodontitis or pyorrhea. In severe cases, tooth extraction will be necessary.

What to do if you have a phlegmon in the mouth

If you develop a boil, you should go urgently to a dental clinic you trust. Generally, at the first visit, they will drain the pus from the phlegmon and prescribe a specific medication to treat the pain and infection.

Secondly, it is necessary to make a diagnosis and analyze whether the problem is caused by a cavity or by a problem in the gums.

If it is a gum problem, we will recommend scaling and root planing to remove all the bacterial plaque between the gum and the bone that holds the tooth.

If the origin is a caries, its extent must be assessed to determine the most appropriate treatment. If the caries has affected the nerve of the tooth, endodontics and a correct dental restoration should be performed. If the infection has already affected the bone, extraction of the tooth may be necessary.

Therefore, it is always advisable to visit a dental clinic with a multidisciplinary team of dentists to provide the most conservative and effective treatment.

How to prevent tooth decay

To avoid the appearance of phlegmons, or any dental infection, you should follow a series of tips:

Maintain proper oral hygiene with two minutes of tooth brushing after every meal, accompanied by the use of dental floss and fluoride rinses.
Make regular visits to the dentist for a general check-up. At least once a year.
Remain attentive to the health of your teeth and self-examine your mouth to notice any sudden changes so that you can see your dentist as soon as possible.

In all cases, phlegmon requires professional dental treatment. That is, once it appears, there is no home remedy or natural solution that is able to cure it.

Therefore, it is necessary to visit the dentist as soon as possible. But, until that time comes, it is possible to alleviate pain and reduce inflammation using some home tricks.

Home remedies for phlegmon

Sure, on the Internet you can find a multitude of pages that contain a lot of home remedies to lower a phlegmon or to soothe a toothache, but resorting to these remedies will only delay the real solution.

Some things you can do at home to ease the pain until you see your dentist.

Apply ice or a cold compress to the inflamed area to reduce swelling.
Apply ice or a cold compress to the inflamed area to reduce swelling.
Heat a black tea bag and when it cools, place it on the phlegmon to deflate the area and drain the pus.
Dissolve a teaspoon of tea tree oil in a glass of water, moisten a cotton ball with the mixture and place it on the affected area to fight the infection.
Mix cloves with water. Apply on the phlegmon and leave on for 15 minutes. You can repeat the procedure three times a day.

But, remember that these home remedies can be very useful while you are waiting for your dental appointment (if you cannot go to a trusted emergency dentist) but, in no case, they are a substitute for dental treatment. Therefore, the sooner you get in the hands of your trusted dentist, the sooner you will eliminate the pathology and prevent it from developing into bigger problems.

Phlegmon. What it is, how to treat it and how to prevent it