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.
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.
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.
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.