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What Is The Cause of Gum Pustules?

Related to teeth: dental pulp inflammation, necrosis, apical abscess, periodontal related, wisdom tooth related and other issues.

Not related to teeth: osteomyelitis, tumors or some infections after tooth extraction, infections after oral surgery, etc.

  1. Dental pulp disease
  2. Deep tooth decay (caries), causing infection of the pulp-dentin system inside the tooth.
  3. Cracked teeth: Cracked teeth cause the dental pulp to become sick.
  4. Severe periodontal disease: The tip of the tooth root is an open channel. Severe periodontal disease can also indirectly cause dental pulp disease. Therefore, we have a special term called “dental pulp-periodontal disease”.
  5. Trauma causes internal damage to the teeth: In addition to causing generalized tooth cracks, trauma can also cause absorption of the root of the tooth and block the operation of the pulp-dentin composite system.
  6. Tooth root absorption.

When the above reasons cause infection and illness of the pulp-dentin composite system inside the tooth, if not treated as soon as possible, the infection will continue to spread to the apex of the tooth and even run to the bone outside the apex of the tooth.

The tooth root is buried in the closed alveolar bone, a series of inflammatory reactions, which in turn causes the bone around the root tip to be eroded, destroyed, hollowed out, and gradually grow like a water ball. We call it inflammation around the apex, and some will become apical abscesses or even cysts.

Because the water polo in a closed space needs pressure to be released, a channel is formed, and the opening is on the gum or the skin outside the mouth. We call it pustule and sinus.

Then the patient will feel:

Early stage: In addition to the pustules and sinuses on the gums or the skin outside the mouth, there are usually few other discomforts and pains.

I often hear patients say, “The teeth are not in pain, just a pustule, which is good and bad. The pustules had disappeared, but they did not sleep well, and the pressure grew again. 』

This is mainly because the pulp nerve has been necrotic, that is, the wire that transmits the pain inside the tooth is broken, and of course there will be no pulp pain.

In the middle and later stages: As the disease progresses, bone destruction around the teeth becomes more serious, and there may be a risk of cellulitis, which may even drag on some structures such as nearby teeth, neural tube, nasal cavity, and paranasal sinuses.

At this time, the tooth itself may be painful, uncomfortable, the tooth shakes and becomes larger, or there may be symptoms of sinusitis and nerve palsy.

In severe cases: it hurts even without touching your teeth. The risk of systemic infection is greatly increased; and the alveolar bone is hollowed out due to invasion.

  1. Related to periodontal disease

The main reason is that the oral cavity is cleaned and the teeth are not in place, and plaque builds up around the teeth, thereby destroying the alveolar bones (bone) around the teeth and forming periodontal disease. Because the source of infection builds up around the teeth, the gums around the teeth become red, swollen, purulent, and pustules due to inflammation.

You will feel:

Early stage: Maybe the gums are inflamed, and the gums are red, swollen and swollen. It is easy to bleed when brushing or the gums will hurt.

In the middle and late stages: At this time, the bones around the teeth are destroyed, which becomes periodontal disease; of course, there will be toothache problems, and at this time, you will find that the gums are atrophy, the teeth become longer, the teeth between the teeth become larger, it is easy to plug food, the teeth shake, eat Loss of strength, disordered teeth, pus gums, pus gums, and bad breath.

Severe periodontal disease will destroy more alveolar bones, the nearby teeth will affect other tissues nearby, and may even be seriously infected, causing cellulitis and life-threatening.

How to check

Of course, most of the pustules caused by dental pulp diseases can be found in apical X-ray photography, but there are still some exceptions. At this time, dental cone beam computerized tomography auxiliary examination, that is, oral CT.

After using the instrument for pulp activity test and temperature test, we can find that the tooth activity is necrosis at this time, in most cases. After the pulp is necrotic, it is like the wire that conducts the pain inside the tooth is broken, and of course there will be no pulp pain or hot soreness.

Other related examinations are roughly as follows: knocking, palpation, pressure diagnosis, shaking test, occlusion examination, oral cleaning status, periodontal examination, periodontal pocket depth, microscope-assisted examination, etc.

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