Periostitis is a dental pathology characterized by an inflammatory process in the periosteum tissue that occurs in the lower or upper jaw. The disease affects people of reproductive age, but sometimes the flux( also known as periostitis) is diagnosed in elderly patients or children.
The disease is quite severe and is accompanied by a high intensity pain syndrome, which most patients can not cope with on their own. To prevent complications( for example, sepsis) it is important to seek medical care at the first signs of periostitis.
Content of the material
- 1 What is this disease?
- 2 Why does a periostitis appear?
- 3 Types and stages
- 3.1 Acute stage
- 3.2 Chronic stage
- 4 Symptoms and signs
- 5 Diagnosis of pathology
- 6 Pediatric perioditis
- 7 Treatment of periostitis of the lower jaw in adult patients
- 7.1 Video - Treatment of periostitis, causes and symptoms
- 7.2 First stage: operation
- 7.3 The second stage: drug therapy
- 7.4 The third stage: physiotherapy
- 8 When does the recovery come?
- 9 Can I do without an operation?
- 10 Prevention Measures
What is this disease?
Periostitis is a complication that accompanies infectious diseases of the oral cavity. Non-observance of personal hygiene, caries, poor oral care - all these factors contribute to the entry of bacteria into the dental canals and the dental root. As the inflammatory process develops, purulent contents form, which penetrates into the surrounding tissues: mucous membranes of the gums, bone tissue, etc.
To distinguish the flux from other dental diseases simply, as the suppuration rapidly increases in volume, breaks through, and a strong edema is formed at the site of the lesion. The patient's fever rises( sometimes to very high marks), symptoms of general intoxication appear.
Periostitis of the lower jaw in medical practice occurs several times more often than damage to the upper teeth. About half of all diagnosed cases of flux occur in the eighth teeth, as they are difficult to erupt, have anatomical structural features and are prone to infectious and inflammatory processes.
Why does a periostitis appear?
Dentists as the main cause of the disease called insufficient control over the condition of the teeth and poor oral hygiene. Most often, inflammation of the periosteum occurs as a result of untimely treatment of periodontitis and pulpitis, as well as in the presence of carious teeth( especially if the patient walks with sick teeth for several months or years).The ingestion of food residues in periodontal pockets, plaque formation also creates ideal conditions for the propagation of pathogenic microorganisms and infection of tissues.
Other causes of periostitis include:
- injuries of the lower jaw;
- angina and other infectious diseases of the upper respiratory tract;
- oral cavity furunculosis;
- blood poisoning.
Sometimes bacteria and microbes enter the dental canals through infected lymph, but this situation is extremely rare.
Because of the occurrence of periostitis, it is divided into 4 types.
|Pathology type|| Reason of occurrence |
|Inflammatory|| The most frequent type of disease. It arises as a result of complications in the untimely or inadequate treatment of dental diseases( most often pulpitis and periodontitis) |
|Specific|| Inflammation develops under the influence of general intoxication in systemic diseases of the body( eg, infection with Koch's rod) |
|Traumatic|| Surrounding tooth root tissues can be damaged as a resultmechanical action, but such a situation occurs extremely rarely( no more than 5-7% of cases) |
|Toxic||The reason for such a flubut becomes the entry of bacteria into the periosteum tissue for infectious diseases of the oral cavity or respiratory tract( stomatitis, tonsillitis, pharyngitis, etc.)|
Types and stages of
Flux can occur in the acute stage, in which the symptoms and signs of pathology are pronounced, and the selfthe current is characterized by an increased soreness of the tissues and the formation of edema, or a chronic form that doctors call sluggish. Each of the forms of the disease is characterized by clinical symptoms and has flow characteristics that must be taken into account when determining the methods of treatment and the selection of medication.
The acute stage of periostitis has two forms: serous and purulent. In the serous form, serous contents form - a physiological fluid that resembles the serum of human blood. After a while infiltration of the periosteum occurs - the bone tissue is impregnated with serous fluid, it becomes inflamed, a strong soreness appears. In the case of attachment of the bacterial flora, inflammation develops, and the pathology passes into a purulent form.
Purulent periostitis can occur with the formation of fistulous passages through which pus enters the oral cavity. If this does not happen, the pus accumulates in the periosteum, on the site of the lesion, a volumetric edema is formed, which in people is called flux.
If the patient does not receive the necessary treatment at the acute stage of the pathology, the inflammation takes a chronic form with flaccid symptoms and significant risks in the formation of complications. Chronic periostitis can be of several kinds. Classification of the disease is presented in the table below.
|Form of chronic periostitis||Description|
|Simple|| On the surface of the lower jaw begins to form a pathological tissue. The process is reversible, and with timely access to the surgeon, pathology can be avoided into other, more dangerous forms |
|Ossifying|| Characterized by abnormal bone material growth in the unchanged periosteal tissue and ossification |
|Fibrous||The periosteum tissue proliferation occurs, resulting in thickening of the|
Most often inIn medical practice, a limited periostitis of the lower jaw occurs when the lesion affects several teeth. In rare cases, the inflammatory process can cover the entire jaw - then they say that we are talking about a diffuse periostitis.
Symptoms and signs
Clinical symptoms differ depending on the form, stage of the disease, localization of the lesion, the state of the immune system and other factors. One of the first signs of inflammation of the periosteum is the swelling of the gums, which quickly spreads to surrounding tissues. The pain can be moderate, but when pressing on the place of the lesion the patient experiences intense pain, which is poorly controlled by drugs.
Among other signs of acute periostitis, we can distinguish:
- pulsating pain inside the damaged tooth;
- asymmetry of the face, which is the result of a plentiful edema;
- redness of the gums;
- swelling of the area around the affected tooth;
- increase in temperature to 38-38.5 degrees.
Important! Pain always appears on the side in which the inflammatory process is localized. Sometimes the pain syndrome can be moderate, but as the disease develops, the patient experiences severe pain that can extend to the area of the temples, neck and orbit.
Chronic periostitis has the same symptoms, but their severity is sharply reduced due to lack of an immune response. The temperature at this stage rises rarely and usually holds within the subfebrile values.
Diagnosis of pathology
In order to correctly determine the cause of pain, it is necessary to contact a specialist. For a start, you can go to the dentist-therapist, who will give directions to the X-ray and, according to his results, will redirect to a specialized specialist. If pain is accompanied by leakage of pus, swelling, or fever, you can immediately go to a dental surgeon or maxillofacial surgeon( these specialists are in district hospitals).
To clarify the diagnosis, a radiograph or tomography of the lower jaw is necessarily performed.
Important! Self-treatment of periostitis is unacceptable, as there is a high probability of confusing pathology with other dental diseases that have similar symptoms( periodontitis, phlegmon, lymphadenitis, etc.).The correct diagnosis can be made only by an experienced specialist after collecting anamnesis and studying the X-ray.
Periostitis in childhood
In childhood, the disease is rarely diagnosed, but sometimes the mandibular periostitis can even affect the milk teeth. Children often encounter an acute form, which is extremely painful and is characterized by rapid development. Several factors contribute to this:
- insufficient activity of the immune system( finally the immunity in the child is formed by 6-7 years);
- anatomical features of the structure of the teeth;
- increased supply of bone structures with blood in childhood;
- enhanced hydrophilicity( ability to absorb and retain fluids) connective tissue and mucous membranes;
- is an unfinished formation of the protective function of the lymphatic system.
Acute periostitis in the acute stage, diagnosed in the child, requires surgical treatment with surgical methods. After removal of pathological tissues and drainage of purulent contents, children are prescribed conservative treatment:
- diet, excluding the reception of lump food, requiring thorough chewing( mashed and ground porridge, mashed potatoes, soups);
- rinsing with decoctions or infusions of marigold, alternating chamomile, chamomile to prevent inflammatory reactions, disinfecting the oral cavity( babies who can not rinse their mouth by themselves can be treated with a tissue moistened with a saline solution);
- bed rest;
- increase in the amount of fluid consumed;
- physiotherapy treatment( UHF, laser therapy).
Important! Antibiotics for children are prescribed only in complicated cases. Do not give the child antibacterial drugs without prescribing a doctor - preventive antibiotic treatment should be performed according to strict medical indications.
Treatment of periostitis of the lower jaw in adult patients
Treatment of pathology in patients over 18 years of age is carried out in three stages, each of which has its own characteristics.
Video - Treatment of periostitis, causes and symptoms
First stage: operation
Acute purulent periostitis is a direct indication for surgical intervention. Manipulation is performed under local anesthesia. General anesthesia is used in exceptional cases, for example, with a strong fear of the patient and increased nervousness. With a special scalpel, the surgeon dissects the periosteal tissue, cuts the abscess, and drains the wound. During the operation, free outflow of pus is ensured.
The second stage: medical therapy
At this stage the following types of treatment are prescribed to the patient:
- application of sterile dressings impregnated with disinfectant solution or therapeutic ointments;
- reception of antibiotics for the prevention of complications and relapses;
- washing of the wound surface with antiseptic compositions.
The third stage: physiotherapy
To eliminate the pain syndrome after surgery and accelerate the regeneration( healing) of tissues, the patient is given physiotherapy treatment. Depending on the degree of the initial lesion, the depth of the incision, the postoperative condition of the patient, the doctor can prescribe the following procedures:
- laser treatment;
- current handling, etc.
When does the recovery come?
Significant improvement and elimination of symptoms of the disease comes already on 2-3 days after the operative treatment. On the full recovery can be said on the 7-10 day - it is at this time the patient ends up taking antibacterial drugs.
Despite the elimination of symptoms, a patient for 3-5 days is given a gentle regimen and a special diet to prevent complications and accelerate the regeneration of the periosteum.
Can I do without an operation?
Conservative therapy of mandibular periostitis is possible only at an early stage of formation( serous form).In this case, the doctor carries out the removal of pus from the dental canals with the subsequent installation of drainage for the outflow of exudate. Of great importance is correct sealing and follow-up, so patients with periostitis for six months are registered with the district dentist.
Improper treatment or untimely recourse to medical care can lead to serious complications - sepsis, osteomyelitis, etc. To prevent this, it is important to follow preventive measures aimed at preventing periostitis and other dental pathologies.
- Teeth cleaning should be performed after each meal. If this is not possible, at least remove large pieces of food by rinsing or dental floss.
- For cleaning teeth, you need to use a high-quality toothpaste, which is suitable for a particular type of teeth. It is best to choose a hygiene product, taking into account the recommendations of the treating dentist.
- Prophylactic examination should be carried out at least once every 6 months. This will help in time to identify existing problems and take measures to eliminate them.
- The food intake should include a sufficient amount of protein foods and foods containing calcium.
- Incorrect bite should be corrected at the earliest possible age. When wearing braces, teeth require increased care and thorough hygiene.
The main preventive measure is the timely treatment of any dental pathologies, injuries and infectious lesions of teeth and gums. Some of them suffer discomfort until the last, because they are afraid of a dentist. It is not right. Now all hospitals and clinics use modern anesthetic drugs, which completely eliminate any pain during treatment, so do not delay the trip to the dentist, especially if the tooth began to hurt, or increased bleeding appeared.