Every part of the human body can be susceptible to disease, and our mouth is no exception. One of the most unpleasant conditions is jaw periostitis, also known as a dental abscess (gum boil).
What is it, and how should it be treated?
What Is Periostitis?
Periostitis is a general term for several conditions associated with inflammation of the periosteum. In a broader sense, periostitis may be caused by repetitive stress on tissues (for example, during running, jumping, powerlifting, and similar activities).
The oral cavity also contains tissues that are exposed to stress during chewing, eating, and even speaking. This is what causes jaw periostitis, which is commonly referred to as a dental abscess (gum boil).
More specifically, periostitis is an inflammation of the periosteum—the membrane that covers the outer surface of the bone. In the oral cavity, periostitis occurs when the periosteum of the jawbone becomes inflamed.
Symptoms of Periostitis
In most cases, a dental abscess is accompanied by pain. Because of the pain, you may find it difficult to eat, drink, or even speak comfortably. Patients also frequently complain of loss of appetite and chills. At a later stage, a lump develops on the gum.
The following symptoms may also occur:
- headaches;
- facial swelling;
- elevated body temperature;
- bleeding;
- bad breath;
- nausea.
In addition, the gums may become more sensitive to hot and cold temperatures.
Types of Periostitis
According to its symptoms and clinical course, periostitis is classified as either acute or chronic.
Acute periostitis may be serous or purulent.
Serous periostitis is characterized by the accumulation of serous (clear) fluid beneath the periosteum, leading to the formation of an abscess. The condition is accompanied by a high fever and acute pain. If left untreated, this type of periostitis may progress to a chronic or purulent form.
In acute purulent periostitis, pus accumulates in the tissues surrounding the affected tooth, resulting in loosening of the tooth, severe pain, and facial asymmetry.
The mechanism of acute periostitis can be explained as follows: suppose a patient has a focus of inflammation around the tooth roots or within the root canals. The resulting serous or purulent exudate (fluid that leaks from small blood vessels during inflammation) seeks an outlet and spreads toward the periosteum.
Acute periostitis is also classified according to the extent of the inflammatory process. It may be localized or diffuse.
In the first case, the inflammatory focus is confined to the area of a single tooth that caused the condition, whereas in the second case, the infection spreads throughout the jaw.
Periostitis may occur in either the upper or the lower jaw. An important factor in the clinical presentation of acute periostitis is which specific tooth caused the inflammation. This determines the direction in which the swelling will spread. For example, if periostitis develops as a result of inflammation of the upper incisors, the swelling will spread to the upper lip and the sides of the nose.
When the purulent process spreads to the periosteum from the upper molars, swelling may develop not only in the cheek and cheekbone area but also around the ear.
In the lower jaw, inflammation originating from the incisors and canines causes swelling of the chin and lower lip, while inflammation associated with the lower molars may spread to the cheek, chin, and cheekbone.
Another mechanism for the development of acute periostitis is the lymphogenous or hematogenous route. In this case, the infection reaches the periosteum through the blood vessels or lymphatic vessels. This type of periostitis is non-odontogenic, meaning that its cause is not related to the teeth.
The most common causes of this type of acute periostitis include:
- otitis;
- sinusitis;
- measles;
- scarlet fever;
- complications of acute viral respiratory infections.
Another cause of periostitis may be trauma to the jaw. This type is referred to as traumatic periostitis. In most cases, traumatic factors are responsible for the development of simple chronic periostitis.
The condition is accompanied by moderate swelling of the inflamed tissues and pain when they are touched. After appropriate treatment, the inflammatory process usually subsides, and the swelling gradually disappears.
In chronic ossifying periostitis, the symptoms may be less pronounced. However, without treatment, the jawbones may become deformed, leading to ossification and hyperostosis—excessive bone growth.
Causes of Periostitis
One of the most common causes of odontogenic periostitis (periostitis related to the teeth) is poor oral hygiene.
Other causes include:
- gum disease;
- dental caries;
- improperly fitted dental prostheses;
and other similar conditions.
A dental abscess may also frequently develop during the eruption of a wisdom tooth. Inflammation of the periosteum may also occur after improper root canal treatment or incomplete tooth extraction.
The development of periostitis may also be promoted by hypothermia (or overheating), excessive physical strain, and stress.
Treatment
Periostitis is a painful and unpleasant condition, so it should always be treated as soon as possible. We do not recommend treating this condition at home or using folk remedies. You should also never apply heat to the cheek or attempt to puncture the lump inside the mouth.
You should seek immediate dental care. Depending on the type and severity of the periostitis, the dentist may perform root canal treatment or adjust dental prostheses. If necessary, the tooth responsible for the inflammation may need to be extracted.
In some cases, surgical treatment of the jaw and drainage of the abscess may be required.
An important part of treating any bacterial infection is antibiotic therapy, and a dental abscess is no exception. Therefore, after completing the necessary procedures, the dentist will prescribe a course of antibiotics and provide the appropriate prescription.
What Happens If a Dental Abscess Is Left Untreated?
Leaving a dental abscess untreated can be life-threatening. Although this is a very unlikely scenario, it is important to understand that periostitis is always the result of a bacterial infection. If the abscess is not treated, the infection may spread through the bloodstream or the bones to other parts of the body.
Jaw periostitis can also occur in children with primary (baby) teeth, as dental caries can affect them as well. As a result, a dental abscess may also develop.
Therefore, if a child complains of tooth pain or pain in the mouth, you should seek dental care immediately.
How Can Periostitis Be Prevented?
There is no better advice than visiting your dentist regularly. Regular dental check-ups allow dental caries and other oral diseases to be detected and treated at an early stage before they lead to complications such as periostitis. It is also essential to maintain good oral hygiene every day.
Always remember that visiting your dentist should be your highest priority if you notice a dental abscess in your mouth.
This article does not replace a medical consultation. For complete and personalized information, please consult your dentist.