Periostitis of the tooth, or flux,
is an inflammatory process that occurs in
periosteum jaw. As a rule, this disease becomes
a consequence of dental diseases, such as pulpitis or periodontitis.
It manifests itself in a pronounced swelling of the gums in the place of accumulation of pus,
while edema can spread to nearby soft
Know and understand the etiology
diseases means being able to prevent or
minimize its effects. Dental pathology more often
just serve as the beginning of periostitis. Everything can start from ordinary
caries, which will be a source of infection and predisposing
factor to the beginning of the purulent process.
Even now, when medicine has advanced far forward, and
painless manipulation has become commonplace, many
people are terrified of visiting dentists and bring to the point that the tooth
save almost impossible.
It should be understood that where there is an infection, there will be
inflammation, it will join the purulent process, resulting in
begin flux, the cause of which has become a banal caries.
Менее распространённая этиология периостита — перелом
или травма челюсти. In this case, the process takes place in
several times faster, because the soft tissues are damaged, and any
the wound surface is the gateway for pathogens.
ATоспаление надкостницы может возникнуть после
переливания крови, а также распространиться через
blood vessels from a nearby wound after injection into
the gum. it нередко можно встретить у детей ввиду их анатомических
It is no secret that many patients at the first symptoms of flux
try to help themselves at home and rarely turn to
to the doctor. Perhaps for some time the inflammation will be removed,
after which the pain will subside. But this does not mean that the disease is gone: she
lurking and continues to evolve, only in a sluggish form and with
Symptoms of the disease
Obviously, all the processes in our body are interrelated, so
the same can be described and diseases affecting a person.
A complete picture of the seriousness of pathology can only be seen
when there is an understanding of the mechanism of the disease. He has a flux
- the infection gets to the root of the carious tooth through its
- then destroys the root nerves;
- dead nerve tissue is an excellent breeding ground for
- then a territory is captured, which means that the tooth itself and
the tissues around it become dangerous to humans because they
concentrate the infection, which at any time can break out and with
blood flow spread throughout the body;
- inflammation passes to the periosteum, and this is periostitis.
Symptoms of flux may be associated with other diseases,
that is, to be their manifestation, but it is not necessary to exclude
individual features of a person. The combination of these factors
helps the doctor to make the correct diagnosis and find the original
cause of inflammation.
As a rule, periostitis is manifested
approximately in the following sequence:
- the pathological process begins with swelling of the gums and gradually
flows over the patient’s cheek;
- the person feels pain in the area of the affected tooth, aggravated
when pressed or chewed;
- 2-3 days later, the periosteum is affected, it forms
Depending on where the affected tooth is located, the process
may spread to the lips, neck, upper or lower eyelid.
Often, flux is accompanied by subfebrile temperature. Pus out
inflammation can erupt through damaged gum tissue in
the mouth, after which the patient will come temporary relief, and the tooth
болеть перестаnot. But after a while the inflammation will return with
new power. The long process can lead to
osteomyelitis of the jaw.
Periostitis after tooth extraction
Due to the fact that this pathology is part of the active process
при пульпитах в кариозном зубе, она довольно часто развивается
after dental extraction.
AT стоматологии принято различать несколько вариантов
- Acute serous periostitis. It has
rapid development (2-3 days), the main symptoms pronounced. AT
the periosteum is involved in the pathological process. Course of the disease
occurs with the formation of exudate. When the liquid is collected in
�A “pouch” (like a cyst), localized under the bone tissue,
necrotic bone damage occurs. ATозникновению этой
flux forms are usually preceded by caries, pulpitis or
непрофессиональное удаление tooth.
- Purulent periostitis in acute form. Patients celebrate acute
throbbing pain radiating to the ear, under the eye, and into the chin.
It must be remembered that in this case warming compresses do
It is impossible, because heat only accelerates the process, but the cold,
on the contrary, will help relieve pain. itт вид флюса появляется
в основном после травм и удаления tooth.
- Chronic form. Quite rare. Localized
usually in the lower jaw periosteum. Characterized by
sluggish symptoms, slight swelling, progressing to
for several weeks. Periostitis in this form is almost not
reminds of itself and is manifested by inflammation passing near
- Diffuse form of acute flux. Here the process is pretty
quickly, accompanied by high body temperature and acute dental
pain. The patient’s general condition is deteriorating;
Obviously, periostitis can occur in different ways. is he
depends on the individual characteristics of a person and diseases,
caused the development of pathological processes.
Most often, inflammation develops in the area of large molars and
wisdom teeth located on the lower jaw. In the maxillary
first molars are most vulnerable in the zone. Periostitis may be
due to a complex dentition or pathological bite, and
also inflammation of the tissues of the partially appeared teeth.
Diagnosis and treatment
At the first symptoms of flux, it is important not to delay the visit to
to the dentist. The longer the process develops, the harder it is
therapy, and the risks of complications increase dramatically. Visual inspection and
instrumental techniques such as x-rays or MRI will help the doctor
establish a diagnosis.
X-ray – a necessary study that will not give
skip incipient osteomyelitis of the jaw and allow the doctor
determine the localization of the inflammation. Very important
дифференциальная диагностика, потому как симптоматика флюса
похожа на проявления таких патологий, как:
- Periodontitis Inflammation of the tissue surrounding the tooth root
(periodontium). The process is local, edema develops in the same way as with
- Osteomyelitis of the jaw. Extensive purulent process involving
nearby healthy tissue.
- Abscess (cellulitis) – strictly localized infectious
- Lymphadenitis – affection of regional lymph nodes.
Treatment of flux on the gums is a rather long process, often
starting with the removal of the affected tooth. If the patient turned in
the very beginning of the disease, then after thorough cleaning and closing
Canal tooth can be saved. The doctor may also open
abscess, allowing you to get purulent content, while
drainage is installed to provide better fluid drainage, and
local antiseptics are prescribed.
inflammatory disease, purulent and septic complications
which are treated with antibacterial drugs.
Of course, the discovery of antibiotics has become a revolution in medicine. Their
use has led to a dramatic increase in survival
patients who were previously doomed to death. But there is also
its drawbacks are the emergence of some resistance
pathogens to common drugs.
By the early sixties of the last century, staphylococcus became
the main infectious agent causing periostitis and other
serious diseases, but by this time his strains became resistant
to antibiotics used at the time. This cocci forms whole
associations with other microorganisms, which creates difficulties in
treatment. On the other hand, streptococcus, next
the prevalence of the pathogen, died from penicillin then and in
Modern scientific approach to the treatment of periostitis does not imply
administration of shock doses of antimicrobial drugs, as was customary
previously, since such tactics may aggravate the process, as well as
cause allergic reactions in the patient. Now doctors use
препараты, имеющие тропизм к bone tissue. Called antibiotics
may vary in different ways, but they often contain such
substances like lincomycin hydrochloride and clindamycin. Therapy
prescribed a course of 7-10 days, while necessarily control
indicators of clinical blood analysis.
If there is confidence that the infection was caused
anaerobic microorganisms, then antibacterial therapy will be
consist of penicillin preparations or cephalosporins.
Self-treatment at home
Many people know or though
would represent what the flux looks like and can define it
symptomatology. Often they believe that this is not a dangerous condition,
so try to handle it yourself.
But periostitis is a serious disease requiring
medical treatment, and his home treatment should
take place under the supervision of a specialist. Пациенту следует чётко
выполнять рекомендации стоматолога. If periostitis is not
complicated, it is quite possible to treat it on an outpatient basis.
Typically, the use of nonsteroidal anti-inflammatory
means and various rinses of the oral cavity is aimed at
slow down the process and relieve pain. With purulent periostitis
surgical treatment is shown (it is necessary to open an abscess). Only
The doctor can assess the severity of the patient’s condition and prescribe
Alternative methods for treating flux include such methods
as applying cold to the affected area, application
various infusions and solutions for rinsing.
Acute purulent form
Therapy is carried out in a complex. The first step here is
operative intervention, the second – conservative treatment. Cavity
after opening the abscess is washed with antiseptic solution,
for example, furatsilinom, chlorhexidine, etc.
procedures usually do not require hospitalization of the patient.
Антибиотикотерапия заключается в назначении
сульфаниламидов. An approximate scheme of their reception looks like
as follows: the first day – 1-2 g of the drug, the second and
subsequent 0.5–1 g. Antibiotics are also included in treatment protocols.
penicillin and cephalosporins. Locally applied ointment
Levomekol or Levosin, as well as the special gel Metrogil
Separately, should be allocated periostitis after injury. This pathology
peculiar to athletes, but can occur in the form of complications
diseases such as syphilis, osteomyelitis and tumors. First
help is to ensure the rest of the damaged area and
applying cold. If signs of a purulent process are required
The disease is characterized by a slow inflammatory course.
process in the periosteum. The doctor will see on the x-ray
destructive bone and hyperplastic changes
Irrational treatment or a situation where the acute stage is erased
periostitis, the causes of the development of this form of pathology. For example,
the patient has not removed a bad tooth that cannot be cured due to
what appears on the periosteum painful thickening. it
education can be for a long time without visible changes,
only radiographs show a moderate destruction of the bone.
In the treatment of chronic flux, removal comes to the fore
tooth. After surgery, a course is prescribed.
Treatment of periostitis of the upper and lower jaw does not have
fundamental differences. All surgical procedures are performed under
X-ray control and local anesthesia.
Because of the physiological and
anatomical features of the inflammatory process in a child
runs much faster than an adult. Periostitis
children can be both post-traumatic and endogenous.
The onset of the disease is characterized by local manifestations, while
may increase overall body temperature to subfebrile
indicators. Further, asymmetric edema occurs (next to the affected
region), may increase and regional lymph nodes.
Ignoring the disease will lead to complications or transition.
process in a chronic form.
Parents should not give a child with a flux of hot drinks and
any medicines before consulting a doctor. Tactics
лечения флюса у детей такая же, как и у взрослых: удаление
очага инфекции и антибиотикотерапия. If necessary
reduce the body temperature or anesthetize the use of drugs
recommended for children, for example, Ibuprofen or
The main preventive measure is timely dental treatment,
periodontitis and pulpitis. It is very important to start fighting in time.
any foci of infection in the body, regularly observe hygiene
oral cavity and routinely visit the dentist. Use
by eating vegetables, such as raw carrots, as well as hard fruits,
for example, apples, allows you to mechanically clean the surface of the teeth from
Observing patients, dentists determined why some
people flux almost never occurs, while others regularly suffer
from jaw inflammation. The experts deduced simple rules, compliance
которых может предотвратить или снизить вероятность
- Thorough tooth brushing, including interdental spaces and
hard to reach places.
- Toothbrush should be medium hard or soft so as not to
damage the mucous membranes and gum tissue.
- Preference should be given to toothpaste containing
- It is useful to use balms and elixirs for rinsing the mouth.
after brushing, and also after eating, when you can brush your teeth
- It is necessary to monitor the condition of the gums. With their bleeding
нужно обратиться к to the dentist.
- Visit a dentist twice a year.
- To carry out professional cleaning of teeth from plaque and dental
It should be excluded from the diet foods that contribute
the destruction of enamel, for example, containing acids, is very hard and,
Of course, candy. Do not use toothpicks because they are
damage the gum tissue, and any wound surface is the entrance to
Time initiated treatment of periostitis
virtually eliminates the risk of complications. Full recovery
tissues will be after the patient undergoes a course of treatment. If everyone
do right, improvement will come within 2-3 days.
Since the edema takes about a day, you should not wait
instant recovery. After the doctor opens the abscess,
the patient’s condition may worsen. it связано с тем, что к
the wound surface is intense blood flow after
If you do not take any action, that is, do not go to
to the dentist and not to undergo treatment, the flux can lead to such
complications like fistula formation, development of an abscess,
Spread purulent process or chronic periostitis.
Modern medicine has extensive tools for complete
elimination of the inflammatory process and cure of periostitis.