A Guide to Dental Cysts
A dental cyst is one of the most common problems resulting in patients needing to see an emergency dentist urgently, as it has the potential to cause sudden and unexpected pain in the affected area and can also spread to the jaw bone.
What is a dental cyst?
A cyst can form in any part of the jaw and it can quickly expand, damaging a lot of jaw bone in the process. A cyst is a closed sac and it may contain air, fluids, or semi-solid material. A collection of pus is called an abscess. Once formed, a cyst will have to be removed through a surgical procedure called cyst enucleation which can be carried out under local anaesthesia in the dental chair.
Problems caused by dental cysts.
A Dental Cyst could do the following:
- The dental cyst will occupy a space in the jaw and may displace or replace normal tissues and cause bone loss.
- Dental cysts may resorb (eat into) adjacent teeth or push the teeth out of their normal alignment.
- Cysts may cause expansion of the jaw bone, usually by painless expansion. That is why many patients are unaware that they have a dental cyst.
- Cysts may compress nerves and cause facial numbness.
Types of dental cyst.
There are many different types of dental cysts but the five most common types of dental cysts are:
- Periapical cysts – This type of cyst occurs around the root apex of a tooth usually as a result of infection within that tooth. If an infected tooth is ignored or treated with antibiotics only, eventualy it is possible to develop a cyst around the root. An untreated perioapical cyst will result in more bone loss around the tooth apex. An infected tooth should either have root canal treatment or extraction.
- Dentigerous cysts – This cyst occurs around unerupted teeth such as wisdom teeth that have not yet come through and causes bone loss in that region. A dentigerous cyst around a wisdom tooth, usually needs to be removed along with a wisdom tooth extraction.
- Lateral Periodontal cysts – This is a developmental cyst that is usually discovered on Xrays taken by dentists and typically does not cause any pain but causes bone loss. This cyst is usually removed by having a periodontal surgery procedure in the dental chair.
- Residual cyst – This cyst is a periapical cyst that persists after a tooth is extracted and is treated by surgical removal in the dental chair.
- Eruption cyst – This cyst usually affects children and occurs when a tooth erupts through the bone and tries to come through the gum too but does not quite manage to erupt through the gum. These cysts usually do not need treatment as they rupture by themselves as the tooth finally erupts into the mouth.
What are the causes of dental cysts?
Dental cysts can often be caused by dental injury or trauma but the most common cause is dental decay that leads to the formation of a cavity, which is usually the starting point of an infection.
A build-up of plaque in the mouth – caused by a lack of cleaning and an unhealthy diet – bacteria usually use sugars found in particular foods to form acid that can gradually erode through the protective layer of enamel and dentin found on the surface of teeth, until the inner pulp is exposed.
Patients can prevent the development of dental decay by maintaining effective oral hygiene routine, which consists of brushing and flossing, while improving their nutrition with more fruit and vegetables – something that could help their overall wellbeing.
Plaque and bacteria usually build up on the teeth every day and are particularly hard to reach on the molars at the back of the mouth.
What are the telltale signs of an abscess?
Cavities in the teeth often go unnoticed by patients and, while this should encourage many to attend dental appointments more frequently, patients may not actually experience any discomfort until the cavity reaches the inner pulp of the tooth – an area consisting of a collection of blood cells and nerve endings that keep the tooth alive.
Patients are also unlikely to feel anything when the cavity spreads through both protective layers of dentin and enamel that surround the vital substances within the mouth.
The pain caused by the infection of a cyst usually arrives suddenly, with one of the most common descriptions given regarding the feeling is that it is not localised. Discomfort often spreads across the cheeks, jaw and face – while the surrounding gums may become sore and swollen.
As a result, many patients could be unaware of the exact tooth that is causing the issue, but this can be determined by biting down on the affected area. Similarly, extensive decay can lead to the infected tooth becoming loose at an early stage.
What course of action should I take?
The type of treatment patients will receive usually depends on the type of cyst they have. Usually, an emergency dentist drains the pus from an infected cyst to relieve pain and pressure for those patients with an abscess.
An emergency dentist will clean the space where the abscess was previously located to remove any remnants of infection or other debris.
The treatment for a periapical abscess – which is formed due to an infection inside the pulp of the tooth – is even more complex than the other forms, with an initial X-ray required to identify its exact location. A root canal procedure will then be carried out after the cyst is identified.
Root canal treatment summary: During root canal treatment, the outer shell of the tooth is preserved following an infection so it does not need to be completely extracted. A hole is drilled inside the tooth to clean away any infected substances that are inside the pulp, which will be scraped out through the root.
Although the area is effectively “dead” – due to the removal of its blood supply and nerves – many patients select this option because it means they are able to continue to smile confidently, without the fear of any gaps.
Can a dental cyst return?
Patients who visit their dentist regularly will find they are able to monitor their oral health more effectively and receive the appropriate treatment should any issues arise.
If the infection does return, a number of complications can arise that affect the teeth and gums. While the affected teeth may need to be removed, the infection can spread from the tooth to the skin and cause discolouration, swelling and soreness around the face.
The jawbone can also be affected by infection in teeth, which can lead to the development of osteomyelitis that can result in very serious issues within the bone. The condition is a debilitating illness that can cause severe pain – with urgent treatment often required.