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Recognizing and Addressing Dental Fistulas

Mara Sugue
Written by
Mara Sugue
Khushbu Gopalakrishnan
Medically reviewed by
Khushbu Gopalakrishnan
DDS, UCLA School of Dentistry

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In this article

Have you noticed a small bump on your gums that occasionally oozes pus? You might be dealing with a dental fistula.

While the bump itself may seem small, the underlying infection can have serious consequences for your oral health.

Here we discuss what a dental fistula is, the causes, symptoms, and most importantly, the treatment options available to help you get back to a healthy smile.

How to Identify A Dental Fistula

A dental fistula is like a tiny tunnel that starts inside your mouth near an infected tooth and burrows its way outward. Its job is to drain the pus from the infection.

Dental fistulas are nearly always caused by an infection that’s been brewing beneath your gums. These infections are often caused by:

  • Advanced tooth decay
  • Severe gum disease (periodontitis)
  • Complications from surgical procedures
  • Trauma or injury

If you notice any of these symptoms, don’t hesitate to call a dentist:

  • Gum boil ⁠— A small, pimple-like bump on your gum, often near the base of a tooth. It might ooze pus from time to time.
  • Foul taste or smell — The pus leaking from the boil may leave a bad taste or smell in your mouth.
  • Discomfort — While the fistula itself isn’t usually painful, the infection causing it can throb, making it hard to eat or sleep.
  • Swelling — The infected area might become swollen, even spreading to the fascial spaces or lymph nodes in your neck.

Why Should You Get Treatment for a Dental Fistula?

Getting treatment for a dental fistula can potentially save the affected tooth. Although fistulas can temporarily relieve some of the painful pressure from an abscess, they don’t fix the underlying problem.

If ignored, the infection can get worse. It can spread and travel to other teeth or your jawbone. A chronic infection can also weaken the bone supporting your teeth, causing bone loss.

Fistulas can close on their own temporarily. However, the infection remains, so the fistula can flare up again.

Treatment Options for Dental Fistulas

Treatment for a dental fistula often involves addressing the infection causing it. The treatment you receive typically depends on the cause, location, and severity of the infection.

Your doctor might recommend antibiotics in conjunction with definitive treatment:

Once the infection is cleared, the fistula usually heals on its own. A minor surgical procedure might be needed to close it if it doesn’t heal.

How Are Dental Fistulas Diagnosed?

Diagnosing a dental fistula involves a multi-faceted approach to pinpoint the cause and extent of the infection. Here’s what you can expect during your dental visit:

  1. Thorough examination ⁠— Your dentist will carefully examine your mouth, looking for telltale signs like swelling, redness, and the fistula opening itself.
  2. X-ray imaging — An X-ray allows your dentist to assess the spread of infection, confirm the presence of a fistula, and identify its origin within a tooth.
  3. Advanced imaging — In more complex cases, additional scans (CT or MRI) may be recommended to help your dentist precisely pinpoint the infection’s extent and plan the most effective treatment.
  4. Symptom review — Your dentist will discuss your symptoms in detail, including pain, swelling, discharge, and overall discomfort. This helps determine the severity of the infection and tailor the treatment plan to your specific needs.

By combining these diagnostic tools, your dentist can confidently diagnose the dental fistula and recommend the best action to eliminate the infection and restore your oral health.

How To Prevent a Dental Fistula

Preventing a dental fistula also means preventing dental decay and gum disease. Here’s how:

  • Brush and floss — Try brushing for two minutes twice daily and floss regularly to reach the areas your toothbrush can’t reach. This prevents plaque buildup.
  • Regular dental checkups — Dentists can spot and prevent issues like cavities, gum inflammation, or tartar buildup.
  • Eat right — Eat leafy greens, dairy, fruits, and fortified foods. Avoid sugary or starchy foods, which can weaken tooth enamel.
  • Stay hydrated — Water rinses away food debris and helps keep your mouth’s natural defenses, including saliva, strong.

A dental fistula is not something to ignore. By recognizing the symptoms and seeking timely treatment, you can effectively address this issue and prevent further complications.

Remember, maintaining good oral hygiene and regular dental checkups are key to preventing dental fistulas and ensuring a healthy smile

Sources

  1. Lee et al. “Clinical Characteristics of Odontogenic Cutaneous Fistulas.” Ann Dermatol, 2016.
  2. Chouk C., & Litaiem N. “Oral Cutaneous Fistula.” Treasure Island (FL): StatPearls Publishing, 2023.
  3. Dental Fistula: Identify, Treat, and Prevent.” Colgate, 2023.
  4. Dental Fistula: What Is It?.” Colgate 2023.
  5. Dental Fistula: Identify, Treat And Prevent.” Sherwood Park Dental.
  6. Weinberg et al. “Sinus Tract vs. Fistula: There is a Difference.” The New York State Dental, 2023.
Khushbu Gopalakrishnan
Dr. Khushbu Aggarwal
Medical Reviewer

UCLA-trained dentist practicing in public health. Focuses on whole-body approach to dental care.

Mara Sugue
Mara Sugue
Writer

Web content writer specializing in making dental research accessible to diverse audiences.