SOFT
TISSUE INJURIES
The
soft tissues in the mouth are delicate and sensitive, and when
they are injured, it can be very painful. Soft tissues, which
include the tongue, cheeks, gums and lips, can be injured when
you accidentally bite down on them, if you fall, are in an accident,
or if you put food in your mouth that is too hot. Chewing on
hard objects also can damage soft tissues.
What
You Can Do
Soft
tissue injuries usually do not bleed a lot, but when they do,
the injury can seem worse than it really is. When the blood
mixes with saliva, it may look like you are bleeding a lot.
In most cases, the bleeding should stop within a few minutes.
In the meantime, here's what you should do:
-
Rinse your mouth thoroughly with a mild saltwater solution (1/2
teaspoon of salt in 8 ounces of water).
-
If the bleeding continues, press a damp piece of gauze against
the injured area for 10 to 15 minutes. If you don't have gauze,
you can use a sanitary napkin, tampon or a clean piece of material
that will soak up blood and saliva.
-
To relieve pain, slow the bleeding, and reduce swelling, hold
ice to the area for five or 10 minutes.
-
If the bleeding doesn't stop within a few minutes, the injury
may be serious and you will need to see a doctor, preferably
an oral and maxillofacial surgeon, right away. Maintain pressure
on the area until you can be treated.
What
Our Dentist Will Do
Our
Dentists are trained to diagnose and repair damage to the soft
tissues, but doctors and oral surgeons in hospital emergency
rooms usually handle serious injuries to these areas.
The
doctor or oral surgeon will wash the area thoroughly and determine
whether the teeth are loose or damaged. If the teeth are not
damaged and the injury is limited to the gum or other soft tissues,
you may need stitches to close the wound and control the bleeding.
In most cases, stitches will not be necessary, and the doctor
will only need to wash the area thoroughly and remove any dirt
or debris.
............................................................................
ABSCESS
When
tissues in the mouth are injured or get irritated, bacteria
may get into the area and cause an infection and a painful,
pus-filled swelling. If the pus can't drain, the area will get
more swollen and painful. This is known as an abscess. An abscess
is your body's attempt to contain an infection and prevent it
from spreading to other areas.
Abscesses
can form very quickly, often within 24 to 48 hours of when the
infection starts. There are two main types of abscesses:
A gum, or periodontal, abscess is usually caused by an infection
in the small space, or pocket, between the teeth and gums. This
may happen when food particles get trapped between the gum and
tooth. In more advanced cases of periodontal disease, bacteria
can build up in deep pockets under the surface of the gums.
A tooth-related abscess, called a peri apical abscess (located
at the tip of the tooth root), occurs within the tooth itself
when the nerve is dead or dying.
This type of abscess can spread to the bone surrounding the
tip of the root.
Most abscesses are painful, which means that people usually
get treatment right away. In some cases, however, the infection
causes little or no pain — or people ignore the discomfort and
wait for it to go away. This can result in a chronic abscess,
in which the infection lasts for months or even years.
When
abscesses aren't treated promptly, the infection can damage
nearby tissues or teeth. The build-up of scar tissue caused
by the infection may result in the development of a hollow tunnel
of tissue called a fistula or "sinus tract." Pus from
the abscess may drain through this "artificial" tunnel
to an opening on the surface, and may be seen in the mouth as
a pimple that comes and goes. People with sinus tracts may feel
a small bump in their mouths, or may have a strange taste in
their mouths due to the drainage of pus.
In
some cases, a chronic abscess can form a cyst in the bone. The
cyst hasto be removed surgically. There also are rare instances
in which the infection spreads to the surrounding tissues and
causes serious health problems.
What You Can Do
Abscesses
are always serious because the infection may spread to other
parts of the body.
If
you can see or feel a pimple-like swelling on the gum, you may
want to try rinsing your mouth several times a day with a mild
salt-water solution (1/2 teaspoon of salt in 8 ounces of water).
This may help draw the pus toward the surface and allow pressure
in the area to be relieved temporarily. In all cases of abscess,
you need to see your dentist as soon as possible.
What
Our Dentist Will Do
Most
gum abscesses will heal quickly once the area is cleaned thoroughly,
the trapped material is allowed to escape, and the source of
the infection is treated.
If
a sinus tract has formed, your dentist will need to trace it
back to the source of the infection. He or she will insert a
probe into the tunnel and take an X-ray to see where the infection
started. Once the source of the infection is identified and
cleaned out, the sinus tract usually will close on its own.
If
the infection started inside a tooth, your dentist may start
root canal treatment by making a small hole in the tooth to
allow the abscess to drain. This type of abscess typically occurs
only when the tooth nerve is damaged or is already dead. The
tooth will need a filling or a crown following successful root
canal treatment.
If
the abscess is severe or the tooth is badly damaged, you may
need to have the tooth removed.
Superficial
abscesses in the gums usually can be treated by cleaning out
the debris or bacteria that has become trapped and washing out
the area thoroughly. Your dentist or oral surgeon calls this
procedure aspiration, incision and drainage. More serious periodontal
abscesses often can be cleared up by the same method. However,
the periodontal disease that caused the infection will require
more intensive treatment to prevent another infection.
Your dentist may give you a prescription for antibiotics to
help the abscess heal and prevent the spread of the infection
to other parts of your body.
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