Topographic anatomy

The hard palate is formed by the palatine processes of the maxillary bones and the horizontal plates of the palatine bones. The mucous membrane lining the bony base of the hard palate from the side of the oral cavity, near the dentition and along the palatal suture line, firmly fuses with the periosteum. Submucosal tissue is completely absent in these areas. Throughout the rest of the hard palate, the layer of submucosal tissue is weakly expressed, with the exception of the area along the line of transition of the alveolar process of the upper jaw into the palatine process. The blood supply to the hard palate is carried out by the large and small palatine arteries (aa. palatinae major et minor).

The greater palatine artery, together with the nerve of the same name, emerges from the greater palatine foramen (foramen palatinum majus), the projection of which is 1-1.5 cm medial to the gingival margin of the third molar (Fig. 33). The lesser palatine foramen (the exit point of the artery of the same name) is located directly behind the greater palatine foramen. The anterior portion of the hard palate receives blood supply from the incisive artery (a. incisiva), which is a branch of the posterior artery of the nasal septum. Together with the incisive artery, the nasopalatine nerve (n. nasopalatinus) approaches the mucous membrane of the hard palate through the opening of the same name.

Foci of odontogenic infection in the area of ​​the teeth of the upper jaw, infectious and inflammatory lesions and infected wounds of the mucous membrane of the hard palate.

Characteristic local signs of abscess of the hard palate

Complaints severe throbbing pain in the upper jaw (palate), aggravated by eating and talking.

Objectively: in the area of ​​the hard palate there is a swelling or protrusion with clear contours. The mucous membrane over the source of inflammation is hyperemic, palpation causes pain. Fluctuation may be detected.

Pterygomaxillary, peripharyngeal cellular spaces, soft palate.

Technique for opening an abscess of the hard palate

1. Pain relief. When the abscess is localized in the anterior part of the hard palate, local infiltration anesthesia in combination with conduction anesthesia at the greater palatine foramen; when the abscess is localized in the posterior part of the hard palate - local infiltration anesthesia in combination with conduction anesthesia at the round opening according to S.N. Weisblat, or subtemporal anesthesia according to A.V. Vishnevsky against the background of premedication.

2. An incision in the mucous membrane of the hard palate through the inflammatory infiltrate along its entire length parallel to the course of the vascular bundle of the palate (Fig. 34).

3. Opening a purulent focus and evacuation of pus by spreading the edges of the wound using a hemostatic clamp.

4. Excision of a strip of mucous membrane 2-3 mm wide along the edge of the wound to ensure good constant outflow of inflammatory exudate without introducing drainage into the wound. Hemostasis.

Abscess of the soft palate (palatum motte)

Topographic anatomy

The soft palate forms the posterior and partially upper walls of the oral cavity. The soft palate consists of a fibrous plate (palatal aponeurosis) with muscles attached to it and a mucous membrane covering them above and below. The anterior edge of the palatine aponeurosis is a direct continuation of the posterior edge of the bony base of the hard palate. The posterior edge of the soft palate ends with a uvula, the lateral side of which has a pair of palatal arches on each side. The anterior arch (arcus palatoglossus) is directed to the lateral surface of the posterior part of the tongue. The posterior arch (arcus palatopharyngeus) goes to the lateral wall of the pharynx. Between the arches is the tonsil fossa (sinus), in which the palatine tonsil (tonsilla palatina) is located. The muscular layer of the soft palate is formed by: m. tensor veli palatini, m. levator veli palatini, m. palatoglossus, m. uvulae (Fig. 35). The blood supply is carried out by the branches of the greater and lesser palatine arteries, the branches of the arteries of the nasal cavity, and the innervation is carried out by the branches of the pharyngeal nerve plexus. To m. tensor veli palatini is a branch from the mandibular branch of the trigeminal nerve.

Main sources and routes of infection

Infectious and inflammatory diseases of the mucous membrane of the soft palate, infected wounds, hematomas (after local anesthesia), tonsillitis, peritonsillitis, pericoronitis.

Characteristic local signs of abscess of the soft palate

Complaints of sore throat, worsening when swallowing or talking. Objectively: asymmetry of the pharynx with a displacement of the uvula of the palate to the healthy side. The affected part of the soft palate is increased in volume due to inflammatory infiltration of its tissues, the mucous membrane covering it is hyperemic. Pressure on the infiltrate (with an instrument, during palpation) increases pain.

Ways of further spread of infection

Peritonsillar and peritonsillar spaces.

Technique for opening an abscess of the soft palate

1. Anesthesia - local infiltration anesthesia (preliminary application anesthesia with a 1% dicaine solution can be performed) against the background of premedication.

2. An incision in the mucous membrane through the top of the inflammatory infiltrate (swelling) along its entire length parallel to the palatine arch (Fig. 36).

3. Separating the edges of the wound and moving towards the center of the purulent-inflammatory focus by tissue separation using a hemostatic clamp, evacuation of pus.

4. Since drainage in the wound of the soft palate is poorly maintained, in order to prevent premature adhesion of the edges of the wound, you can excise a strip of thinned mucous membrane along the edge of the wound 2-4 mm wide, or periodically spread the edges of the wound.

Abscess, Oral abscess, Palate abscess, Cheek abscess, Tongue abscess, Alveolitis, Jaw dislocation, Chronic odontogenic sinusitis, Gingivitis, Bad breath, Toothache, Tartar, Caries, Jaw cyst, Bleeding after tooth extraction surgery, Bleeding gums, Non-carious lesions of teeth, Tumors of the maxillofacial area, Periodontitis, Mumps (non-epidemic), Jaw fractures, Periodontitis, Filling, Teething, Difficult eruption of wisdom teeth, Pulpitis, Oral sepsis, Stomatitis, Dry mouth

Chapter IX. Dentistry

Dentistry is a branch of medicine that combines various diseases of the maxillofacial area, oral mucosa, teeth and neck. Among all human ailments, the most common are dental lesions, neglect of treatment of which leads to various complications of an inflammatory nature (abscess, phlegmon, osteomyelitis) that threaten human health, and in severe cases, life.

With diseased teeth, even if several are missing, the act of mechanical processing of food is not perfect, which affects the condition of the stomach and intestinal tract and contributes to the occurrence of gastritis, gastric ulcers, and duodenal ulcers.

According to statistics, traumatism is very high, including the face, where fractures of the facial skeleton predominate: the lower and upper jaws, the zygomatic bone, the nose, and the orbit. Properly provided pepper care - its methods are outlined in this chapter - will alleviate the fate of the victim and improve the prognosis of treatment.

The occurrence of tumor processes in the maxillofacial area is a common occurrence. Knowledge of their signs will allow you to contact specialists even in the early period of tumor development and ensure a more favorable outcome.

Dentistry also affects very common, alarming phenomena for a person such as toothache, bad breath, bleeding from the gums and after tooth extraction - everything that disrupts the usual feeling of health and beauty of the face.

Abscess. Limited accumulation of pus in tissues that occurs during inflammation. In the maxillofacial area, as a rule, it is a consequence of complicated dental disease. It can also be caused by a boil, sore throat, damage to the skin or mucous membrane of the oral cavity, introduction of bacteria into the tissue by a syringe during anesthesia, etc. An abscess can also form as a result of infection through the blood or lymph flow during common infectious diseases (influenza, etc.).

Symptoms and course. Usually the abscess is preceded by toothache, characteristic of periodontitis (see). It appears in the area of ​​a certain tooth, biting on which causes increased pain. Soon a swelling of the soft tissues and a thickening appear, painful when touched. If an abscess develops under the oral mucosa, bulging and redness are visible upon examination. When the abscess is located closer to the skin (face and submandibular region), the picture is similar.

The progression of the purulent process is accompanied by a deterioration in the general condition, an increase in body temperature, disturbances in appetite and sleep. To remove the source of infection from a diseased tooth, and most importantly to prevent its spread to the surrounding tissue and area, it is necessary to promptly open the abscess by a doctor. Otherwise, the possibility of limited inflammation developing into diffuse inflammation with its transition to phlegmon cannot be ruled out.

The development of an abscess can lead to pus leaking out or into the oral cavity. The discharge of pus relieves acute symptoms, pain subsides or disappears, normal contours of the face or oral mucosa are restored, and general well-being is stabilized. This outcome should not be reassuring, since the process continues, but in a chronic stage. In the future, it can worsen, and this is pus from the fistulous tract with bad breath, sensitization of the body with toxic decay products.

Treatment. The speed of development of the process gives reason to strongly recommend not to delay contacting the dentist. Before this, as relief measures, you can use painkillers, warm mouth rinse, and a thermal bandage. Taking antibiotics and other strong drugs without prescription is not recommended.

Below are the features of process recognition depending on the place of its occurrence and the most common localizations.

Abscess of the floor of the mouth - characterized by the appearance of redness in the sublingual area, and soon a thickening, which is very painful when irritated during conversation and eating. The tongue becomes less mobile and is raised upward. Gradually, the swelling of the floor of the mouth increases, and the general condition worsens. An independent breakthrough of pus into the oral cavity is possible, and although the acute symptoms then subside, at this moment the spread of pus into the peripharyngeal region and neck is extremely dangerous. Therefore, waiting for spontaneous opening is unacceptable. Seeing a doctor is mandatory.

Abscess of the palate. It usually occurs as a complication of periodontitis of the teeth of the upper jaw. More often the cause is the second incisor, canine or second premolar. The disease begins with pain in the hard palate and redness of the mucous membrane. When it bulges, the pain becomes most intense. Eating becomes difficult.

Spontaneous opening of the abscess is possible, after which relief occurs. However, to prevent the possible spread of the abscess to a large area of ​​the hard palate and the development of osteomyelitis of the palatine plate of the bone, opening the abscess in a clinic setting is indicated.

Before consulting a doctor, you can use painkillers and warm rinses.

Cheek abscess. Depending on the depth of development of the process, swelling and redness will be more pronounced either on the side of the skin of the cheek or the mucous membrane of the oral cavity. The PAIN is mild, but intensifies when opening the mouth. The general condition is moderately impaired. The spread of the abscess to neighboring parts of the face is dangerous. Before contacting a doctor (mandatory), it is recommended to take a pain reliever, a thermal bandage, and rinse your mouth.

Tongue abscess. It begins with the appearance of pain in the thickness of the tongue, which quickly grows. The tongue increases in volume, as if raised, and has little mobility. It becomes very difficult to chew and swallow; breathing is often impaired, in rare cases to an extreme degree, when a feeling of suffocation occurs.

Urgent hospitalization is indicated to take emergency measures.

Alveolnt. Inflammation of the jaw socket as a result of infection after traumatic tooth extraction. In this case, damage to the socket itself and crushing of the surrounding gums are often observed. It can also develop as a consequence of a violation of the postoperative regimen, when the blood clot is washed out of the hole by actively rinsing the mouth, microbes penetrate into it, causing inflammation. Food getting into the socket and lack of oral hygiene also contribute to the occurrence of alveolitis.

Symptoms and course. The disease often begins 2-3 days after surgery (the appearance of severe pain in the area of ​​the socket of the extracted tooth, an increase in body temperature dc 37.5-38.5 ° C. Gradually the pain intensifies, spreading to neighboring parts of the head. A bad odor appears from the mouth. In the submandibular areas the lymph nodes become enlarged and painful. The duration of the disease is up to two weeks.

Treatment. At home, before consulting a doctor, which is necessary when the symptoms described above appear, frequent rinsing of the mouth with a warm solution (3%) of hydrogen peroxide, baking soda (1/2 teaspoon per glass of water), and painkillers is recommended. Alveolitis can be complicated by osteomyelitis of the socket, which lengthens the time of illness and rehabilitation of the patient.

Dislocation of the jaw. The causes of dislocation of the lower jaw can be varied: a blow, strong opening of the mouth during yawning, screaming, vomiting, during tooth extraction, when biting off a large and hard piece of food, etc. It occurs more often in women due to the shallower depth of the articular fossa and the severity of the bone tubercle, as a result, the articular head of the lower jaw moves more easily. If this is an anterior displacement, then they speak of an anterior dislocation; if it is backward, then a posterior dislocation; there are bilateral ones, which are common. A habitual dislocation is diagnosed when it occurs repeatedly.

Symptoms and course. When the lower jaw is dislocated, the picture is quite typical. The victim complains of pain, inability to close his mouth and eat, and speech is difficult. Any attempt to close the mouth is unsuccessful and is accompanied by increased pain. Therefore, if your jaw is dislocated, you should not try to straighten it yourself; this will only exhaust the person.

Treatment. Emergency assistance from a doctor is needed, who, using pain relief, will apply knowledge of certain techniques. It is not worth refraining from timely measures, since it will be much more difficult to straighten the jaws in the future.

Chronic odontogenic sinusitis. Inflammation of the mucous membrane of the maxillary sinus, resulting from the formation of communication between the maxillary sinus and the oral cavity after the removal of molars or premolars of the upper jaw. Similar messages arise when in some people the roots of these teeth penetrate into the maxillary sinus and are separated from it only by the mucous membrane or a thin bone plate. In this case, even with a very careful operation, the integrity of both the bone plate and the mucous membrane separating the maxillary sinus from the apex of the tooth root is compromised. Through this anastomosis that occurs after tooth extraction, bacteria penetrate from the oral cavity, causing inflammation of the sinus.

Attempts by dentists to suture the gum mucosa immediately after the formation of an anastomosis to close the communication do not always end well. More often the fistulous tract remains.

Its signs are very clear. When liquid food is taken, some of it enters the nasal cavity. If you exhale air through the nose, after closing the nostrils with your fingers, the air will exit into the oral cavity through the fistula opening. In addition, a clear or cloudy liquid is sometimes released from the fistula into the oral cavity - a product of inflammation of the maxillary sinus.

Treatment only surgical in a hospital setting

Gingivitis. A type of stomatitis when the mucous membrane covering the alveolar process of the jaw is affected. In addition to the general causes that cause diseases of the membrane of other localizations (see Stomatitis), the most common is dirty oral contents, the presence of dental plaque (see Tartar)

Symptoms. During the examination, redness and swelling of the gums are noticeable; slight bleeding is possible when eating and brushing. If oral hygiene is not observed, the gums become covered with plaque, ulcers, areas of tissue necrosis, and bad breath occur. The disease can spread to other parts of the oral mucosa.

Treatment: systematic dental care, rinsing, removing tartar, treatment of parodontitis, gentle diet.

Smell from the mouth. It occurs primarily due to unsystematic oral hygiene. Particles of food remaining after ingestion in the interdental spaces, as well as in carious teeth, deflated epithelium of the mucous membrane are exposed to bacteria that are abundant in the oral cavity. The breakdown of food proteins and epithelium occurs and their subsequent decay, which causes the appearance of odor. In addition, it can be caused by an inflammatory process in the tissues surrounding the tooth (see Periodontitis), damage to the mucous membrane of the oral cavity, tongue (see Gingivitis, Stomatitis), and also, in rare cases, stomach disease (gastritis).

Prevention and removal of odor mainly comes down to regular oral care. It is necessary to brush your teeth in the morning and evening: the movement of the toothbrush should be both horizontal and vertical to thoroughly remove food debris from the interdental spaces. This can be helped by using toothpicks and rinsing your mouth with water after eating. It is effective to use solutions of scented substances: mint, special deodorants. For diseases of the oral mucosa, tissues around the tooth, and stomach, special treatment is indicated.

Toothache. Unpleasant and often unbearable sensations caused by irritation of sensory nerves. The role of irritants can be a blow, burn, injection, inflammation, injury, etc. It is usually a manifestation of dental disease.

If the integrity of the hard tissues of the tooth (enamel, dentin) is damaged, pain occurs only when taking cold or hot water, sour or sweet food. With the removal of these irritants (rinsing the mouth with warm water), the pain stops.

In cases where it occurs independently, often intensifies at night and spreads to the areas surrounding the tooth, acquiring a diffuse character, it should be assumed that we are talking about the occurrence of acute inflammation of the dental pulp - the dental pulp. In this case, the pain is long-lasting and often excruciating. Count on stopping it by taking painkillers - analgin, etc. - even in large doses, it’s not necessary. Recommendations for introducing various agents into the cavity of a diseased tooth (alcohol, analgin, aspirin, etc.) are also erroneous. The most that can be achieved is to slightly reduce its intensity.

It is possible that the pain itself will decrease or stop when destructive phenomena destroy the bridge between the carious cavity and the pulp chamber of the tooth. In this case, the acute period of pulp inflammation passes into the chronic stage, which is accompanied by subsidence or disappearance of pain. However, the pathogenic lesion continues, spreading to the entire dental pulp, including the pulp in the root canals of the tooth, and then to the surrounding tissue. The transition of purulent inflammation beyond the tooth is called acute periodontitis. In this case, the painful sensation is characterized by independent occurrence, precise localization in the area of ​​the tooth; touching it, especially tapping, causes a sharp increase in pain. Painkillers can reduce it and even remove it. But you cannot count on a cure without the participation of a dentist; it is necessary, and in the coming days, to prevent possible serious complications - abscess, phlegmon, osteomyelitis.

Thus, being the most common signal indicating tooth disease (see Caries, pulpitis, periodontitis), toothache at the same time can also be the result of injury when the breaking off of part of the crown exposes dental pulp (pulp), rich in nerve endings. The slightest touch to it causes severe pain. Only a dentist can provide assistance in this case.

It should be borne in mind that a jaw tumor, inflammation of the maxillary sinus, nerves, or disease of the central nervous system can create the impression of toothache. Therefore, pain in the dentofacial area should be assessed by a doctor to identify its cause and not be considered only as dental pain.

Tartar. More than 80% of people have dental deposits called “tartar.” It consists of food debris, epithelium (deflated), bacteria, phosphorus salts, calcium, etc. Its formation begins with the accumulation of soft plaque on the rough surface of the tooth neck, onto which lime salts are deposited. As this formation thickens, it covers the gingival part of the tooth with a “muff”. Most often, tartar occurs on teeth that are less involved in the act of chewing, which makes their natural cleansing more difficult.

The causes of tartar are poor oral hygiene, the habit of eating only soft foods, and chewing on one side. Metabolic disorders, primarily salt metabolism, can become a common cause of dental plaque.

With a disease of the periodontal tissues (parrdontitis), stone forms under the gum: between the root of the tooth and the wall of the alveolus, which contributes to a more aggressive development of periodontitis (previously this disease was called alveolar pyorrhea).

If you have tartar, you must contact your dentist to have it removed. Otherwise, various complications are possible - the occurrence of a focus of chronic inflammation of the gums, bad breath, intoxication of the body.

Prevention comes down to hygienic measures, eating solid foods (apples, carrots, cabbage, etc.) along with soft ones.

Caries. Common disease affecting 95 % of people. It is based on the destruction of hard tooth tissues: enamel and the underlying dentin. The reason has not been fully clarified. However, irregular dental care is a predisposing factor.

Symptoms and course. Caries occurs gradually: a pigment spot (first white and then yellow) appears on the surface of the enamel of a tooth. Soon it turns brown. Subsequently, the enamel is destroyed, and then the dentin. The process usually proceeds slowly, in more rare cases - quickly. The resulting cavity, first in the enamel and then in the dentin, progresses in depth and width. Remains of food in it serve as a breeding ground for bacteria that are abundant in the oral cavity. The rotting they cause aggravates its unhygienic condition. An unpleasant odor occurs.

Tooth caries is accompanied by characteristic pain. Quite acute pain occurs when eating cold, hot, sour, or sweet foods. It quickly disappears after eliminating these factors (rinsing the mouth with warm water). A person, unfortunately, adapts to the “conditions” of food, excluding temperature and chemical stimuli. He develops an erroneous belief about complete well-being and considers going to the doctor unnecessary. At the same time, the destructive process continues, which leads to significant destruction of the tooth crown and the spread of the process to the dental pulp - the pulp. This, in turn, complicates tooth treatment and reduces the possibility of saving it.

And this is extremely important. Teeth that are destroyed or removed not only distort the act of chewing, speech phonetics, and appearance, but also have a detrimental effect on the condition of the stomach. Poorly chewed food can cause gastritis, stomach ulcers, etc.

Treatment. A timely visit to the dentist is absolutely necessary when signs of dental caries appear. Its functional effectiveness will be restored: the destroyed enamel and dentin tissue will be economically removed and the integrity of the crown will be restored using filling material. In certain regions of the globe, where drinking water contains less fluoride salts than the norm, particularly active dental caries is observed in the entire population. In such cases, measures are recommended aimed at artificially introducing fluoride salts into the human body by including them in table salt or centralized fluoridation of drinking water.

Jaw cyst. It usually occurs as a complication of dental disease, which results in the development of a chronic inflammatory process at the apex of the tooth root with the formation of a cyst. In very rare cases, it arises from the membrane of the follicle surrounding the crown of the tooth, when the process of its eruption is disrupted. Therefore, such a cyst is called follicular.

In contrast, root disease is much more common, since dental disease many times exceeds the number of cases of difficult eruption. A root cyst develops against the background of chronic inflammation (see Periodontitis) and grows slowly but steadily. Increasing in volume, it constantly puts pressure on the surrounding bone tissue, which is forced to “retreat”, making room for the growing cyst.

Little or no manifestation of the cyst is visible only when a protrusion of the jaw appears with thinning of its outer dense bone plates, which is noticed by the patient himself or those around him. Often, when X-raying the jaws for one reason or another, a cyst is discovered as an accidental finding.

Its growth sometimes causes such significant destruction of the jaw bone that it leads to spontaneous fracture. In addition, penetration of pyogenic microbes into the cavity of the cyst can cause a severe inflammatory process involving the bone marrow of the jaw and the development of osteomyelitis. It is possible that a root cyst, as a long-term process, can degenerate into a cancerous tumor.

Treatment cysts - surgical. For small sizes, it is permissible to perform the operation on an outpatient basis. Recommendation: periodic monitoring (once a year) of the dentofacial system using radiography.

Bleeding after tooth extraction surgery. Usually, surgical intervention is undertaken when therapeutic measures have not produced the desired results, and saving the tooth can cause an acute purulent inflammatory process. Teeth that are subject to removal are decayed, incorrectly erupted, highly mobile, etc. During the operation, damage occurs - rupture of blood vessels, which causes moderate bleeding from the socket of the extracted tooth and usually stops after applying a gauze ball after 10-15 minutes. However, in some cases, bleeding can be significant, occurring immediately after surgery or some time later, as a result of difficult removal, rough intervention, or dilation of small injured vessels, which sometimes happens after the use of adrenaline for pain relief. It can also be caused by a blood clotting disorder. If bleeding occurs immediately after tooth extraction, the doctor will find a way to stop it. It is more difficult when it occurs after a certain time, i.e. outside the clinic. The cause of such bleeding can be a variety of circumstances: violation of the regime (rinsing the mouth, eating hot food), increased blood pressure, disintegration of a blood clot.

First aid. You must try to stop the bleeding yourself. To do this, it is better to make a small tampon out of gauze, place it on the cavity of the extracted tooth and bite it, closing your teeth. The tampon should rise up to the level of the hole: the higher the tampon, the greater the pressure on the blood vessels when the teeth are closed. In a position with clenched jaws, you need to lie down or sit down, relax and calm down. If after 15-20 minutes the bleeding still continues, threatening a large loss of blood, you need to consult a doctor, and at night - to a surgical duty hospital where there is no dental hospital. An increase in blood pressure, the disintegration of a blood clot in the hole as a cause of bleeding will require not only local, but also general treatment methods.

Bleeding gums. The result of a disease of the mucous membrane of the gums and can be the result of not only a local but also a general illness of the body.

Bleeding usually occurs when brushing your teeth. Sometimes eating food can cause blood to appear in the mouth. It flows from the edge of the gum when its mucous membrane is inflamed (see Gingivitis). Particular attention is required in cases where oral care is sufficient, but vascular changes in the gums persist or reappear, and bleeding continues. The reason for this may be various general diseases: blood, endocrine, acute respiratory infections, influenza, vitamin deficiency, etc. Swelling and an increase in the volume of the interdental papillae of the gums often accompany pregnancy.

In cases where the disease worsens, bleeding occurs even with minor trauma, or even without it, on its own. Treatment and medical supervision are necessary. At home, you should maintain oral hygiene.

Necarnosial lesion of teeth. Diseases of non-carious origin can be the result of either a malformation of the tooth or damage to it after eruption. Disturbances in the development of teeth manifest themselves in the form of different types of changes in the enamel: normal color, underdevelopment, absence of it, or, conversely, an excessive amount in the form of enamel drops. Manifestations can occur on most teeth or on individual ones. Anomalies in the shape of teeth are often observed.

It happens that pigment spots or streaks appear on the enamel, more often on the incisors, less often on other teeth. Sometimes defects occur in the form of enamel erosion. The reason is an excess of fluoride salts in drinking water. Hence the name of the disease - fluoroe (in Latin fluorine-fluorum). It is detected already in childhood on permanent teeth. Pigmented spots and stripes (stripes) create significant cosmetic inconvenience. And in cases of erosion, conditions arise for the destruction of the tooth enamel. The disease is often endemic, i.e. affects the population of a certain region, where one liter of water contains more than 1-1.5 mg of fluoride salts.

Centralized technologies have been developed to reduce their levels in drinking water. Existing changes in tooth enamel can be treated cosmetically by a dentist.

TUMORS OF THE MAXILLOFACIAL AREA.

With a wide variety of tumor processes affecting the maxillofacial area, it is advisable to distinguish two groups: benign and malignant. This division is arbitrary, given the frequent degeneration when a “good” tumor, under the influence of characteristics characteristic of its location, acquires the qualities of “evil” growth. Therefore, every neoplasm that appears on the face, neck, or in the oral cavity should be the reason for mandatory consultation with a dentist and oncologist.

Benign processes can be localized on the skin of the face, on the mucous membrane of the oral cavity, lips, in the thickness of soft tissues and jaws. When located superficially, they are easily identified. The interstitial position creates an area of ​​bulging and asymmetry. Among the benign ones, the most common are papilloma, fibroma, atheroma, cyst, and supragingival. A tumor in the oral cavity is subject to constant trauma from a food bolus when chewing, teeth, or talking. Its systematic irritation can stimulate its degeneration into a malignant one. Education itself... protruding into the oral cavity will create inconvenience of both a functional and cosmetic nature, but will not cause any disturbance in well-being. In rare cases, an increase in its size can injure some nerve branch with moderate pain. Tumors located in the thickness of the jaw bones can thin them, deform them, and sometimes cause a fracture of the jaw.

Malignant neoplasms The maxillofacial region accounts for about 20% of the total number of cancers and sarcomas affecting humans. 90% of skin cancers occur on the face. To date, there is no clear causal understanding. However, it is quite obvious that a number of factors, acting on tissues, induce their cells to malignant growth. These include the habit of excessively hot or cold food, spicy or rough, smoking - active or passive (inhalation of tobacco smoke), prolonged mechanical irritation of the oral mucosa, tongue with the sharp edge of a decayed tooth or poorly fitting denture, exposure to acid or alkali at work , chewing tobacco, etc. In some cases - long-term chronic inflammation (periodontitis, sinusitis, cyst), genetic prerequisites. The most common localization of malignant neoplasm is the lip, mucous membrane of the oral cavity, and tongue.

Lip cancer. As a rule, it is located on the lower lip, more often in men. The predecessor is often a fissure that does not heal for a long time, which later takes on the appearance of an ulcer that bleeds easily. At the same time, an infiltrate occurs, which tends to spread, causing the lip to increase in size. Her mobility is limited. The tumor eventually metastasizes to the lower jaw bone. Its cells are transported by lymph to the mental and submandibular lymph nodes. They enlarge and become inactive. The progression of the process leads to the emergence of new malignant foci in the lymph nodes of various parts of the patient’s body.

Early recognition and treatment lead to the most favorable results. At the first sign (a non-healing lip crack or a tumor formation in its thickness), it is necessary to immediately contact a dental surgeon or oncologist.

Cancer of the oral mucosa. The tumor can develop on the mucous membrane of the cheeks, alveolar process, soft and hard palate. The first sign is often the appearance of epithelial growth on the mucous membrane in the form of a brush or wart;

sometimes redness in a certain place, where erosion then occurs - a defect in the mucous membrane, and then an ulcer. When palpating the area around it, tissue compaction is determined. Relatively early, cancer cells spread through nearby lymph nodes into surrounding tissues, including the tissue of the upper or lower jaw.

Deserves special attention leukoplakia - damage to the mucous membrane, which; may suddenly disappear, and then appear again in the form of a whitish spot located on the mucous membrane of the cheeks, often along the closure of the molars. Leukoplakia is an area of ​​keratinization and desquamation of the epithelium of the mucous membrane and occurs due to constant irritation: when closing teeth, injury from a prosthesis, smoking. Experience shows that the removal of these factors leads to the disappearance of the disease, and their resumption leads to its relapse. This is especially evident in people who smoke, when giving up a bad habit almost always saves them from leukoplakia, and returning to tobacco leads to its recurrence.

Leukoplakia is a benign disease, but for unknown reasons, due to the action of an irritation factor (tobacco, trauma), it degenerates into a malignant process with all the severe consequences that follow.

Tongue cancer. Most often occurs on the lateral surfaces and at the tip. That is, those areas that are most actively exposed to mechanical irritation by teeth, especially by the sharp edges of destroyed ones or those of them that stand separately outside the arch, protruding towards the tongue.

The first manifestation of the tumor process is the proliferation of the epithelium of the mucous membrane of the tongue. Doctors often consider this as a papilloma - a benign tumor. However, continued traumatization of the formation during conversation and eating accelerates its ulceration. The tumor spreads to the floor of the mouth and jaw. The presence of abundant microflora causes inflammatory phenomena, aggravating the severity of the process, sometimes obscuring the true diagnosis of the disease. Self-medication is unacceptable. An urgent visit to a specialist is necessary: ​​a dental surgeon, an oncologist.

Periodontitis. The second most common disease of the dental system after caries. After 30 years, most of the population suffers from it. This inflammatory process is localized in the tissues surrounding the root of the tooth: the ligamentous apparatus with which it is held in the jaw socket, the alveolus and gums. The main signs are inflammation of part of the gum near the root of the tooth, suppuration from the alveolus, the formation of a pathological pocket between the alveolus and the root of the tooth, and its looseness. The cause of the disease has not been fully elucidated. Among the proposed theories, some authors point to a general nature (vascular sclerosis, disease of the nervous system, endocrine, etc.), others - to local factors (tartar, microorganisms, poor oral care, etc.).

Silttoms and current. The first signs of periodontitis appear against the background of apparent well-being in the form of itching, burning, and numbness in the gum area. Then its swelling and redness can be seen, it seems to creep onto the crown of the tooth and acquires a bluish color, and a bad breath appears. In the developing stage of periodontitis, the gum, on the contrary, “slides” towards the root, and when pressure is applied, pus is released from under it. The chronic disease is usually localized along a number of teeth, most often the frontal ones. The outcome is an increase in their mobility due to the destruction of the ligamentous apparatus and prolapse.

Treatment. There is no radical solution. Even surgery does not guarantee success. Therefore, prevention of the disease itself and measures that slow down the progress of the process are very important. It is necessary to maintain oral hygiene and consult a dentist at least twice a year to remove tartar and sanitation. If a disease occurs, strictly follow the doctor’s recommendations. A careless attitude towards oneself threatens the rapid loss of many teeth. In addition, the existence of purulent foci around the roots of the teeth, sometimes many and for a long time, the penetration of decay products (proteins) foreign to the body from them into the body contributes to the development of an allergic condition and negatively affects the function of a number of organs and systems. Therefore, in terms of preventing common diseases, it is important to maintain the state of the dental-jaw system in a healthy state.

Mumps (non-epnemic). Inflammation of the parotid salivary gland. Unlike epidemic (“mumps”), it develops, as a rule, on one side. Usually associated with the penetration of bacteria from the oral cavity into the salivary gland. Most often it is caused by a decrease in salivation when a salivary stone or foreign body enters the excretory duct of the gland, as well as the spread of the inflammatory process from the tissues surrounding the gland." Stagnation of saliva in the gland and its further infection can occur after major operations, with influenza, measles, typhoid, dysentery etc. However, even with apparent general health, dirty oral contents can be a sufficient reason for the development of the inflammatory process.

Symptoms and course. The disease begins with the appearance of swelling and pain in the area of ​​the parotid salivary gland, dry mouth, general malaise, and increased body temperature. Characterized by increased pain when eating.

Treatment. Considering the possibility of severe mumps and the occurrence of complications, it is necessary to call a doctor. Before his arrival, it is recommended to frequently warmly rinse the mouth with a solution of baking soda (1/2 teaspoon per glass of water), consume salivary foods (lemon, cranberry) and a warm compress (camphor oil, petroleum jelly). In some cases, hospitalization is indicated.

JAW FRACTURES. Among injuries to the bones of the facial skeleton, jaw fractures are of greatest importance. Of these, the predominant number falls on fractures of the lower jaw (70% of all fractures of the facial bones).

Fractures of the upper jaw. When the upper jaw is fractured, its fragments are displaced downward, disrupting the usual relationship of the teeth of the upper and lower jaw and somewhat lengthening the face. As a result, the victim cannot close his mouth, and the pain that occurs during the fracture intensifies with any attempt. Rupture of the gums by fragments is accompanied by moderate bleeding.

Symptoms and course. A fracture usually occurs with a strong enough impact. Loss of consciousness indicates a concussion, and the acute pain caused by the injury can cause the development of a state of shock. The most serious combined injury occurs with a fracture of the base of the skull.

First aid. Aimed at creating rest conditions for the injured bone. For this purpose, the lower jaw is brought as close as possible to the upper jaw and they are fixed in this position with a bandage, scarf, or belt through the cranial vault. You can use a ruler, a knife, or plywood, which are applied transversely to the teeth of the upper jaw and also fixed with any available material. Considering the possibility of complications (bleeding, difficulty breathing, loss of consciousness, etc.), transporting the victim to the hospital should be urgent, preferably in a supine position.

Fracture of the lower jaw. In case of trauma to the lower jaw, double and triple fractures are more often observed, which is explained by the shape of its bone (horseshoe type). Concussion is a common complicating factor.

Symptoms and course. A fracture of the lower jaw is characterized by pain, which sharply intensifies when trying to move it. Mouth half open. The correct relationship between the teeth of the upper and lower jaws is disrupted. Soon soft tissue swelling occurs. When touched, there is sharp pain in the area of ​​the fracture. Saliva is often stained with blood.

Due to the fact that a number of muscles that carry out its movement are attached to the lower jaw bone, their reflex contraction causes displacement of jaw fragments, which increases pain, bleeding, and discomfort.

In case of severe injuries, heavy bleeding, difficulty breathing, and shock may develop.

First aid. Try to use available means to stop or reduce the bleeding (tampon, pressing the bleeding area), try to eliminate the cause of difficulty breathing (put the patient face down, move the tongue forward), and in case of shock, use artificial respiration. An ambulance must be called immediately.

In practice, there are cases of fracture of the lower jaw without such severe consequences. Then the main task in providing assistance is to create relative rest for the damaged organ.

To do this, the lower jaw is, if possible, carefully “brought” to the upper jaw and fixed in this position with a bandage (gauze, bandage, belt, scarf, etc.) through the cranial vault. Given the possibility of a concussion, it is advisable to transport to the hospital in a supine position.

Patients with fractures of the lower jaw are absolutely advised to see a doctor, since self-medication usually causes complications that lead to the destruction of the jaw bone itself.

Periodontitis. Disease of the tissues surrounding the tooth root. As a rule, it is preceded by pulpitis (see) with its inherent pain. Refusal to treat it predetermines the penetration of bacteria through the root canal of the tooth beyond its limits, causing acute inflammation under new conditions, called acute periodontitis.

Symptoms and course. A characteristic symptom is the appearance of independent pain, weak at first, then intensifying, becoming pulsating. Its difference from pain with pulpitis is that it is strictly localized and becomes sharp with mechanical stress on the diseased tooth, especially in the form of tapping. The closing of teeth is so painful that many people refuse to eat even liquid food. A moderate increase in body temperature is possible (up to 37.5 ° C). With these symptoms, the need for help from a dentist in the very near future is extremely great. Using home remedies, including pain relievers, warm rinses and bandages, may provide only occasional relief. Delaying the time to contact a specialist is fraught with serious complications due to the development of a purulent process, first limited and then widespread (see Abscess, Cellulitis, Osteomyelitis,

Ch. Dentistry and ch. Surgical diseases).

Resolution of this rapidly occurring acute process is possible with milder consequences. When a path is found for pus to exit from the source of inflammation into the oral cavity (through the molten mucous membrane covering the alveolar process) or through the skin to the outside with the formation of a fistulous tract, acute periodontitis passes into the chronic stage. In this case, the threat of dangerous complications is reduced, but does not disappear altogether.

Treatment. It is desirable and quite possible to avoid the formation of a fistula tract. In an outpatient clinic, an outflow of pus is artificially created from the source of inflammation through the tooth canal and the pulp chamber, previously freed from rotting particles of decay of the pulp tissue. Then they are disinfected, followed by filling the canal and chamber with filling material. When the root canals are narrow, the diseased tooth is forced to be removed.

Chronic periodontitis. The presence of affected teeth in the human oral cavity, which! in his opinion, “they don’t hurt*, because no pain is actually associated with complications that arise not acutely, but gradually unpredictable. This problem worries not only dentists, but also doctors of general diseases. The fact is that with chronic In periodontitis, a focus of sluggish inflammation remains at the apex of the tooth root - a kind of incubator for various bacteria. For their life, reproduction, there are almost no barriers or they are insignificant. At the same time, the waste products of bacteria, the harmful substances they produce (toxins), as well as the products of cell decay. tissues are, by their protein nature, foreign to humans. Constantly, sometimes over many years, penetrating into the body of the “host”, foreign proteins sensitize (poison) it and distort natural reactions. Considering that there can be several periodontitis teeth (which is often the case), It is not difficult to imagine the massiveness of protein aggression. It has been established that as a result of such sensitization, severe general organ diseases may occur: heart, kidneys, joints, eyes, etc. In addition, the perverted reactivity of the body aggravates and aggravates the course of existing diseases. In this regard, chronic foci of inflammation in the periodontal tissues, despite their almost asymptomatic course, must be eliminated to improve the health of the body.

Seal. A plastic, hardening material that fills a defect or cavity formed in a tooth in order to restore the anatomical and functional integrity of the tooth.

Fillings can be cement, metal, plastic, etc. The choice is made depending on the indications. Thus, cement or plastic are used to fill front teeth, since this material is more similar to the color of tooth enamel. Metal ones are more resistant to mechanical factors when chewing food, but cosmetically they are not suitable for front teeth (by color). A very strong and durable amalgam filling, unfortunately, stains the entire tooth a dark color. Composite fillings are the most promising at present.

Teething. This process is physiological and serves as an indirect indicator of the correct or impaired development of the child. As a physiological act, teething is not a painful phenomenon and cannot cause any diseases. It is in direct connection with the general health of the child - timely growth of teeth in a certain sequence indicates the normal development of his body. A delay in timing may be a consequence of rickets, an infectious disease, prolonged dysfunction of the intestines and changes in metabolism. Earlier teething - endocrine disorders. A discrepancy in the time of the beginning of the eruption of the central incisors by 1-2 months from the conditional period cannot be considered as the effect of any pathology.

The newborn does not have a single tooth, although in rare cases their intrauterine development is observed. Between 6 and 8 months of life, the child begins to develop the central incisors of the lower jaw* and then the upper. By 8-12 months - lateral incisors, first on the lower jaw, then on the upper jaw. By 12-16 months, the first molars erupt, by 16-20 months - the canines, and by 20-30 months - the second molars, which complete the formation of the primary bite.

The eruption of baby teeth often affects the child’s well-being. In weakened children, this physiological process is accompanied by general malaise, poor sleep, restless behavior, crying, and moodiness. Sometimes the temperature rises to 37.5 ° C, the nature of bowel movements changes, short-term rashes on the body and redness of the facial skin are possible. The child's weight gain is temporarily suspended and immune defense is reduced. To establish the true cause of the malaise, a consultation with a pediatrician is necessary.

At the 7th year of life, the replacement of baby teeth with permanent ones occurs, the time of eruption of which, as a rule, coincides with the resorption of the roots of baby teeth and their loss. In contrast, the formation of a permanent bite begins with the appearance of the first molars of the lower jaw and normally ends by the age of 15-18 years. Sequentially, the central incisors (8-9 years), first premolars (9-10 years), canines (10-11 years), second premolars (11-12 years), second molars (12-13 years) erupt. jaws, or “wisdom” teeth as they are sometimes called, grow later, often after the age of 20-25 (for complications associated with their difficult eruption, see separately).

A correctly and timely formed bite plays a big role in the normal development of the child’s body. Violation of the timing of teething (early or late), the order, as well as the absence of one or another tooth require the attention of a pediatrician and dentist, since they are evidence of pathology not only of a local, but often of a general nature (the result of diseases suffered by the mother during pregnancy, or any anomalies in the child’s health).

For various reasons, a number of deviations can occur in the structure of teeth, their location and development: the absence of a rudiment of a tooth, incorrect position of the tooth axis (horizontal or oblique), which is why it erupts outside the arch of the dentition or remains in the thickness of the jaw bone. In addition, incorrect formation of the tooth itself - size, shape, position, color, lack of enamel coating, etc. Such changes should be analyzed by a specialist.

Eruption of wisdom teeth is difficult. Disruption of normal eruption is most often observed with the eighth teeth of the lower jaw - the “wisdom” teeth. As a rule, it occurs due to a lack of space in the lower jaw, since all the others have already appeared before the wisdom tooth, without “leaving” enough space for it. A delay in eruption creates conditions for the development of an inflammatory process that develops from a local focus into a diffuse one, fraught with serious consequences. The disease is associated with permanent trauma to the edge of the gum above the cusps of the wisdom tooth, where an ulcer forms, which, with an abundance of bacteria in the oral cavity, is the cause of inflammation. The process quite quickly spreads to the surrounding soft tissues, including the masticatory muscles involved in the movement of the lower jaw. Due to pain, the patient is unable to open his mouth even half a centimeter.

Symptoms and course. The disease is usually accompanied by general malaise, loss of appetite, decreased sleep, and an increase in body temperature, sometimes to high levels (38 °C and above). Since it is necessary to prevent the possibility of the process spreading to the surrounding bone tissue and fiber with the development of acute inflammation of the bone marrow (osteomyelitis) or soft tissues (phlegmon), it is very important, without relying on home remedies, to consult a dentist.

Before seeking medical help, in order to alleviate the condition, it is permissible to take painkillers such as analgin (0.5 g) and rinse the mouth with a warm solution of boric acid (half a teaspoon per glass of water) or potassium manganese (pink).

Pulpitis. Acute inflammation of the dental pulp (pulp) due to the penetration of bacteria into it from the carious cavity of the tooth. As a result of the inflammatory process, the nerve endings, of which there are many in the pulp, are injured by its increased volume and waste products of bacteria (toxins), which causes acute pain. As the process spreads to the entire pulp tissue and the appearance of pus, the pain becomes pulsating in nature, especially (which is typical for acute pulpitis) intensifying at night with irradiation to various parts of the maxillofacial region.

Treatment. Fighting pain with home remedies is not very effective (see Toothache). Self-healing is impossible. The ongoing destructive process, destroying the bridge between the pulp chamber and the bottom of the carious cavity, creates conditions for free communication between them and thereby for the unhindered outflow of pus from the pulp into the carious cavity, and then into the oral cavity. With the weakening of the intrapulmonary pressure on the nerve endings, the pain subsides, giving rise to the erroneous idea that the disease is over. And frivolous inattention to the fate of the tooth is a common cause of the emergence, as a complication of pulpitis, of a new disease - acute periodontitis. Therefore, an unconditional visit to the dentist, even if the pain disappears, will prevent the possibility of its development and increase the chances of saving the tooth.

Treatment Pulpitis involves removing painfully altered pulp, disinfecting the pulp chamber, as well as mechanical and medicinal treatment of the carious cavity, tooth root canals and filling them with filling material. A tooth treated for pulpitis in a timely and correct manner can serve its purpose for many years.

Oral sepsis. The name of a condition when a person feels unwell for a long period of time, fatigue, increased sweating, decreased appetite, and sleep disturbance. In addition, pain in the heart area, rapid pulse, increased nervousness, headache, etc. may occur. Due to the mild manifestations of the disease, patients get used to this condition and find ways and means to adapt to it (painkillers, tonics, etc.), calming yourself down and considering this state to be normal.

However, as indicated in the “Periodontitis” section, these manifestations are associated with the presence of a chronic inflammatory process at the apex of the roots of sometimes many teeth. The waste products of bacteria, tissue decay and toxins, penetrating into the body, poison and change its sensitivity and reactivity to many factors (infection, cold, injury, overwork, etc.)"

The condition that occurs as a result of a focus of allergy nesting in the body (augoallergy) proceeds extremely slowly. However, against this background, it creates the possibility of developing such serious diseases as: inflammation of the inner lining of the heart (endocarditis), its muscles (myocarditis), kidneys, eyes, blood vessels, etc. It should be assumed that autosensitization and allergization can aggravate or contribute to the occurrence of many diseases.

The cause-and-effect relationships are very complex, a qualified doctor can navigate them; you should not rely on self-medication, since the consequences can be the most unexpected and complicate the provision of medical care.

Stomatitis. The name combines diseases of the oral mucosa of various origins and manifestations. The reason that caused it may be local or general. Local is associated with the participation of a direct factor - trauma, chemical, thermal, radiation exposure, as a result of which redness, erosion, and ulcers occur on the mucous membrane.

Treatment. It comes down to eliminating the cause and rinsing the mouth with an antiseptic solution. Recovery usually occurs within 7 days. However, individual forms tend to repeat themselves after a certain period of time, for example, appearing in the spring and winter periods of the year. Others develop when taking certain foods (oranges, strawberries, etc.) or medications (sulfonamides, antibiotics, etc.). Particular attention should be paid to dentures and sharp edges of teeth, which, by creating conditions for constant long-term irritation, can thereby cause a tumor process of the mucous membrane.

The most common causes of stomatitis are general diseases. Among them: infectious (measles, scarlet fever, chicken pox, tuberculosis, syphilis, etc.), allergies, intoxication, diseases of the gastrointestinal tract, cardiovascular system, endocrine, blood, etc. Often their first signs appear on the mucous membrane of the cavity mouth Therefore, if an area of ​​redness, erosion, ulcer, or crack appears on it, consultation with both a therapist and a dentist is necessary. Relying on self-medication is more than frivolous.

The following hygienic measures are indicated: brushing teeth, rinsing with solutions of boric acid, potassium permangaic acid, furatsilin, hydrogen peroxide. Taking any medications orally without a doctor's prescription is prohibited. Food should be liquid and not irritating.

Establishing a connection between stomatitis and a general disease will allow its treatment to begin. At the same time, against the background of improving general well-being, normalization of the condition of the oral mucosa is inevitable. The control periods for restoring its integrity range from 10 to 20-25 days. The lack of a tendency toward healing gives cause for concern and obligatory detailed examination in order to exclude the oncological nature of the formation.

Dry mouth. It can develop as a result of a number of local and general diseases. Local causes include: acute surgical and chronic disease, in which there is a decrease in saliva production, blockage of the gland duct by a salivary stone, or compression of it by a tumor.

Common causes are: diseases - Mikulicz, Sjögren, radiation, acute infectious diseases, diabetes, conditions after surgery on the abdominal organs, collagenosis, vitamin deficiencies A, B, E, increased function of the thyroid gland, menopause, etc. In old age, the possibility of dryness. increases in the oral cavity. Insufficient hydration of the oral cavity and tongue with saliva causes difficulty in eating and speaking. The mucous membrane is increasingly injured, cracks, erosions, and inflammation occur. With a lack of saliva, dental plaque increases and the growth of microflora in the mouth is activated. Various anomalies of nasal breathing also aggravate the phenomenon of “dryness” due to increased evaporation of liquid when breathing through the mouth.

Treatment comes down to eliminating the cause of dry mouth, or at least reducing its effects. At home, they use products that protect the mouth and tongue from irritation. For this purpose, the mucous membrane is treated with peach and sunflower oil. A mixture of borax and glycerin gives a good result. (10% solution). The prescription of other medications should be carried out by a doctor in conjunction with other types of treatment. The appearance of a constant feeling of dry mouth is a symptom of a number of diseases, which requires mandatory consultation with a specialist.

Ulcers in the mouth or periodontal ulcers are painful formations with purulent discharge from the gums. Factors that provoke their occurrence are: mechanical injury to the tooth or gums and inadequate oral care. Therefore, you need to use salt rinses and also take vitamin C 2 times a day.

However, purulent formations should not be treated independently, in particular if this applies to infants. First, you need to consult with a therapist, who will conduct an examination and then refer the sick patient to an ENT specialist or dentist.

Ulcers in the oral cavity appear gradually. The reason for their appearance is various ailments in which ulcerative abscesses form in the mouth. If hygiene standards are not observed, ulcerative abscesses transform into ulcers. The most common factors for the appearance of suppurating neoplasms in the mouth include:

• tuberculosis;
• bacterial infections;
• diabetes;
• fungi, viruses.

Let's look at the various factors in more detail.

Infection.

Periodontal ulcers occur when a bacterial infection occurs between the jawbone and the root of the tooth (gingival pocket).

Dental factors.

Gum injuries also include wounds caused by a hanging filling or a poorly placed crown.

How to treat an abscess in the mouth

Abscess.

Harmful microorganisms are constantly found in periodontal pockets. An infection passing from the pocket to nearby tissues activates the body's protective functions in order to localize inflammation. The ulcerative formation contains blood serum, leukocytes and purulent elements of deteriorated tissue. Thus, a purulent abscess is formed.

Touching an abscess on the tongue is quite painful. Also, unpleasant sensations appear if you bite a tooth located near an abscess. In addition, the teeth may be wobbly, and purulent discharge may ooze from the gums located next to the ulcer.

Stomatitis.

If the doctor has diagnosed stomatitis, then it is necessary to establish the signs that contribute to its occurrence. For example, fungal stomatitis mainly appears after undergoing antibacterial treatment. To get rid of the disease, dentists advise wiping the affected areas with a simple gauze cloth soaked in a soda solution.

The appearance of stomatitis

Diseases of the mucous membrane.

Diseases develop against a background of general weakening of the body. For example, aphotic stomatitis provokes the appearance of aphthae formations in the oral cavity. These white pustules in the mouth are caused by stress, as well as intestinal diseases.

Injuries.

Quite often, the causes of ulcers in the mouth are injuries caused by the use of a bad toothbrush. If hygiene rules are not followed, injuries begin to fester.

Tuberculosis.

Most often, pathologies in the mouth arise due to the presence of an existing disease - pulmonary tuberculosis, which spreads to the mucous membrane.

Gingivitis.

In addition, ulcers form due to gingivitis caused by viral infections. Factors causing this disease are decreased immune function of the body, weakness, injury, and hypothermia.

Symptoms and diagnosis of stomatitis

Most often, an abscess on the side of the tongue appears due to stomatitis. Signs of this disease are white oval or round spots that form in the oral cavity. In this case, erosions, ulcers or blisters appear in the mouth. These formations hurt constantly, but most of all when eating food. And when chewing, the patient feels a burning sensation and discomfort.

In addition, a patient suffering from stomatitis experiences weakness and an increase in temperature. Stomatitis also causes swelling, redness, fever, and ulcers on the mucous membrane.

To diagnose stomatitis, you should systematically conduct an examination by a specialist to establish an initial diagnosis. If the dentist has any suspicions, then the dentist will refer the patient for additional examinations: smears for bacterial culture and PCR. And if necessary, the doctor prescribes a blood test for glucose levels. You may also need to see a pediatrician if the patient is a child, or visit a therapist.

How to get rid of a sore in the mouth

Gum diseases

An abscess in the mouth, particularly on the gums, is accompanied by a high fever. Occasionally, spontaneous opening of an ulcer occurs. During hospitalization, the abscess is treated by surgery, i.e. removal of the abscess.

However, after the above surgical procedure, the pain only slightly decreases, but in the case of a periodontal abscess, this will not help. Moreover, it should be remembered that inflammation and abscesses on the gums can even be fatal. For these reasons, delaying a visit to the dentist is deadly!

Treatment of abscesses using traditional medicine

How to treat an abscess in the mouth if you cannot visit the dentist? In this case, you cannot do without traditional therapy. Home care is aimed at reducing pain. To do this, use various rinses made from medicinal herbs that have an antiseptic effect.

Important! It is not worth warming up the area of ​​the abscess; it is better to resort to applying cool compresses or bandages. Heat will only intensify the inflammatory process, which can contribute to complications.

So, to reduce pain you can:

• rinse your mouth with a weak solution of potassium permanganate or furatsilin;
• apply a cold compress to the swollen area;
• Always rinse your mouth to get rid of food debris hidden between your teeth;
• take painkillers: paracetamol, analgin.

But self-medication and taking anti-inflammatory drugs, as well as antibiotics without a doctor’s recommendation is strictly prohibited!

Herbal decoctions

To remove the taste of pus in the mouth, you can use various folk recipes. To relieve pain, all kinds of decoctions are prepared from antiseptic herbs (sage, St. John's wort, calendula, linden flowers, etc.).

Calendula and sage

A very effective, analgesic and antibacterial agent is a decoction of sage and calendula leaves. To prepare the medicine you need to mix 1 table. spoon of chopped herbs. Then put them in a small enamel ladle and pour 350 ml of boiling water. After which everything is simmered in a water bath for ten minutes. The finished broth must be cooled, strained, and then you can start rinsing.

Chamomile and St. John's wort

To make ulcers on the tongue less painful and not interfere with chewing, prepare a healing decoction by mixing 2 tablespoons. spoons of chamomile and St. John's wort flowers. The mixture must be placed in a glass container filled with boiling water. Then the raw material should be left for an hour and a half, covering the pan with a lid so that it can brew well. Afterwards, the broth must be filtered and you can begin rinsing.

Chamomile and linden flowers

Two tables. spoons of linden and chamomile flowers should be poured with two glasses of boiling water. Then the container in which the decoction is located is closed with a lid and the decoction is infused for half an hour. Afterwards, the mixture is filtered and you can begin treatment procedures.

Preventive measures and treatment of stomatitis

How to remove an abscess on the tongue? Treatment of stomatitis consists of irrigating the oral cavity with antiseptic agents and rinsing the mouth with various solutions and decoctions.

Abscess in the mouth - what to do?

For preventive purposes it is necessary:

• to relieve the inflammation process, the oral cavity should be regularly rinsed with chamomile decoction;
• at high temperatures, when stomatitis progresses in children, you need to take antipyretic drugs recommended by the pediatrician;
• it is better to remove acidic foods from the daily diet, which stimulate the mucous membrane receptors;
• for the purpose of prevention, you need to monitor your oral hygiene (proper, systematic brushing of your teeth, choosing a good brush for cleaning your teeth);
• provide conditions for the normal functioning of all organs in order to prevent the occurrence of various ailments.

Basics of stomatitis therapy

To cure ulcers, as well as remove the taste of pus in the mouth, the causes of which are the presence of stomatitis, you should visit a specialist. After diagnosis, the doctor will prescribe comprehensive treatment, which consists of the following:

• rinsing the mouth with antiseptics (Miramistin, Furacilin) ​​before eating;
• to speed up the healing process, use herbal infusions of oak bark, calendula, sage;
• for viral stomatitis, ulcerative formations are smeared with antiviral creams;
• To create a protective film over the purulent blisters, they are treated with petroleum jelly, aloe juice, and sea buckthorn oil, which promote rapid tissue regeneration.

Also, the doctor often prescribes vitamin, physical and immunotherapy to the patient.

In general, stomatitis can be safely cured in any person. But to diagnose the exact cause of the disease, it is necessary to do a detailed blood test. This is necessary to study the disease in detail, and then prescribe the correct, most correct, treatment.

What is an oral abscess

Oral abscess is an acute inflammatory disease of the oral cavity, which is characterized by focal accumulation of pus in the tissues. With an abscess of the oral cavity, limited compaction and swelling of the mucous membrane is observed, painful to the touch, which is accompanied by a deterioration in general well-being and an increase in body temperature. An oral abscess is diagnosed by a dentist during an examination based on an assessment of the condition of the tissues. Treatment of an oral abscess includes surgery - opening the abscess, as well as anti-inflammatory drug therapy.

An oral abscess is a local purulent inflammation of the tissues of the gums, tongue, palate or cheek. This disease is one of the most common problems in surgical dentistry and manifests itself regardless of the age and gender of the patient. Most often, an oral abscess occurs as a result of complicated dental pathology, but its development is also possible due to a violation of the integrity of the mucous membrane or in general infectious diseases. In the absence of timely and correct treatment, an oral abscess can develop into a chronic form and also cause severe complications such as phlegmon and sepsis. Therefore, self-medication for oral abscess is strictly prohibited. To prevent consequences, it is necessary to immediately consult a specialist at the first symptoms of the disease.

Causes (etiology) of oral abscess

Most often, an oral abscess occurs as a complication of dental pathologies, for example, periodontitis or advanced periodontal disease. These diseases are characterized by the destruction of periodontal joints and the formation of so-called periodontal pockets, in which intensive proliferation of pathogenic microorganisms occurs, causing an inflammatory process.

An oral abscess can form as a result of infection in the wound when the integrity of the mucous membrane is violated, for example, with a syringe needle during anesthesia or in case of mechanical trauma. The cause that provokes the development of pathology can be boils in the facial area, streptococcal and staphylococcal sore throats. It has been noticed that oral abscesses often occur against the background of influenza or other common infectious diseases that weaken the immune system.

In most cases, an oral abscess is caused by an infection involving more than 3-5 microorganisms. The most common etiological agents are staphylococci, streptococci and gram-negative anaerobic flora (Eikenella corrodens, Porphyromonas gingivalis, Enterobacteriaceae spp., etc.).

Classification of oral abscesses

Depending on the location, there are several types of oral abscesses:

A gum abscess appears near a specific tooth. This is the most common type of abscess. In the absence of proper treatment, it can develop into diffuse inflammation or into a chronic form, which is characterized by periodic exacerbations, leakage of pus from the formed fistula, foul odor from the mouth and intoxication of the body.

An abscess in the floor of the mouth is located under the tongue and causes severe pain during talking and eating. If spontaneous opening occurs, the leakage of pus can cause secondary foci of inflammation in the pharynx and neck.

Palate abscess most often occurs due to periodontitis of the teeth of the upper jaw. It threatens the spread of infection to adjacent tissues of the palate and peritonsillar region, as well as the development of osteomyelitis of the palatine plate.

An abscess of the cheek, depending on the depth of the lesion, can be localized both internally - on the side of the mucous membrane, and on the outer surface of the cheek. An abscess in this location is extremely dangerous due to possible spread to nearby facial tissues.

A tongue abscess is characterized by swelling of the tongue, difficulty eating, speaking, and even breathing. This type of abscess is the most dangerous; when the first symptoms develop, urgent hospitalization is necessary.

Symptoms (clinical picture) of oral abscess

Usually the abscess is preceded by toothache, characteristic of periodontitis. It appears in the area of ​​a certain tooth, biting on which causes increased pain. Soon a swelling of the soft tissues and a thickening appear, painful when touched.

If an abscess develops under the oral mucosa, bulging and redness are visible upon examination. When the abscess is located closer to the skin (face and submandibular region), the picture is similar. The progression of the purulent process is accompanied by a deterioration in the general condition, an increase in body temperature, disturbances in appetite and sleep. To remove the source of infection from a diseased tooth, and most importantly to prevent its spread to the surrounding tissue and area, it is necessary to promptly open the abscess by a doctor. Otherwise, the possibility of limited inflammation developing into diffuse inflammation with its transition to phlegmon cannot be ruled out.

The development of an abscess can lead to pus leaking out or into the oral cavity. The discharge of pus relieves acute symptoms, pain subsides or disappears, normal contours of the face or oral mucosa are restored, and general well-being is stabilized. This outcome should not be reassuring, since the process continues, but in a chronic stage. In the future, it can worsen, and this is pus from the fistulous tract with bad breath, sensitization of the body with toxic decay products.

Diagnosis and treatment of oral abscess

An oral abscess is diagnosed by a specialist based on a visual assessment of the condition of the mucous membrane during a dental examination. It is completely unacceptable to wait for the spontaneous opening of an oral abscess or to independently use antibacterial agents. To relieve symptoms before contacting a doctor, you can use painkillers and rinse your mouth with warm antiseptic solutions.

Oral abscess is treated exclusively through surgery. In order to eliminate the source of infection and prevent the spread of the inflammatory process, the dental surgeon performs an opening of the abscess, drainage and antiseptic treatment of the cavity. Sutures are usually not required after such an operation, since the size of the incision is small. After removal of the pus, as a rule, the patient feels better, the pain subsides, the swelling subsides, and the normal contours of the face are restored, but if the oral abscess has developed significantly, the final recovery may be somewhat delayed.

In the postoperative period, antibiotics, antihistamines, immunostimulants and vitamin-mineral complexes are prescribed. In some cases, physiotherapeutic procedures, such as fluctuarization or UHF therapy, are used for a speedy cure. It is also recommended to avoid solid foods and eat a nutritious diet after surgery.

Forecast and prevention of oral abscess

In general, the success of treatment of oral abscesses depends on the timeliness of contacting a doctor and the general condition of the patient’s body.

It is very important to start treatment as early as possible - in this case the prognosis is usually favorable. If surgery is performed on time and there are no complications, the oral abscess will completely heal within 1–2 weeks.

To prevent oral abscess, it is necessary to follow the rules of hygiene, avoid injuries to the mucous membrane, and, in the presence of periodontal diseases, promptly treat them.

Which doctors should you contact if you have an oral abscess?

• Facial surgeon

Dentistry is a branch of medicine that combines various diseases of the maxillofacial area, oral mucosa, teeth and neck.

Among all human ailments, the most common are dental lesions, neglect of treatment of which leads to various inflammatory complications (abscess, phlegmon, osteomyelitis) that threaten human health, and in severe cases, life.

With diseased teeth, even if several are missing, the act of mechanical processing of food is not perfect, which affects the condition of the stomach and intestinal tract and contributes to the occurrence of gastritis, gastric ulcers, and duodenal ulcers.

According to statistics, traumatism is very high, including the face, where fractures of the facial skeleton predominate: the lower and upper jaws, the zygomatic bone, the nose, and the orbit. Correctly provided first aid - its methods are outlined in this chapter - will ease the fate of the victim and improve the prognosis of treatment.

The occurrence of tumor processes in the maxillofacial area is a common occurrence. Knowledge of their signs will allow you to contact specialists even in the early period of tumor development and ensure a more favorable outcome.

Dentistry also affects very common, alarming phenomena for a person such as toothache, bad breath, bleeding from the gums and after tooth extraction - everything that disrupts the usual feeling of health and beauty of the face.

Limited accumulation of pus in tissues that occurs during inflammation. In the maxillofacial area, as a rule, it is a consequence of complicated dental disease. It can also be caused by a boil, sore throat, damage to the skin or mucous membrane of the oral cavity, introduction of bacteria into the tissue by a syringe during anesthesia, etc. An abscess can also form as a result of infection through the blood or lymph flow during common infectious diseases (influenza, etc.).

Symptoms and course. Usually the abscess is preceded by toothache, characteristic of periodontitis (see). It appears in the area of ​​a certain tooth, biting on which causes increased pain. Soon a swelling of the soft tissues and a thickening appear, painful when touched. If an abscess develops under the oral mucosa, bulging and redness are visible upon examination. When the abscess is located closer to the skin (face and submandibular region), the picture is similar.

The progression of the purulent process is accompanied by a deterioration in the general condition, an increase in body temperature, disturbances in appetite and sleep. To remove the source of infection from a diseased tooth, and most importantly to prevent its spread to the surrounding tissue and area, it is necessary to promptly open the abscess by a doctor. Otherwise, the possibility of limited inflammation developing into diffuse inflammation with its transition to phlegmon cannot be ruled out.

The development of an abscess can lead to pus leaking out or into the oral cavity. The discharge of pus relieves acute symptoms, pain subsides or disappears, normal contours of the face or oral mucosa are restored, and general well-being is stabilized. This outcome should not be reassuring, since the process continues, but in a chronic stage. In the future, it can worsen, and this is pus from the fistulous tract with bad breath, sensitization of the body with toxic decay products.

Treatment. The speed of development of the process gives reason to strongly recommend not to delay contacting the dentist. Before this, as relief measures, you can use painkillers, warm mouth rinse, and a thermal bandage.

Taking antibiotics and other strong drugs without prescription is not recommended.

Below are the features of process recognition depending on the place of its occurrence and the most common localizations.

It is characterized by the appearance of redness in the sublingual area, and soon a thickening, which is very painful when irritated during conversation and eating. The tongue becomes less mobile and is raised upward. Gradually, the swelling of the floor of the mouth increases, and the general condition worsens.

An independent breakthrough of pus into the oral cavity is possible, and although the acute phenomena then subside, at this moment the spread of pus into the peripharyngeal region and neck is extremely dangerous. Therefore, waiting for spontaneous opening is unacceptable. Seeing a doctor is mandatory.

It usually occurs as a complication of periodontitis of the teeth of the upper jaw. More often the cause is the second incisor, canine or second premolar. The disease begins with pain in the hard palate and redness of the mucous membrane. When it bulges, the pain becomes most intense.

Eating becomes difficult.

Spontaneous opening of the abscess is possible, after which relief occurs. However, to prevent the possible spread of the abscess to a large area of ​​the hard palate and the development of osteomyelitis of the palatine plate of the bone, opening the abscess in a clinic is indicated.

Before contacting a doctor, you can use painkillers and warm rinses.

Depending on the depth of development of the process, swelling and redness will be more pronounced either on the side of the skin of the cheek or the mucous membrane of the oral cavity. The pain is mild, but intensifies when opening the mouth. The general condition is moderately impaired. The spread of the abscess to neighboring parts of the face is dangerous.

It begins with the appearance of pain in the thickness of the tongue, which quickly increases.

The tongue increases in volume, seems to be raised, and is not very mobile. The act of chewing and swallowing becomes sharply difficult, breathing is often impaired, in rare cases to an extreme degree, when a feeling of suffocation occurs.

Urgent hospitalization is indicated to take emergency measures.

Inflammation of the jaw socket as a result of infection after traumatic tooth extraction. In this case, damage to the socket itself and crushing of the surrounding gums are often observed. It can also develop as a consequence of a violation of the postoperative regimen, when the blood clot is washed out of the hole by actively rinsing the mouth, microbes penetrate into it, causing inflammation. Food getting into the socket and lack of oral hygiene also contribute to the occurrence of alveolitis.

Symptoms and course. The disease often begins 2-3 days after surgery with the appearance of severe pain in the area of ​​the extracted tooth socket and an increase in body temperature to 37.5-38.5°C. Gradually the pain intensifies, spreading to neighboring parts of the head.

A bad odor appears from the mouth. In the submandibular areas, the lymph nodes enlarge and become painful. The duration of the disease is up to two weeks.

Treatment. At home, before consulting a doctor, which is necessary when the symptoms described above appear, frequent rinsing of the mouth with a warm solution (3%) of hydrogen peroxide, baking soda (1/2 teaspoon per glass of water), and painkillers is recommended.

Alveolitis can be complicated by osteomyelitis of the socket, which lengthens the time of illness and rehabilitation of the patient.

The causes of dislocation of the lower jaw can be varied: a blow, strong opening of the mouth during yawning, screaming, vomiting, during tooth extraction, when biting off a large and hard piece of food, etc. It occurs more often in women due to the shallower depth of the articular fossa and the severity of the bone tubercle, as a result, the articular head of the lower jaw moves more easily. If this is an anterior displacement, then they speak of an anterior dislocation; if it is backward, then a posterior dislocation; there are bilateral ones, which are common. A habitual dislocation is diagnosed when it occurs repeatedly.

Symptoms and course. When the lower jaw is dislocated, the picture is quite typical. The victim complains of pain, inability to close his mouth and eat, and speech is difficult. Any attempt to close the mouth is unsuccessful and is accompanied by increased pain. Therefore, if your jaw is dislocated, you should not try to straighten it yourself; this will only exhaust the person.

Treatment. Emergency assistance from a doctor is needed, who, using pain relief, will apply knowledge of certain techniques. You should not refrain from taking timely measures, since it will be much more difficult to straighten the jaws in the future.

Inflammation of the mucous membrane of the maxillary sinus, resulting from the formation of communication between the maxillary sinus and the oral cavity after the removal of molars or premolars of the upper jaw. Similar messages arise when in some people the roots of these teeth penetrate into the maxillary sinus and are separated from it only by the mucous membrane or a thin bone plate. In this case, even with a very careful operation, the integrity of both the bone plate and the mucous membrane separating the maxillary sinus from the apex of the tooth root is compromised. Through this anastomosis that occurs after tooth extraction, bacteria penetrate from the oral cavity, causing inflammation of the sinus.

Attempts by dentists to suture the gum mucosa immediately after the formation of an anastomosis to close the communication do not always end well. More often the fistulous tract remains.

Its signs are very clear. When liquid food is taken, some of it enters the nasal cavity. If you exhale air through the nose, after closing the nostrils with your fingers, the air will exit into the oral cavity through the fistula opening. In addition, a clear or cloudy liquid is sometimes released from the fistula into the oral cavity - a product of inflammation of the maxillary sinus.

Treatment is only surgical in a hospital setting.

A type of stomatitis when the mucous membrane covering the alveolar process of the jaw is affected. In addition to the general causes that cause disease of the membrane of a different localization (see Stomatitis), the most common is dirty oral contents, the presence of dental plaque (see Tartar).

Symptoms. During the examination, redness and swelling of the gums are noticeable; slight bleeding is possible when eating and brushing teeth. If oral hygiene is not observed, the gums become covered with plaque, ulcers, areas of tissue necrosis, and bad breath occur. The disease can spread to other parts of the oral mucosa.

Treatment: systematic dental care, rinsing, removing tartar, treatment of periodontitis, gentle diet.

It occurs primarily due to unsystematic oral hygiene. Particles of food remaining after ingestion in the interdental spaces, as well as in carious teeth, deflated epithelium of the mucous membrane are exposed to bacteria that are abundant in the oral cavity. The breakdown of food proteins and epithelium occurs and their subsequent decay, which causes the appearance of odor. In addition, it can be caused by an inflammatory process in the tissues surrounding the tooth (see Periodontitis), damage to the mucous membrane of the oral cavity, tongue (see Gingivitis, Stomatitis), and also, in rare cases, stomach disease (gastritis).

Prevention and removal of odor mainly comes down to regular oral care. It is necessary to brush your teeth in the morning and evening: the movement of the toothbrush should be both horizontal and vertical to thoroughly remove food debris from the interdental spaces. This can be helped by using toothpicks and rinsing your mouth with water after eating. It is effective to use solutions of scented substances: mint, special deodorants.

For diseases of the oral mucosa, tissues around the tooth, and stomach, special treatment is indicated.

Unpleasant and often unbearable sensations caused by irritation of sensory nerves. The role of irritants can be a blow, burn, injection, inflammation, injury, etc. It is usually a manifestation of dental disease.

If the integrity of the hard tissues of the tooth (enamel, dentin) is damaged, pain occurs only when taking cold or hot water, sour or sweet food. With the removal of these irritants (rinsing the mouth with warm water), the pain stops.

In cases where it occurs independently, often intensifies at night and spreads to the areas surrounding the tooth, acquiring a diffuse character, it should be assumed that we are talking about the occurrence of acute inflammation of the dental pulp - the dental pulp. In this case, the pain is long-lasting and often excruciating. Count on stopping it by taking painkillers - analgin, etc.

It is possible that the pain itself will decrease or stop when destructive phenomena destroy the bridge between the carious cavity and the pulp chamber of the tooth. In this case, the acute period of pulp inflammation passes into the chronic stage, which is accompanied by subsidence or disappearance of pain. However, the pathogenic lesion continues, spreading to the entire dental pulp, including the pulp in the root canals of the tooth, and then to the surrounding tissue. The transition of purulent inflammation beyond the tooth is called acute periodontitis. In this case, the painful sensation is characterized by independent occurrence, precise localization in the area of ​​the tooth; touching it, especially tapping, causes a sharp increase in pain. Painkillers can reduce it and even remove it. But you cannot count on a cure without the participation of a dentist; it is necessary, and in the coming days, to prevent possible serious complications - abscess, phlegmon, osteomyelitis.

Thus, being the most common signal indicating tooth disease (see Caries, pulpitis, periodontitis), toothache can at the same time be the result of injury when the breaking off of part of the crown exposes the dental pulp (pulp), rich in nerve endings. The slightest touch to it causes severe pain. Only a dentist can provide assistance in this case.

It should be borne in mind that a jaw tumor, inflammation of the maxillary sinus, nerves, or disease of the central nervous system can create the impression of toothache. Therefore, pain in the dentofacial area should be assessed by a doctor to identify its cause and not be considered only as dental pain.

More than 80% of people have dental deposits called “tartar.” It consists of food debris, epithelium (deflated), bacteria, phosphorus salts, calcium, etc. Its formation begins with the accumulation of soft plaque on the rough surface of the tooth neck, on which lime salts are deposited. As this formation thickens, it covers the gingival part of the tooth with a “muff”. Most often, tartar occurs on teeth that are less involved in the act of chewing, which makes their natural cleansing more difficult.

The causes of tartar are poor oral hygiene, the habit of eating only soft foods, and chewing on one side. Metabolic disorders, primarily salt metabolism, can become a common cause of dental plaque.

With a disease of the periodontal tissues (periodontitis), stone forms under the gum: between the root of the tooth and the wall of the alveolus, which contributes to a more aggressive development of periodontitis (previously this disease was called alveolar pyorrhea).

If you have tartar, you should contact your dentist to have it removed. Otherwise, various complications are possible - the occurrence of a focus of chronic inflammation of the gums, bad breath, intoxication of the body.

Prevention comes down to hygienic measures, eating solid foods (apples, carrots, cabbage, etc.) along with soft ones.

A common disease that affects 95% of people. It is based on the destruction of hard tooth tissues: enamel and the underlying dentin. The reason has not been fully clarified. However, irregular dental care is a predisposing factor.

Symptoms and course. Caries occurs gradually: a pigment spot appears on the surface of the enamel of a tooth (first white and then yellow). Soon it turns brown. Subsequently, the enamel is destroyed, and then the dentin. The process usually proceeds slowly, in more rare cases - quickly. The resulting cavity, first in the enamel and then in the dentin, progresses in depth and width. Remains of food in it serve as a breeding ground for bacteria that are abundant in the oral cavity. The rotting they cause aggravates its unhygienic condition. An unpleasant odor occurs.

Tooth caries is accompanied by characteristic pain. Quite acute pain occurs when eating cold, hot, sour, or sweet foods. It quickly disappears after eliminating these factors (rinsing the mouth with warm water). A person, unfortunately, adapts to the “conditions” of food, excluding temperature and chemical stimuli. He develops an erroneous belief about complete well-being and considers going to the doctor unnecessary. At the same time, the destructive process continues, which leads to significant destruction of the tooth crown and the spread of the process to the dental pulp - the pulp. This, in turn, complicates tooth treatment and reduces the possibility of saving it.

And this is extremely important. Teeth that are destroyed or removed not only distort the act of chewing, speech phonetics, and appearance, but also have a detrimental effect on the condition of the stomach. Poorly chewed food can cause gastritis, stomach ulcers, etc.

Treatment. A timely visit to the dentist is absolutely necessary when signs of dental caries appear. Its functional effectiveness will be restored: the destroyed enamel and dentin tissue will be economically removed and the integrity of the crown will be restored using filling material. In certain regions of the globe, where drinking water contains less than normal levels of fluoride salts, there is particularly active dental caries in the entire population. In such cases, measures are recommended aimed at artificially introducing fluoride salts into the human body by including them in table salt or centralized fluoridation of drinking water.

It usually occurs as a complication of dental disease, which results in the development of a chronic inflammatory process at the apex of the tooth root with the formation of a cyst. In more rare cases, it arises from the follicle shell surrounding the crown of the tooth, when the process of its eruption is disrupted. Therefore, such a cyst is called follicular.

In contrast, root disease is much more common, since dental disease many times exceeds the number of cases of difficult eruption. A root cyst develops against the background of chronic inflammation (see Periodontitis) and grows slowly but steadily. Increasing in volume, it constantly puts pressure on the surrounding bone tissue, which is forced to “retreat”, making room for the growing cyst.

Little or no manifestation of the cyst is visible only when a protrusion of the jaw appears with thinning of its outer dense bone plates, which is noticed by the patient himself or those around him. Often, when X-raying the jaws for one reason or another, a cyst is discovered as an accidental finding.

Its growth sometimes causes such significant destruction of the jaw bone that it leads to spontaneous fracture. In addition, penetration of pyogenic microbes into the cavity of the cyst can cause a severe inflammatory process involving the bone marrow of the jaw and the development of osteomyelitis. It is possible that a root cyst, as a long-term process, can degenerate into a cancerous tumor.

Treatment for cysts is surgical. For small sizes, it is permissible to perform the operation on an outpatient basis. Recommendation: periodic monitoring (once a year) of the dentofacial system using radiography.

Usually, surgical intervention is undertaken when therapeutic measures have not produced the desired results, and saving the tooth can cause an acute purulent inflammatory process. Teeth that are subject to removal are decayed, incorrectly erupted, highly mobile, etc. During the operation, damage occurs - rupture of blood vessels, which causes moderate bleeding from the socket of the extracted tooth and usually stops after applying a gauze ball after 10-15 minutes.

However, in some cases, bleeding can be significant, occurring immediately after surgery or some time later, as a result of difficult removal, rough intervention, or dilation of small injured vessels, which sometimes happens after the use of adrenaline for pain relief. It can also be caused by a blood clotting disorder. If bleeding occurs immediately after tooth extraction, the doctor will find a way to stop it. It is more difficult when it occurs after a certain time, i.e. outside the clinic. The cause of such bleeding can be a variety of circumstances: violation of the regime (rinsing the mouth, eating hot food), increased blood pressure, disintegration of a blood clot.

First aid. You must try to stop the bleeding yourself. To do this, it is better to make a small tampon out of gauze, place it on the socket of the extracted tooth and bite down, closing your teeth. The tampon should rise above the socket: the higher the tampon, the greater the pressure on the vessels when the teeth are closed. In a position with clenched jaws, you need to lie down or sit down, relax and calm down. If after 15-20 minutes the bleeding still continues, threatening a large loss of blood, you need to consult a doctor, and at night - to a surgical duty hospital where there is no dental hospital. Increased blood pressure, disintegration of a blood clot in the eye as a cause of bleeding will require not only local, but also general treatment methods.

The result of a disease of the mucous membrane of the gums and can be a consequence of not only local and general illness of the body.

Bleeding usually occurs when brushing your teeth. Sometimes eating food can cause blood to appear in the mouth. It flows from the edge of the gum when its mucous membrane is inflamed (see Gingivitis). Particular attention is required in cases where oral care is sufficient, but vascular changes in the gums persist or reappear, and bleeding continues. The reason for this may be various general diseases: blood, endocrine, acute respiratory infections, influenza, vitamin deficiency, etc. Swelling and an increase in the volume of the interdental papillae of the gums often accompany pregnancy.

In cases where the disease worsens, bleeding occurs even with minor trauma, or even without it, on its own. Treatment and medical supervision are necessary. At home, you should maintain oral hygiene.

Diseases of non-carious origin can be the result of either a malformation of the tooth or damage to it after eruption. Disturbances in the development of teeth manifest themselves in the form of different types of changes in the enamel: normal color, underdevelopment, absence of it, or, conversely, an excessive amount in the form of enamel drops. Manifestations can be on most teeth or on individual ones. Anomalies in the shape of teeth are often observed.

It happens that pigment spots or streaks appear on the enamel, more often on the incisors, less often on other teeth. Sometimes defects occur in the form of enamel erosion. The reason is an excess of fluoride salts in drinking water. Hence the name of the disease - fluorosis (in Latin fluorine-fluorum). It is detected already in childhood on permanent teeth. Pigmented spots and stripes (stripes) create significant cosmetic inconvenience. And in cases of erosion, conditions arise for the destruction of the tooth enamel. The disease is often endemic, i.e. affects the population of a certain region, where one liter of water contains more than 1-1.5 mg of fluoride salts.

Centralized technologies have been developed to reduce their levels in drinking water. Existing changes in tooth enamel can be treated cosmetically by a dentist.

With a wide variety of tumor processes affecting the maxillofacial area, it is advisable to distinguish two groups: benign and malignant. This division is arbitrary, given the frequent degeneration when a “good” tumor, under the influence of characteristics characteristic of its location, acquires the qualities of “evil” growth. Therefore, every neoplasm that appears on the face, neck, or in the oral cavity should be the reason for mandatory consultation with a dentist and oncologist.

Benign processes can be localized on the skin of the face, on the mucous membrane of the oral cavity, lips, in the thickness of soft tissues and jaws. When located superficially, they are easily identified. The interstitial position creates an area of ​​bulging and asymmetry. Among the benign ones, the most common are papilloma, fibroma, atheroma, cyst, and supragingival. A tumor in the oral cavity is subject to constant trauma from a food bolus when chewing, teeth, or talking. Its systematic irritation can stimulate its degeneration into a malignant one. In itself, the formation protruding into the oral cavity creates inconvenience of both a functional and cosmetic nature, but does not cause any disturbance in well-being. In rare cases, an increase in its size can injure some nerve branch with moderate pain. Tumors located deep within the jaw bones can thin them, deform them, and sometimes cause a jaw fracture.

Malignant neoplasms of the maxillofacial region account for about 20% of the total number of cancers and sarcomas affecting humans. 90% of skin cancers occur on the face. To date, there is no clear causal understanding. However, it is quite obvious that a number of factors, acting on tissues, induce their cells to malignant growth. These include the habit of excessively hot or cold food, spicy or rough, smoking - active or passive (inhalation of tobacco smoke), prolonged mechanical irritation of the oral mucosa, tongue with the sharp edge of a decayed tooth or poorly fitting denture, exposure to acid or alkali at work , chewing tobacco, etc. In some cases - long-term chronic inflammation (periodontitis, sinusitis, cyst), genetic prerequisites. The most common localization of malignant neoplasm is the lip, mucous membrane of the oral cavity, and tongue.

Lip cancer. As a rule, it is located on the lower lip, more often in men. The predecessor is often a fissure that does not heal for a long time, which later takes on the appearance of an ulcer that bleeds easily. At the same time, an infiltrate occurs, which tends to spread, causing the lip to increase in size. Her mobility is limited. The tumor metastasizes to the lower jaw bone over time. Its cells are transported by lymph to the mental and submandibular lymph nodes. They enlarge and become inactive. The progression of the process leads to the emergence of new malignant foci in the lymph nodes of various parts of the patient’s body.

Early recognition and treatment lead to the most favorable results.

At the first sign (a non-healing lip crack or a tumor formation in its thickness), it is necessary to immediately contact a dental surgeon or oncologist.

Cancer of the oral mucosa.

The tumor can develop on the mucous membrane of the cheeks, alveolar process, soft and hard palate. The first sign is often the appearance of epithelial growth on the mucous membrane in the form of a brush or wart; sometimes redness in a certain place, where erosion then occurs - a defect in the mucous membrane, and then an ulcer. When palpating the area around it, tissue compaction is determined. Relatively early, cancer cells spread through nearby lymph nodes into surrounding tissues, including the tissue of the upper or lower jaw.

Leukoplakia deserves special attention - a lesion of the mucous membrane that can suddenly disappear and then reappear in the form of a whitish spot located on the mucous membrane of the cheeks, often along the closure of the molars. Leukoplakia is an area of ​​keratinization and desquamation of the epithelium of the mucous membrane and occurs due to constant irritation: when closing teeth, injury from a prosthesis, smoking. Experience shows that the removal of these factors leads to the disappearance of the disease, and their resumption leads to its relapse. This is especially evident in people who smoke, when giving up a bad habit almost always saves them from leukoplakia, and returning to tobacco leads to its recurrence.

Leukoplakia is a benign disease, but for unknown reasons, due to the action of an irritation factor (tobacco, trauma), it degenerates into a malignant process with all the severe consequences that follow.

Tongue cancer. Most often occurs on the lateral surfaces and on the tailbone. That is, in those areas that are most actively exposed to mechanical irritation by teeth, especially by the sharp edges of destroyed ones or those that stand separately from the stump of the arch. protruding towards the tongue.

The first manifestation of the tumor process is the proliferation of the epithelium of the mucous membrane of the tongue. Doctors often consider this as a papilloma - a benign tumor. However, continued traumatization of the formation during conversation and eating accelerates its ulceration. The tumor spreads to the floor of the mouth and jaw. The presence of abundant microflora causes inflammatory phenomena, aggravating the severity of the process, sometimes obscuring the true diagnosis of the disease. Self-medication is unacceptable. An urgent visit to a specialist is necessary: ​​a dental surgeon, an oncologist.

The second most common disease of the dental system after caries. After 30 years, most of the population suffers from it. This inflammatory process is localized in the tissues surrounding the root of the tooth: the ligamentous apparatus with which it is held in the jaw socket, the alveolus and gums. The main signs are inflammation of part of the gum near the root of the tooth, suppuration from the alveolus, the formation of a pathological pocket between the alveolus and the root of the tooth, and its looseness. The cause of the disease has not been fully elucidated. Among the proposed theories, some authors point to a general nature (vascular sclerosis, disease of the nervous system, endocrine, etc.), others - to local factors (tartar, microorganisms, poor oral care, etc.).

Symptoms and course. The first signs of periodontitis appear against the background of apparent well-being in the form of itching, burning, and numbness in the gum area. Then swelling and redness are observed, it seems to creep onto the crown of the tooth and acquires a bluish color, and a bad breath appears. In the developing stage of periodontitis, the gums, on the contrary, “slide” towards the root, and when pressure is applied, pus is released from under it

The chronic disease is usually localized along a number of teeth, most often the frontal ones. The outcome is an increase in their mobility due to the destruction of the ligamentous apparatus and prolapse.

Treatment. There is no radical solution. Even surgery does not guarantee success. Therefore, prevention of the disease itself and measures that slow down the course of the process are very important. It is necessary to maintain oral hygiene and visit the dentist at least twice a year to remove tartar and sanitation. If a disease occurs, strictly follow the doctor’s recommendations. A careless attitude towards oneself threatens the rapid loss of many teeth.

In addition, the existence of purulent foci around the roots of teeth, sometimes many and for a long time, the penetration of decay products (proteins) that are foreign to it into the body contributes to the development of an allergic condition and negatively affects the function of a number of organs and systems. Therefore, in terms of preventing common diseases, it is important to maintain the state of the dental-jaw system in a healthy state.

Inflammation of the parotid salivary gland. Unlike epidemic (“mumps”), it develops, as a rule, on one side. Usually associated with the penetration of bacteria from the oral cavity into the salivary gland. Most often it is caused by a decrease in salivation when a salivary stone or foreign body enters the excretory duct of the gland, as well as the spread of the inflammatory process from the tissues surrounding the gland. Stagnation of saliva in the gland and its further infection can occur after major operations, with influenza, measles, typhus, dysentery, etc. However, even with apparent general health, dirty contents of the oral cavity can be a sufficient reason for the development of the inflammatory process.

Symptoms and course. The disease begins with the appearance of swelling and pain in the area of ​​the parotid salivary gland, dry mouth, general malaise, and increased body temperature. Characterized by increased pain when eating.

Treatment. Considering the possibility of severe mumps and the occurrence of complications, it is necessary to call a doctor. Before his arrival, it is recommended to frequently warmly rinse the mouth with a solution of baking soda (1/2 teaspoon per glass of water), consume salivogenic foods (lemon, cranberry) and a warm compress (camphor oil, petroleum jelly). In some cases, hospitalization is indicated.

Among injuries to the bones of the facial skeleton, jaw fractures are of greatest importance. Of these, the predominant number falls on fractures of the lower jaw (70% of all fractures of the facial bones).

Fractures of the upper jaw. When the upper jaw is fractured, its fragments are displaced downward, disrupting the usual relationship of the teeth of the upper and lower jaw and somewhat lengthening the face. As a result, the victim cannot close his mouth, and the pain that occurs during the fracture intensifies with any attempt. Rupture of the gums by fragments is accompanied by moderate bleeding.

Symptoms and course. A fracture usually occurs with a strong enough impact. Loss of consciousness indicates a concussion, and the acute pain caused by the injury can cause the development of a state of shock. The most serious combined injury occurs with a fracture of the base of the skull.

First aid. Aimed at creating rest conditions for the injured bone. For this purpose, the lower jaw is brought as close as possible to the upper jaw and they are fixed in this position with a bandage, scarf, or belt through the cranial vault. You can use a ruler, a knife, or plywood, which are applied transversely to the teeth of the upper jaw and also fixed with any available material. Considering the possibility of complications (bleeding, difficulty breathing, loss of consciousness, etc.), transporting the victim to the hospital should be urgent, preferably in a supine position.

Fracture of the lower jaw. In case of trauma to the lower jaw, double and triple fractures are more often observed, which is explained by the shape of its bone (horseshoe type). Concussion is a common complicating factor.

Symptoms and course. A fracture of the lower jaw is characterized by pain, which sharply intensifies when trying to move it. Mouth half open. The correct relationship between the teeth of the upper and lower jaws is disrupted. Soon soft tissue swelling occurs. When touched, there is sharp pain in the area of ​​the fracture. Saliva is often stained with blood.

Due to the fact that a number of muscles that carry out its movement are attached to the lower jaw bone, their reflex contraction causes displacement of jaw fragments, which increases pain, bleeding, and discomfort.

In case of severe injuries, heavy bleeding, difficulty breathing, and shock may develop.

First aid. Try to use available means to stop or reduce the bleeding (tampon, pressing the bleeding area), try to eliminate the cause of difficulty breathing (put the patient face down, move the tongue forward), and in case of shock - artificial respiration. An ambulance must be called immediately.

In practice, there are cases of fracture of the lower jaw without such severe consequences. Then the main task in providing assistance is to create relative rest for the damaged organ. To do this, the lower jaw is, if possible, carefully “brought” to the upper jaw and fixed in this position with a bandage (gauze, bandage, belt, scarf, etc.) through the cranial vault. Given the possibility of a concussion, it is advisable to transport to the hospital in a supine position.

Patients with fractures of the lower jaw are absolutely advised to see a doctor, since self-medication usually causes complications that lead to the destruction of the jaw bone itself.

Disease of the tissues surrounding the tooth root. As a rule, it is preceded by pulpitis (see) with its inherent pain. Refusal to treat it predetermines the penetration of bacteria through the root canal of the tooth beyond its limits, causing acute inflammation under new conditions, called acute periodontitis.

Symptoms and course. A characteristic symptom is the appearance of independent pain, weak at first, then intensifying, becoming pulsating. Its difference from pain with pulpitis is that it is strictly localized and becomes sharp with mechanical stress on the diseased tooth, especially in the form of tapping. The closing of teeth is so painful that many people refuse to eat even liquid food. A moderate increase in body temperature is possible (up to 37.5°C). With these symptoms, the need for help from a dentist in the very near future is extremely great. Using home remedies, including pain relievers, warm rinses and bandages, may provide only occasional relief. Delaying the time to contact a specialist is fraught with serious complications due to the development of a purulent process, first limited and then widespread (see Abscess, Cellulitis, Osteomyelitis, chapter Dentistry and chapter Surgical diseases).

Resolution of this rapidly occurring acute process is possible with milder consequences. When a path is found for pus to exit from the source of inflammation into the oral cavity (through the molten mucous membrane covering the alveolar process) or through the skin to the outside with the formation of a fistulous tract, acute periodontitis passes into the chronic stage. In this case, the threat of dangerous complications is reduced, but does not disappear altogether.

Treatment. It is entirely possible to avoid the formation of a fistula tract. In an outpatient clinic, an outflow of pus is artificially created from the source of inflammation through the tooth canal and the pulp chamber, previously freed from rotting particles of decay of the pulp tissue. Then they are disinfected, followed by filling the canal and chamber with filling material. When the root canals are narrow, the diseased tooth is forced to be removed.

Chronic periodontitis. The presence of affected teeth in a person’s mouth, which, in his opinion, “don’t hurt” because there is no pain, is actually associated with unpredictable complications that arise not acutely, but gradually. This problem worries not only dentists, but also general doctors. The fact is that with chronic periodontitis, a focus of sluggish inflammation remains at the apex of the tooth root - a kind of incubator for various bacteria. There are almost no barriers to their life and reproduction, or they are insignificant. At the same time, the waste products of bacteria, the harmful substances they produce (toxins), as well as the breakdown products of tissue cells are, by their protein nature, foreign to humans. Constantly, sometimes over many years, penetrating into the body of the “host”, foreign proteins sensitize (poison) it and distort natural reactions.

If we consider that there can be several teeth with periodontitis (which is often the case), it is not difficult to imagine the massiveness of protein aggression. It has been established that as a result of such sensitization, severe general organ diseases can occur: the heart, kidneys, joints, eyes, etc. In addition, the perverted reactivity of the body aggravates and aggravates the course of existing diseases. In this regard, chronic foci of inflammation in the periodontal tissues, despite their almost asymptomatic course, must be eliminated to improve the health of the body.

A plastic, hardening material that fills a defect or cavity formed in a tooth in order to restore the anatomical and functional integrity of the tooth.

Fillings can be cement, metal, plastic, etc. The choice is made depending on the indications. Thus, cement or plastic are used to fill front teeth, since this material is more similar to the color of tooth enamel.

Metal ones are more resistant to mechanical factors when chewing food, but are not cosmetically suitable for front teeth (by color). A very strong and durable amalgam filling, unfortunately, stains the entire tooth a dark color. Composite fillings are the most promising at present.

This process is physiological and serves as an indirect indicator of the correct or impaired development of the child. As a physiological act, teething is not a painful phenomenon and cannot cause any diseases. It is in direct connection with the general health of the child - timely growth of teeth in a certain sequence indicates the normal development of his body. A delay in timing may be a consequence of rickets, an infectious disease, prolonged dysfunction of the intestines and changes in metabolism. Earlier teething - endocrine disorders. A discrepancy in the time of the beginning of the eruption of the central incisors by 1-2 months from the conditional period cannot be considered as the effect of any pathology.

The newborn does not have a single tooth, although in rare cases their intrauterine development is observed. In the period between 6 and 8 months of life, the central incisors of the lower jaw, and then the upper, begin to appear in the child. By 8-12 months - lateral incisors, first on the lower, then on the upper jaws. By 12-16 months, the first molars erupt, by 16-20 months - the canines, and by 20-30 months - the second molars, which complete the formation of the primary bite.

The eruption of baby teeth often affects the child’s well-being. In weakened children, this physiological process is accompanied by general malaise, poor sleep, restless behavior, crying, and moodiness. Sometimes the temperature rises to 37.5°C, the nature of bowel movements changes, short-term rashes on the body and redness of the facial skin are possible. The child's weight gain is temporarily suspended and immune defense is reduced. To establish the true cause of the malaise, a consultation with a pediatrician is necessary.

At the 7th year of life, the replacement of baby teeth with permanent ones occurs, the time of eruption of which, as a rule, coincides with the resorption of the roots of baby teeth and their loss. In contrast, the formation of a permanent bite begins with the appearance of the first molars of the lower jaw and normally ends by the age of 15-18 years. The central incisors (8-9 years), first premolars (9-10 years), canines (10-11 years), second premolars (11-12 years), second molars (12-13 years) sequentially erupt. The third molars of the lower jaw, or “wisdom” teeth as they are sometimes called, grow later, often after the age of 20-25 (see separately for complications associated with their difficult eruption).

A correctly and timely formed bite plays a big role in the normal development of the child’s body. Violation of the timing of teething (early or late), the order, as well as the absence of one or another tooth require the attention of a pediatrician and dentist, since they are evidence of pathology not only of a local, but often of a general nature (the result of diseases suffered by the mother during pregnancy, or any anomalies in the child’s health).

For various reasons, a number of deviations can occur in the structure of teeth, their location and development: the absence of a rudiment of a tooth, an incorrect position of the tooth axis (horizontal or oblique), which is why it erupts outside the arch of the dentition or remains in the thickness of the jaw bone. In addition, incorrect formation of the tooth itself - size, shape, position, color, lack of enamel coating, etc. Such changes should be analyzed by a specialist.

Disruption of normal eruption is most often observed with the eighth teeth of the lower jaw - the “wisdom” teeth. As a rule, it occurs due to a lack of space in the lower jaw, since all the others have already appeared before the “wisdom” tooth, without “leaving” enough space for it. A delay in eruption creates conditions for the development of an inflammatory process that develops from a local focus into a diffuse one, fraught with serious consequences. The disease is associated with constant trauma to the edge of the gum above the cusps of the wisdom tooth, where an ulcer forms, which, with an abundance of bacteria in the oral cavity, causes inflammation. The process quite quickly spreads to the surrounding soft tissues, including the masticatory muscles involved in the movement of the lower jaw. Due to pain, the patient is unable to open his mouth even half a centimeter.

Symptoms and course. The disease is usually accompanied by general malaise, loss of appetite, decreased sleep, and an increase in body temperature, sometimes to high levels (38°C and above). Since it is necessary to prevent the possibility of the process spreading to the surrounding bone tissue and fiber with the development of acute inflammation of the bone marrow (osteomyelitis) or soft tissues (phlegmon), it is very important, without relying on home remedies, to consult a dentist.

Before seeking medical help, in order to alleviate the condition, it is permissible to take painkillers such as analgin (0.5 g) and rinse the mouth with a warm solution of boric acid (half a teaspoon per glass of water) or potassium manganese (pink).

Acute inflammation of the dental pulp (pulp) due to the penetration of bacteria from the carious cavity of the tooth into it. As a result of the inflammatory process, the nerve endings, of which there are many in the pulp, are injured by its increased volume and waste products of bacteria (toxins), which causes acute pain. As the process spreads to the entire pulp tissue and the appearance of pus, the pain becomes pulsating, especially (which is typical for acute pulpitis) intensifying at night with irradiation to various parts of the maxillofacial area.

Treatment. Fighting pain with home remedies is not very effective (see Toothache). Self-healing is impossible. The ongoing destructive process, destroying the bridge between the pulp chamber and the bottom of the carious cavity, creates conditions for free communication between them and thereby for the unhindered outflow of pus from the pulp into the carious cavity, and then into the oral cavity. With the weakening of intrapulpal pressure on the nerve endings, the pain subsides, giving rise to a misconception about the end of the disease. And frivolous inattention to the fate of the tooth is a common cause of the emergence, as a complication of pulpitis, of a new disease - acute periodontitis. Therefore, an unconditional visit to the dentist, even if the pain disappears, will prevent the possibility of its development and increase the chances of saving the tooth.

Treatment of pulpitis consists of removing the painfully altered pulp, disinfecting the pulp chamber, as well as mechanical and medicinal treatment of the carious cavity, tooth root canals and filling them with filling material.

A tooth treated for pulpitis in a timely and correct manner can serve its purpose for many years.

The name of a condition when a person feels unwell for a long period of time, fatigue, increased sweating, decreased appetite, and sleep disturbance. In addition, pain in the heart area, rapid pulse, increased nervousness, headache, etc. may occur. Due to the mild manifestations of the disease, patients get used to this condition and find ways and means to adapt to it (painkillers, tonics, etc.), calming yourself down and considering this state to be normal.

However, as indicated in the “Periodontitis” section, these manifestations are associated with the presence of a chronic inflammatory process at the apex of the roots of sometimes many teeth. The waste products of bacteria, tissue decay and toxins, penetrating into the body, poison and change its sensitivity and reactivity to many factors (infection, cold, injury, overwork, etc.).

The condition that occurs as a result of a focus of allergy nesting in the body (autoallergy) proceeds extremely slowly. However, against its background, it creates the possibility of developing such serious diseases as: inflammation of the inner lining of the heart (endocarditis), its muscles (myocarditis), kidneys, eyes, blood vessels, etc. It should be assumed that autosensitization and allergization can aggravate or contribute to the occurrence of many diseases.

The cause-and-effect relationships are very complex, a qualified doctor can navigate them; you should not rely on self-medication, since the consequences can be the most unexpected and complicate the provision of medical care.

The name combines diseases of the oral mucosa of various origins and manifestations. The reason that caused it may be local or general. Local is associated with the participation of a direct factor - trauma, chemical, thermal, radiation exposure, and as a result of which redness, erosion, and ulcers occur on the mucous membrane.

Treatment. It comes down to eliminating the cause and rinsing the mouth with an antiseptic solution. Recovery usually occurs within 7 days. However, individual forms tend to repeat themselves after a certain period of time, for example, appearing in the spring and winter periods of the year. Others develop when taking certain foods (oranges, strawberries, etc.) or medications (sulfonamides, antibiotics, etc.). Particular attention should be paid to dentures and sharp edges of the teeth, which, by creating conditions for constant long-term irritation, can thereby cause a tumor process of the mucous membrane.

The most common causes of stomatitis are general diseases. Among them: infectious (measles, scarlet fever, chicken pox, tuberculosis, syphilis, etc.), allergies, intoxication, diseases of the gastrointestinal tract, cardiovascular system, endocrine, blood, etc. Often their first signs appear on the mucous membrane of the cavity mouth Therefore, if an area of ​​redness, erosion, ulcer, or crack appears on it, consultation with both a therapist and a dentist is necessary. Relying on self-medication is more than frivolous.

The following hygienic measures are indicated: brushing teeth, rinsing with solutions of boric acid, potassium permanganate, furatsilin, hydrogen peroxide. Taking any medications orally without a doctor's prescription is prohibited. Food should be liquid and not irritating.

Establishing a connection between stomatitis and a general disease will allow its treatment to begin. At the same time, against the background of improving general well-being, normalization of the condition of the oral mucosa is inevitable. The control periods for restoring its integrity range from 10 to 20-25 days. The lack of a tendency toward healing gives cause for concern and obligatory detailed examination in order to exclude the oncological nature of the formation.

It can develop as a result of a number of local and general diseases. Local causes include: surgical and chronic disease, in which there is a decrease in saliva production, blockage of the gland duct by a salivary stone or compression by a tumor.

Common causes are: diseases - Mikulicz, Sjögren, radiation, acute infectious diseases, diabetes, conditions after surgery on the abdominal organs, collagenosis, vitamin deficiencies A, B, E, increased function of the thyroid gland, menopause, etc. In old age, the possibility of dryness. increases in the oral cavity. Insufficient hydration of the oral cavity and tongue with saliva causes difficulty in eating and speaking. The mucous membrane is increasingly injured, cracks, erosions, and inflammation occur. With a lack of saliva, dental plaque increases and the growth of microflora in the mouth is activated. Self-cleaning of her cavity during eating is seriously impaired due to illness, especially when eating hard and spicy foods.

Various anomalies of nasal breathing also aggravate the phenomenon of “dryness” due to increased evaporation of liquid when breathing through the mouth.

Treatment comes down to eliminating the cause of dry mouth, or at least mitigating its effects. At home, they use products that protect the mouth and tongue from irritation. For this purpose, the mucous membrane is treated with peach and sunflower oil. A mixture of borax and glycerin (10% solution) gives a good result. The prescription of other medications should be carried out by a doctor in conjunction with other types of treatment.

The appearance of a constant feeling of dry mouth is a symptom of a number of diseases, which requires mandatory consultation with a specialist.