View full version. Methods for treating a fistula in children on the gum of a baby tooth

With various inflammatory processes and infections of the oral cavity, fistulas or otherwise fistulas often appear on the gums. They represent a void in the gum tissue that can be filled with pus.

This process is very dangerous and has serious consequences , so it’s better not to delay its treatment. A timely visit to a specialist will help save the tooth and prevent complications.

Features of therapy in a dental clinic

Many people are used to enduring toothache, putting off going to the dentist until later. But it is precisely these actions that lead to an advanced form of fistula. Best recommendation If a fistula is detected, a visit to the dental office is required.

Only high-quality diagnostics and treatment to eliminate the cause will help quickly get rid of gum lesions.

The presence of a fistula is determined visually, but how deep the infection has penetrated can only be judged by x-ray. The doctor determines how much the granuloma has grown and whether it has touched the periosteum tissue.

The process of fistula formation is briefly presented in the following video:

Treatment of a fistula in a dental clinic begins with treatment of the affected tooth. It is opened, the canals are thoroughly cleaned of pus and treated with a disinfecting solution.

A visit to the dentist may not be enough if, in the doctor's opinion, a temporary filling is necessary. Then medicine is placed into the affected canals, and the tooth is closed with a soft filling material.

After a few days, the temporary filling is removed, the canals are thoroughly cleaned again, and the tooth is filled with a permanent filling.

If the affected tooth has already been filled before, the treatment process may take a little longer. After all, the tooth must first be unfilled, then treated, and only then closed.

When a pin is installed in the root of the tooth, the unfilling procedure is complicated by the fact that the pin must be removed. If for some reason this is not possible, then it would be safer to remove the tooth root along with the pin.

Antibiotic therapy program

In complicated cases, accompanied by extensive tissue damage and a serious inflammatory process, an additional course of antibiotics may be prescribed.

Typically, these are drugs in tablets or solutions for intramuscular injections. The antibiotic stops the inflammatory process and destroys bacteria in a short time.

The type of antibiotic should only be determined by a doctor. When selecting the most effective drug the cause of the fistula, the extent of inflammation, the rate of development of the disease and other parameters are taken into account.

Therefore, you should not prescribe antibiotics yourself. There may be no benefit, but harm will be done to the body.

Most often, preference is given to Gentamicin in ampoules and drugs that contain this component. The course of treatment with tablets ranges from seven to ten days, and Gentamicin may be sufficient with two ampoules administered within one week.

Here is a small list of antibiotics that are used in dentistry in the treatment of such inflammatory processes:

Amoxiclav;
Doxycycline;
Trichopolum;
Amoxicillin;
Flemoxin solutab.

Each of these drugs has a number of side effects, including individual intolerance to the components of the drug. If the patient has previously had any allergic reaction to medications, you must inform the doctor about this before he makes an appointment.

Rehabilitation in the clinic

Photo: dental diathermocoagulator

If you delay treatment of the fistula, damage to neighboring tissues may begin. IN severe cases the fistula can spread to the adjacent tissues of the cheek.

After a course of antibiotic treatment and antimicrobials, as well as eliminating the cause of the fistula, may require rehabilitation measures aimed at tissue restoration.

For more fast healing Laser tissue treatment is applied to the affected areas of the gums. During this procedure, wounds on the gums and cheeks are burned with a laser, which stops possible bleeding.

Cauterization of tissue areas with a diametric current or in another way has the same effect. diathermocoagulation. Some patients are very sensitive to the effects of current pulses and this method of rehabilitation cannot be applied to them.

One more modern method, used to restore tissue structure after a fistula, is ultrasonic influence . With its help, tissue regeneration is accelerated, and healing occurs much faster.

All these techniques are performed in a dental clinic or physical therapy office.

What can you do at home?

Some therapeutic actions, aimed at eliminating the fistula and the consequences of its occurrence, can be done at home. From medications antimicrobial and anti-inflammatory agents are effective.

Promotes faster tightening of the fistula passage regular rinses saline solution , prepared independently, or specially intended pharmaceutical solutions: Chlorhexidine or Betadine.

Special gels with antimicrobial and antiseptic effects can also have a positive effect on the healing of the fistula tract. Among them are used Solcoseryl, Asepta, Metrogyl Denta.

At severe pain you can sometimes use cooling gels designed to remove pain syndrome in children during teething or analgesics.

It must be remembered that it is impossible to cure a fistula at home without consulting a dentist. If the cause is not eliminated, the problem will return. Therefore, all treatment must be agreed with the attending physician.

Use of folk remedies

There are many recipes for the treatment of fistula in folk medicine. Some consider them safer, but you should always remember the possible allergic reactions on herbs.

In combination with traditional treatment successfully used:

herbal infusions and decoctions for rinsing;
medicinal ointments and balms;
various lotions.

Can be used to relieve inflammation decoction. To prepare it, take in equal parts dandelion, yarrow, tansy and calendula. One tablespoon of the prepared mixture is brewed with boiling water, and when the broth has cooled to a comfortable temperature, you can rinse your mouth.

The herbs included in the decoction have a strong anti-inflammatory effect and healing effect.

Another popular remedy is considered to be a healing ointment, which contains many medicinal plants. To prepare an ointment for two parts of yarrow flowers and leaves, calendula flowers and dandelion root, take one part of tansy inflorescences and herbs, garden sorrel root, and sweet clover herb.

All plants need to be ground in a meat grinder or chopper, and then one part should be added to them ichthyol ointment or Vishnevsky's liniment. If the resulting mass is not homogeneous, you can add a little calendula oil. The resulting ointment is infused for 12 hours and then spread on the affected gum.

Cooking with your own hands will help pull out pus from the fistula tract. eucalyptus ointment. About forty grams of eucalyptus should be combined with a tablespoon sunflower oil and leave for 24 hours. Then chopped onion is added to the mixture.

The mixture wrapped in a gauze bag is applied once a day to the damaged area. You should be careful, as eucalyptus can cause irritation and ulcers. In this case, the amount of eucalyptus in the mixture should be halved.

Another recipe for a medicinal lotion can speed up the healing of the fistula passage. To the crushed leaves of aloe and Kalanchoe (three pieces of each) add several cloves of finely chopped garlic.

The resulting pulp is wrapped in gauze or bandage and applied to the affected gum for ten minutes. If you leave the lotion on for too long, burning and irritation may occur.

For admirers traditional medicine It should be remembered that the listed recipes are only effective as aids to speed up recovery. But you shouldn't rely only on healing properties plants, because to cure you must first eliminate the cause of the fistula.

Features of therapy in a child

A fistula in a child is a very dangerous dental problem. Therefore it is not timely treatment or attempts to deal with a fistula on your own can lead to unpleasant complications.

At the first signs of fistula formation in a child, you should immediately contact pediatric dentist . There is no point in saving a baby tooth, so it is better to remove it immediately to save the baby from pain.

After removing a diseased tooth, you need to relieve the inflammatory process. For this, external agents are often used, for example, the affected part of the gum is lubricated with an ointment containing an antibiotic.

Internal antibiotics can only be prescribed for extensive lesions bacterial infection, which is confirmed only by laboratory tests.

If the child already knows how to brush his teeth on his own, then you can resort to saline rinses. But you should not leave the child alone during the procedure to avoid accidental ingestion of the solution along with the pus that gets into it.

You should not start the course of the disease either in children or adults, then the treatment will pass fast. Recurrence of a fistula can be avoided by observing good oral hygiene and timely treatment of problems with teeth and gums.

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Any disease related to teeth or gums requires an urgent visit to the dentist. Only a specialist can make the correct diagnosis and perform necessary treatment. You need to take the hole in your gum especially seriously. Because this leads to the formation of a fistula. And fistula, as you know, is an inflammatory and purulent disease, and you should not delay its treatment.

What is a fistula and the reasons for its appearance

Fistula is purulent formation, which looks like a pouch on the gum or a small hole. In fact, it is a canal running inside the gums, and it connects the surface with the suppuration that has formed at the root of the tooth. Fluid and pus pass through this channel from the source of inflammation. It can even be seen with the naked eye. The cause of the formation of a growth on the gum is the activity of pyogenic microorganisms. The causative agents of fistulas are staphylococci, pneumococci and gonococci. But the main culprits in the formation of fistulas are diseases such as caries, periodontitis and pulpitis. With caries, the tooth tissue begins to rot, thereby forming caries on it, and due to the active activity of carious bacteria, a fistula is formed in the gum. Pulpitis is a complication, which appears as a result of untreated caries. So that decay does not reach the root of the tooth and does not enter the bone and soft cloth jaw, the diseased tooth should be filled and the nerve removed. Periodontitis is caused by an infection that inflames the tissue around the tooth. This disease, if left untreated, also contributes to the formation of a fistula. In addition to the above, a cyst can be the cause of a growth on the gum. It forms on top of the tooth root due to untreated pulpitis. The cyst is filled with pus and can reach a size of 2–3 cm. When the pus fills the cyst, it comes out and thereby forms a fistula on the gum. There is another disease - granuloma, which also provokes the formation of a growth on the gum. Granuloma is similar to a cyst, only it has smaller size and does not have a shell. Granuloma is easier to treat than a cyst. These diseases also appear after advanced caries or improper treatment. During canal filling, voids should not remain, because they are what cause inflammation and then fistulas. Many people do not know that the cause of growth on the gums can be wisdom teeth, as well as difficult eruption of baby teeth. Sometimes the long eruption of children's baby teeth or complex wisdom teeth contribute to gum swelling and inflammation, which leads to the formation of a fistula.

Symptoms

This dental disease has some symptoms by which it can be identified:

A fistula on the gum can be of two types: external and internal. A person can detect an external fistula himself. But the internal fistula cannot be seen during visual inspection. To see it you need to undergo an x-ray.

Kinds

This disease has several varieties that appear as a result of exposure to various factors. But These types should be highlighted separately:

A fistula formed after tooth extraction. After the removal of a diseased tooth, a fistula may appear due to suppuration in the sinuses or gums. It should be noted that this type is rare and is a consequence of infection during tooth extraction.
After tooth extraction, serious complications may occur, which are characterized by the appearance of a fistula from the diseased tooth to maxillary sinuses, and therefore the sinuses may become inflamed.
Fistula under the crown. This type of fistula can be found often. When a person often places crowns, and this operation is not an easy one, inflammation occurs as a result of the canals not being healed. The situation is difficult because the patient has already installed a crown and in order to treat the fistula it will need to be removed.
After tooth implantation. This type of fistula is formed due to poor cleaning of the place where the implant is to be installed or, conversely, its incorrect installation.

Treatment

Treatment of fistula in the gum

For fistula treatment to be effective, it is first necessary establish the reason for its appearance, namely to cure the tooth. The dentist must thoroughly clean the dental canals, remove pus and all carious deposits. After this, it is necessary to treat the tooth disinfectant and seal it. At the very moment when the pus comes out, the patient will be able to feel obvious relief, while toothache decreases noticeably. But sometimes a fistula rupture can occur before a visit to the doctor, and at this moment a person thinks that it is no longer worth pursuing treatment, but this opinion is erroneous. Affected tissue must be removed by curettage, otherwise inflammation may start again. After the dentist opens the fistula itself, the wound on the gum should remain open, but it should be periodically disinfected. With the help of rinsing, all the exudate should come out, and thanks to physiotherapy, the inflammatory process is eliminated. Along with external treatment, it is imperative to take anti-inflammatory and antiviral drugs. If the symptoms of the disease begin to disappear, the patient will immediately notice this, because the swelling subsides, the pus will stop oozing, the redness will disappear, and the wound itself will begin to heal. On a sore tooth you should put a temporary filling, and after 10 days change it to a permanent one. This is necessary to exclude signs of a new infection. If a complication arises, for example, the spread of infection to the periosteum, then removal of the fistula is possible only surgically. A timely visit to the dentist will avoid serious complications and operations.

Treatment during pregnancy

As a result of the fact that the expectant mother’s body is highly susceptible various infections, then sometimes they may also develop fistulas on the gums. Naturally, in this case, the fistula cannot be treated with antibiotics. Therefore, the dentist takes completely different measures for pregnant women. Most often, treatment of fistula during pregnancy is based on the use of drugs herbal and ointment form.

Treatment of fistula in children

In children, the disease occurs due to impaired growth of baby teeth. For small child this situation serious, so you should immediately consult a dentist. If it is not treated in time, the child’s body may weaken and he will become irritable due to toothache. Also, a neglected fistula can lead to chronic diseases already permanent teeth. Treatment in children is based on two methods:

medication, with the help of which the doctor selects medications for the child and herbal infusions for rinsing the mouth;
removal of the tooth that is the cause of the disease. The dentist makes this decision only if the fistula is serious and other treatment will not help.

Folk remedies

Only a doctor should choose the method of treating a fistula on the gum, and he does this after an examination. After dental procedures the patient undergoes a course of antibiotic treatment and at the same time rinses the mouth medicinal solutions, for example, furatsilin. But there are many medicinal herbs, which have an anti-inflammatory effect. Naturally, they cannot eliminate the cause of the disease and lead to complete cure, but for the purpose of quick healing they will be of great help. You can treat a fistula with rinses using the following herbs:

Prevention

There is no such thing as prevention, the only thing necessary is keep your mouth clean. This can be done using daily hygiene and frequent visits to the dentist to clean plaque and tartar from your teeth. You need to remember that everything depends on the person himself and on whether the visit to a specialist was carried out in a timely manner and how well control over dental health is exercised.

Fistula is one of the possible options advanced inflammatory process, which in some cases has a hidden course. Poor filling of dental canals or periodontitis not treated in a timely manner - often these factors are the root cause of a fistula. The situation threatens tooth loss, so urgent appeal See a doctor to help save your tooth.

Fistula on the gum: what is it?

IN general concept fistula (fistula) is a channel that is formed as a result of the release of infected contents from the source of inflammation to the surface. Fistulas can form in different organs. By different types classification, the manifestation can be external, internal, acquired or congenital. More specifically, a fistula on the gum (fistula gingivalis) appears when purulent inflammation in the thickness of the jaw or periodontium connects with oral cavity. In some cases it can be detected during routine dental examination, but radiography is a more reliable method.

Manifestations of fistula

The gums around the tooth are swollen and red;
The tooth is movable;
When you touch a tooth, the pain intensifies;
Purulent contents come out into the fistula canal.

Causes of fistula formation

A fistula forms on the gum usually due to chronic infectious and inflammatory diseases, the course of which occurs in hidden form. This and chronic periodontitis(inflammation of the soft tissue of the gums around the root of the tooth), and chronic periostitis (inflammation of the periosteum), and problems with eruption pathological teeth wisdom. If, during the treatment of dental caries, the carious cavity has been insufficiently treated and microorganisms remain in it, then they cause further destruction and infection of the tooth tissue. With a cyst, a gingival fistula can also form.

Most common cause fistula formation is granulating periodontitis. With this form of inflammation, active growth is observed granulation tissue(formed during the healing of wound areas and inflamed areas), which spreads through the surrounding tissues, causing their destruction. Ultimately, a fistula appears at approximately the level of the apex of the tooth root. Sometimes granulating tissue can form a fistulous tract in the thickness of the cheek and open it on the surface of the face. Exacerbating factors for periodontitis with a complication in the form of a fistula can be previous illnesses, stress, hypothermia, etc.

Treatment of gingival fistula

Since a fistula is a consequence of inflammation, treatment begins from the root cause, that is, it is necessary to get rid of periodontitis. After high-quality treatment of caries, tooth filling, cyst treatment, a drug therapy in the form of ointments and gels on the affected area, as well as antibiotics and histamines for oral administration. Additionally, salt baths (rinses) are recommended to quickly reduce inflammation and relieve swelling.

You must be prepared for the fact that periodontitis complicated by a fistula will require more than one visit to a specialist. But if you apply in a timely manner, the process will not be very long, and most importantly, it will be possible to do without surgical removal granulations. Otherwise, the tooth will have to be removed with curettage of the fistula canal.

Preventive actions

Regular visit dentist;
Compliance personal hygiene oral cavity;
Professional oral hygiene procedures (every six months);
Healthy image life and proper nutrition.

A fistula is the final stage of tooth destruction, which begins with caries, progresses to pulpitis and then to periodontitis. If timely treatment is not received, then the tooth must be removed. But even if shown surgical intervention, specialists try to save the tooth if possible. In order for specialists to have the maximum chance for this, first of all, the patient himself must carefully monitor his oral cavity and contact a dentist for regular preventive examination, and do not hesitate in case of obvious problems or any suspicion of problems in the oral cavity.

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The phenomenon of a fistula (fistula), which occurs on the gum in the area of the root of the affected tooth, is familiar to many patients dental clinics. Usually, a fistula is easy to detect with the naked eye, since it looks like a swelling of the gums, or a wound from which purulent masses are discharged. The appearance of a fistula is always accompanied by pain and causes discomfort to a person.

Patients who have this problem in an advanced form often come to the LeaderStom clinic. To help you avoid unpleasant consequences inflammation that occurs in the area of the tooth root, we will tell you in more detail about the reasons for the appearance of a fistula on the surface of the gum, methods of treatment and prevention of the fistula. What is a fistula localized on the gum? Translation of the word "fistula" from Latin language sounds like a "tube". And, indeed, it looks like a narrow channel-tube through which purulent masses are removed from the source of inflammation (located at the root of the tooth). In this way, the accumulated pus makes its way: it moves from the root through the jaw bone and eventually breaks through the gum tissue. At this point, the person usually feels relieved and, thinking that the disease has subsided, cancels the visit to the dentist. But since the cause of the fistula has not been eliminated, the existing canal is filled with pus again and again. Symptoms by which you can recognize a fistula on the gum. A fistula formed in the gum is accompanied by a number of unpleasant symptoms. They usually push the patient to go to the dental clinic.

Symptoms indicating the presence of a fistula are as follows:

Swelling and redness of the gums.
Severe or moderate pain when pressing on a tooth.
The formation of a wound on the gum, from which pus separates.
The occurrence of tooth root mobility.
Increase in patient's body temperature.

Causes of fistula in the oral cavity

The key factor in the formation of a fistula on the gum is inflammation. Let's now figure out why the tooth root can become inflamed?

This happens in a number of the following cases:

Advanced carious processes in teeth. Why is untreated caries dangerous? Over time carious cavities become deeper, they first affect the dentin, and then the pulp of the tooth. Acute toothache usually indicates that the infection has reached the nerve tissue. Then the nerve dies, and then the inflammation passes into the canals of the tooth root. In this case, either a granuloma or cyst forms on the root of the tooth, or purulent masses make their way in the form of a fistula in the gum.

Incorrect treatment of caries. A number of cases have been recorded in which a fistula formed on the gum above the patient’s apparently healthy teeth. This happened because the person’s tooth was treated incorrectly at one time. Those. if it was dead tooth and the canals were treated, they were not completely sealed. Or there was a leaky filling on the tooth, under which the inflammatory process continued to occur.

Damage to dental canals. When a dentist performs root canal treatment, sometimes he can damage them, so to speak, perforate them. Holes such as perforations often cause a dental fistula to develop on the gum.

How is a fistula on the gum diagnosed?

When talking about diagnosing a fistula that appears due to inflammation in the area of the tooth root, it should be noted that there are two forms of manifestation of this problem:

External. When the fistula is visible to the naked eye, the doctor can easily identify the affected tooth during a visual examination.
Internal. When the process is still in progress initial stage and it can be diagnosed using x-ray examination, which also allows you to determine the size of the inflammation and the degree of damage to the gums and bone tissue.

Why is a fistula in the mouth dangerous?

In addition to unpleasant symptoms and noticeable pain, the formation of a fistula on the gum can lead to more tragic consequences: If treatment for the fistula is not started in time, the patient risks losing a tooth in the area of the root canals of which inflammation has developed. The area affected by the inflammatory process, manifested in the form of a fistula on the gum surface, increases over time. This means that in an advanced situation, people can also become infected. healthy teeth patient. As a result, an inflammatory process will also begin in them.

How to cure tooth inflammation and cope with a fistula on the gum?

Treatment of fistula requires thorough measures and professional medical care, which will be provided to you by specialists at the dental clinic. The solution to the problem is that the doctor either prepares the patient’s diseased tooth or gets to the source of inflammation through the gums.

The fight against fistula in the oral mucosa in various cases involves:

Preparation of the patient’s tooth, which showed inflammation, cleaning of the canals, followed by placement antiseptic medicine and their filling.

Unsealing the canals, if they were previously not completely sealed, using an anti-inflammatory drug, installing a temporary filling. Then, just as in the first case, the canals are re-filled and permanent filling or crowns. When the root is perforated, all contents are also removed from the canals, and then the inflammation is neutralized and the damage is closed using special cement. In a situation where it is easier to get to the source of inflammation through the gums (for example, if a crown is installed on a patient’s diseased tooth), the doctor performs surgery using a laser.

After the tooth has been treated in the dentist’s office and the fistula has been eliminated, the patient performs a series of preventive measures, accelerating the healing process and preventing the occurrence of new inflammation. These measures involve the use of rinses and other preparations. local action. In more difficult situations The patient is prescribed a course of antibiotics.

Need to know

The problem with such a phenomenon as a fistula on the gum is that it is not always possible to “foresee” it. If in the case of advanced caries the situation is more or less clear, then when the cause of inflammation is poor-quality canal filling or perforation of the patient’s tooth root, the source of inflammation for a long time remains hidden from the eyes of the doctor and the patient and can only be detected during an x-ray examination.

Another unpleasant point associated with “retreated teeth”, on the gums near which a fistula has appeared, is the fact that in 60-70% of cases, the canals are not completely filled. As a result, inflammation appears again after some time. And this means that a fistula on the gum above the root of such a tooth may occur again in the patient. In order to avoid similar situation, patients with fistula problem should only go to a professional clinic and choose experienced doctor. Such a specialist will be able not only to technically competently fill the root canals of the tooth, but also mandatory will order an x-ray examination. Based on the results of the image, the doctor will determine whether there are cavities left inside the canal.

If you want to get quality medical service and avoid dental problems in the future, we invite you to become patients of the LeaderStom network of dental clinics. Our dentistry has everything necessary equipment for diagnostics and competent treatment of fistula on the gum without relapses and complications. Our doctors have solid practice in this matter and specialize in solving complex and ambiguous situations.

The infectious-inflammatory process spreads deep into the roots of the tooth, next to which an accumulation of purulent exudate forms. The pus seeks a way out, and a fistula is formed - a tubular cavity through which part of the purulent contents pours into the oral cavity. Also, a fistulous tract can form due to difficult teething, perforation of roots during treatment, incorrect filling of a tooth, or re-implantitis (inflammation near the installed implant). A fistula on the gum requires immediate and professional treatment, since it is a constant source of infection in the mouth and a source of possible dangerous complications.

Treatment of fistulous tract on the gum

When a fistula forms, severe toothache, swelling and redness of the gums are observed. After the opening of the passage and drainage of pus, the pain decreases or disappears altogether, which some people take as a sign of “recovery” and postpone an already planned visit to the dentist. In fact, the inflammatory process is in full swing, and it must be promptly eliminated.

If a fistulous tract is detected on the gum, treatment will depend on the cause of its appearance:

In cases where the cause is caries, pulpitis or periodontitis, it is necessary to thoroughly clean the dental canals, remove pus and carious tissue. After thorough antiseptic treatment, the canals, and then the tooth itself, are sealed.
If the filling is of poor quality, the doctor will have to unfill the canals, carry out anti-inflammatory therapy (usually anti-inflammatory drugs are temporarily placed in the canals themselves, closing the cavity with a temporary filling) and, only after the infection has been completely eliminated, refill the tooth. If it is not possible to completely clean the canals of the teeth, root resection or complete tooth extraction will be required (according to indications and in case of emergency).
When the root of a dental unit is perforated, treatment is difficult; a favorable prognosis is only possible if you consult a dentist early.
A fistula after dental implantation is an indication for removal of the implant and anti-inflammatory therapy.

For the final elimination of pathology during the formation of a fistula on the gum, treatment with antibiotics is practically prerequisite. The doctor selects medications individually, taking into account the characteristics of the patient’s body, the severity of the inflammatory process, and the possibility of allergic reactions.

Is it possible to treat a fistula on the gum at home?

In this case, home treatment will not only not give desired effect, but can also lead to complications, since it will smooth out the main symptoms and the infection will develop covertly. As a temporary measure to treat gums before visiting a doctor or as an additional anti-inflammatory agent after dental intervention You can use rinses from decoctions of chamomile and calendula flowers, yarrow, and sage leaves.

The Center for Implantation and Orthodontics “Zuub”, among other services, provides treatment for fistula tracts of various etiologies and degree of expression qualitatively, competently and with optimal results for the patient. Competent specialists using modern equipment and safe the latest drugs will help eliminate the infection and save the tooth.

If you have the symptoms described in this article, be sure to make an appointment at our clinic.

Don't self-medicate! Even the smallest problem, if not proper treatment, can make your life much more difficult.