Abscesses, phlegmon of the buccal area. Abscess in the mouth on the cheek

Formation of an inflammatory purulent focus in the tissues of the maxillofacial area of ​​the face. It manifests itself as local swelling, redness and fluctuation (fluctuation) of the skin over the source of inflammation, facial asymmetry, difficulty and pain in swallowing, and symptoms of intoxication. It can develop into diffuse inflammation - phlegmon, involving the peripharyngeal and infraorbital region, neck. Treatment is always surgical - opening and draining the abscess cavity.

General information

- this is a limited focus purulent inflammation tissues of the maxillofacial zone. If abscesses are left untreated, purulent decay and purulent melting of adjacent tissues begin.

Causes of perimaxillary abscess

The abscess is caused by streptococcal and staphylococcal microflora; the most common cause is dental disease and inflammatory processes in the maxillofacial area. Furunculosis, tonsillitis, and tonsillitis in chronic cases are complicated by perimandibular abscesses. Damage to the skin and mucous membranes in the mouth, infection during dental procedures can provoke an abscess in the perimaxillary area.

Common infectious diseases of the sepsis type, as a result of the spread of microorganisms by blood and lymph, cause multiple abscesses in various organs and tissues, including abscesses of the perimaxillary area. An abscess in the maxillary area can occur due to facial trauma. During hostilities and natural Disasters due to the lack of first aid, dislocations and fractures of the jaws are often complicated by abscesses. Periapical and pericoronal foci of inflammation and periodontal pockets during exacerbations can provoke jaw abscess due to resorption bone tissue.

Symptoms of perimandibular abscess

The formation of an abscess is preceded by toothache, as in periodontitis. Biting on the affected area increases the pain. Next comes dense swelling with the formation of a painful compaction. An abscess developing under the mucous membrane is characterized by bright hyperemia and protrusion of the affected area. Facial asymmetry is sometimes noted.

Without treatment, it gets worse general state patient: body temperature rises, refusal of food is observed. After spontaneous opening of the abscess, the pain subsides, the contours of the face take on normal shape, and general health stabilizes. But because favorable conditions for microorganisms in the oral cavity, the process is chronic, so its spontaneous opening does not indicate a cure. With short-term weakening of the immune system, perimaxillary abscesses worsen. Chronic suppuration from the fistulous tracts is possible; it is accompanied by an unpleasant odor from the mouth and ingestion of purulent masses. The body becomes sensitized by decay products, and allergic diseases worsen.

Abscesses of the floor of the mouth are characterized by hyperemia in the sublingual zone with rapid formation of infiltrate. Conversation and eating become sharply painful, and hypersalivation is noted. The mobility of the tongue decreases, it rises slightly upward so as not to come into contact with the forming abscess. As the swelling increases, the general condition worsens. Upon spontaneous opening, the pus spreads to the peripharyngeal region and neck, which leads to the appearance of secondary purulent foci.

Palate abscess most often occurs as a complication of periodontitis of the upper second incisor, canine and second premolar. During the formation of an abscess, hyperemia and soreness of the hard palate are observed; after the bulging, the pain becomes more intense, eating becomes difficult. Upon spontaneous opening, the purulent contents spread to the entire area of ​​the hard palate with the development of osteomyelitis of the palatine plate.

If a cheek abscess occurs, then depending on the location and depth, swelling and redness may be more pronounced on the outside or on the oral mucosa. The soreness of the lesion is moderate; when the facial muscles work, the pain intensifies. The general condition is practically not affected, but an abscess of the cheek is dangerous if it spreads to neighboring parts of the face even before opening the abscess.

A tongue abscess begins with pain in the thickness of the tongue, the tongue increases in volume and becomes inactive. Speech, chewing and swallowing food are severely difficult and painful. Sometimes with an abscess there may be a feeling of suffocation.

Diagnosis and treatment of perimandibular abscess

The diagnosis is made based on a visual examination of the dentist and patient complaints. Sometimes during the survey it turns out that there have been boils in the facial area, or there are chronic infectious diseases. Before visiting a doctor, it is recommended to take analgesics and rinse the mouth with antiseptic solutions; self-administration of antibiotics is unacceptable. The ultimate goal of treatment is complete elimination infectious process and restoration of impaired functions in the shortest possible time.

The treatment regimen depends on the stage of the disease, on the virulence of the microorganism and on the characteristics of the response from the macroorganism. The localization of abscesses in the perimaxillary area, the age of the patient and the presence of concomitant diseases significantly influence the principles of treatment. The more complicating factors, the more intense the therapy should be.

During the treatment of abscesses of the perimaxillary area, it is recommended to follow a diet with a predominance of pureed soups and purees. If there is a persistent refusal to eat, they resort to intravenous administration of protein solutions. If there is a formed abscess, its opening followed by drainage of the cavity is indicated. In other cases, antibiotic therapy is resorted to, and only if it is inappropriate, the question of surgical treatment is raised.

Antibiotics are prescribed by injection or in tablet forms, and an additional course of vitamin therapy is given. Immunostimulants and detoxification therapy are indicated. Rinsing the mouth with warm solutions of furatsilin and soda relieves swelling and prevents the spread of infection. In the presence of pronounced pain syndrome analgesics are used. When complex therapy is started on time, the prognosis is usually favorable, recovery occurs within 6-14 days.

: upper - lower edge of the zygomatic bone, lower - lower edge lower jaw, posterior - the anterior edge of the masticatory muscle, anterior - a line drawn from the zygomatic-maxillary suture through the corner of the mouth to the lower edge of the lower jaw.

1 - zygomatic bone; 2 - a line drawn from the zygomatic-maxillary suture through the corner of the mouth to the edge of the lower jaw; 3 - lower edge of the lower jaw; 4 - anterior edge of the masticatory muscle.
In the buccal region, superficial and deep cellular spaces are distinguished. The superficial cellular space is located above the buccal muscle, between the laughter muscle and m. platysma from the outside, and the buccal muscle with the buccal aponeurosis covering it and the body of the mandible from the inside.

In addition to loose fiber, the space contains the facial artery, vein and fatty lump of the cheek, which is delimited from the surrounding tissues by its own case, whose processes penetrate into neighboring areas. The lower lobe of the fatty lump lies in the buccal region, the middle lobe is under the zygomatic arch. The upper deep part of the fatty lump extends to the temporal region, while the posterior process penetrates into the subgaleal cellular space, the upper one - to the inferior infraorbital fissure and the medial one - into the pterygopalatine fossa. The medial process can extend through the superior orbital fissure onto the intracranial surface sphenoid bone and adjacent to the wall of the cavernous sinus. This anatomical feature can cause sinus thrombosis as a result of the spread of infection without involving the facial veins in the process. The fatty lump of the cheek and its fascial sheath can serve as a conductor of infection into the buccal area from the parotid-masticatory and temporal.
Thus, in the buccal region there are two forms of phlegmon: superficial and deep.

Main sources and routes of infection: foci of odontogenic infection in the area of ​​the upper and lower premolars, molars, infected wounds of the skin and mucous membrane of the cheek. Secondary damage as a result of the spread of infection from the infraorbital, parotid-masticatory, zygomatic and infratemporal areas.

Objectively: with superficial phlegmon, a pronounced asymmetry of the face is determined due to inflammatory infiltration of the tissues of the cheek. The skin is tense and hyperemic. Palpation causes pain. Limitation of mouth opening.

With deep phlegmon, facial asymmetry is determined due to swelling of the cheek. Skin of normal color. When examined from the oral cavity, swelling of the buccal mucosa due to infiltration is revealed. The mucous membrane is tense and hyperemic. Palpation causes pain. Mouth opening is limited.

Ways of spread of infection: infraorbital region and canine fossa, pterygomaxillary space, temporal region, parotid-masticatory region.

Technique: superficial phlegmon of the buccal area is opened using extraoral access, by making radial incisions from the tragus of the ear to the outer corner of the palpebral fissure, to the wing of the nose and to the corner of the mouth. and for phlegmon located in the lower part of the buccal region, use an incision parallel to the edge of the lower jaw and 1-1.5 cm below.

When opening deep phlegmon of the buccal region, intraoral access is used, by dissecting the mucous membrane of the cheek parallel to the projection of the excretory duct of the parotid salivary gland - above or below. Then they bluntly penetrate to the place where pus accumulates. The operation is completed by draining the abscess by introducing rubber glove graduates into the surgical wound.

When there is a combination of superficial and deep phlegmon, simultaneous extraoral and intraoral incisions are made.

"Operative surgery of abscesses, phlegmons of the head and neck", Sergienko V.I. et al. 2005

Dental flux is an inflammatory disease of the periosteum. Already at the first stage, the disease begins to manifest itself due to the appearance of pus and pain. In order to understand what flux looks like, you need to look at its photo. At the initial symptoms of the disease, you should immediately contact your dentist.

Why does flux occur?

There are many reasons for the occurrence of this disease. Flux on the cheek appears as a complication of pulpitis. Often inflammation occurs due to serious damage to the oral mucosa or infection. In parallel with the gumboil, the gums and cheek begin to become inflamed. They become painful and redness occurs.

The disease is accompanied by swelling of the gums located near the diseased tooth and severe pain. Purulent exudate accumulates in the tissues of the gums and teeth.

Causes of suppuration

There are several factors that can cause your gums to swell:

1. Untreated pulpitis and caries. Over time, it can penetrate into the dental pulp. This will lead to the development of inflammation. Pulpitis is characterized by aching and sharp pain in the tooth that occurs spontaneously. At this stage, you should urgently visit the dentist, as the inflammation will continue to develop and enter the tissues that surround the tooth. It is because of this that inflammation forms near its roots, which leads to the appearance of a periodontal abscess. Pus actively accumulates inside and subsequently gets under the gum mucosa. This leads to its swelling and formation of flux.
2. Poor quality filling of molars. Flux often appears due to poor root canal treatment. They are filled when periodontitis or pulpitis occurs. Sometimes they are not filled to the very top of the root, and because of this, an infection begins to develop in the upper part, which eventually leaves the confines of the tooth. In the tips of the roots, the canals of which have not been filled, there occurs severe inflammation.
3. Exacerbation of periodontitis. If the disease progresses between the gum and the tooth root, the dental-gingival attachment begins to collapse. This leads to the appearance of periodontal pockets containing dental plaque. A pocket that is too deep can cause fluid to leak out. As a result, a fistula or severe swelling forms on the gum.

Symptoms of the disease with photos

During flux, symptoms such as severe aching pain are observed. It may intensify when tapping on the crown. During this disease, inflammation develops, an unpleasant odor emanates from the mouth and swelling of the oral mucosa occurs.

The infection begins to appear at the top of the tooth roots. Over time, fluid accumulates in this area and makes its way out. It also accumulates in bone tissue. Because of this, a painful compaction forms in the tissues near the diseased tooth.

If the disease persists for a long time, it has the following symptoms:

• inflammation of local lymph nodes;
• swollen cheek;
• high temperature, which can reach 38 degrees;
• the appearance of pus outside;
• throbbing pain radiating to the temples, throat and ears.

To understand what a particular symptom looks like in life, you should familiarize yourself with its photo. This will allow the person to have a visual representation of each symptom.

Flux treatment

To avoid complications in the future, tooth flux must be treated promptly. There are many ways to treat this disease. Flux can be removed not only with the help of a dentist, but also at home. Before starting home treatment, you should visit the clinic in advance and consult with your dentist.

What can you do at home?

At home, antiseptic solutions are used that need to be treated oral cavity:

1. Furacillin. To prepare the solution, use two tablets per liter of water. The oral cavity is rinsed several times a day.
2. Miramistin. This solution relieves inflammation. It is recommended to rinse your mouth 4 times a day.
3. Chlorhexidine. This pharmaceutical drug, which is used to rinse the mouth 3 times a day. It is advisable to do this before bed or after meals.

Tablets will help you quickly get rid of the tumor

Flux should be treated with antibiotics very carefully. It is not recommended to treat flux yourself. Only a dentist can correctly select the right medications.

The most commonly used antibiotics are:

1. Lincomycin. With this drug you can quickly cure the infection. He has side effects, so it is prescribed by the attending physician.
2. Amoxiclav. This remedy has a wide spectrum of action. It is often used when the patient has various dental diseases. It allows you to get rid of streptococcal and staphylococcal infections. Also, the antibiotic easily copes with inflammation. You can take powder or tablets. For swelling of the gums, powder is used, as it is more effective.

With a purulent form of flux, it is impossible to cure only with antibiotics. So it can be cured only after the intervention of a surgeon.

There are factors that influence the effectiveness of antibiotics in fighting disease. You need to take your medications correctly. You should find out in advance how much medication you need to take and take the dose prescribed by your doctor every day.

Dentist help

You should contact your dentist immediately after the first signs of the disease are detected. The doctor may need an X-ray of the gums with flux to determine from the photo whether there is internal suppuration. At an early stage of the disease, the dentist may prescribe a course of antibiotics. This will give you a chance to save the diseased tooth.

If the flux has acquired an advanced form, you will have to seek help from a surgeon. Often in such cases, the diseased tooth is removed. During the operation, the abscess is opened and cleared of fluid. After cleaning, everything is treated with antiseptics. In order for the newly appeared fluid to drain away, a special drainage tube is installed. Already a few days after the procedure, your health improves.

• Do not take painkillers without consulting a doctor;
• Do not take aspirin, as it may increase bleeding;
• The sore spot should not be warmed with compresses or a heating pad.

Rinse with herbs and salt - traditional methods

When treating with traditional methods, you can use salt, herbs and other recipes. TO folk methods relate:

1. A solution of soda and salt. Helps remove inflammation. To prepare such a solution, you need to mix a spoonful of salt and soda in a glass warm water. Rinse throughout the day after meals or before bed.
2. Sage and lemon balm. They have a calming effect and help relieve pain. If your cheek is swollen, you can use them with oak bark. For preparation, an equal amount of these plants per liter is mixed hot water. You need to rinse your mouth after the solution has cooled to room temperature.
3. Honey propolis. You can chew it throughout the day. This helps with strong aching pain. If the patient has severe inflammation, then an alcohol extract of the plant is used. It lubricates the place where the flux came out.
4. Alcohol tincture of calendula. One teaspoon is diluted in a glass of warm water. Rinse your mouth about 8 times a day. In this case, the liquid should be held behind the cheek for 20 seconds. This will help relieve the swelling.

Why is it necessary to treat suppuration?

If the disease is ignored, consequences may appear over time. These include:

1. Abscess. It is a reservoir in which liquid accumulates. Its initial stage is accompanied by severe pain. External manifestations begin only in subsequent stages of the abscess. These include the appearance of swelling, compaction and facial asymmetry. The patient may experience malaise, fever, problems with appetite and sleep.
2. Phlegmon. Appears when the patient was unable to get rid of the abscess. In this case, the reservoir with pus does not have walls, which allows it to spread freely. The complication is accompanied by high temperature, which can reach forty degrees. There are breathing problems. The complication develops very quickly, so if phlegmon appears, you should immediately consult a doctor.

Features of flux treatment in children

A doctor should monitor the treatment of the disease in children. Treatment tactics for children may vary. For example, you can get rid of a temporary baby tooth. However, this is not recommended if the child is less than seven years old.

When treating children, surgery is often necessary. In this case, the flux is opened and the accumulation of pus is removed from it. This relieves acute pain. Sometimes surgery is not enough for a complete recovery.

Parents should continue treatment at home with prescribed antibiotics and mouth rinses. Antiseptic solutions are used for rinsing. In this case, rinsing should be carried out under the full supervision of parents. This will avoid accidents.

If you find a lump-shaped formation in your mouth, you should immediately contact your dentist. This symptom indicates the presence of a purulent abscess and requires immediate medical attention. Otherwise, this problem can lead to infection of the surrounding tissues in the mouth and poor health.

Concept and causes of oral abscess

An oral abscess is popularly known as an abscess or phlegmon. It is a clot of pus that accumulates in a sheath of fibrous fibers and granulation tissue on the roof of the mouth, gum, or other area. The appearance of the abscess can be seen in the photo. Its appearance is facilitated by the development of an inflammatory process, in which harmful organisms begin to actively multiply.

Causes of oral abscess:

• lack of therapy or an incomplete course of it for sore throat, pneumonia and others inflammatory diseases;
• entry of pyogenic microorganisms into open wounds in the mouth;
• failure to comply with the rules of asepsis and antisepsis during dental treatment;
• lack of treatment of skin and other tissues after injuries.

Classification and symptoms

Abscesses may appear on various areas oral cavity:

1. They break out on the gum near a tooth that has been damaged and has begun to rot. This abscess is considered the most common. Lack of treatment leads to severe consequences: formation of a fistula with leaking pus, unpleasant odor, general intoxication of the body.
2. A purulent formation under the tongue prevents a person from speaking and eating normally, causing severe pain when chewing or talking. It can spread to the pharyngeal mucosa and cause more serious consequences.
3. The cause of a palatal abscess is periodontitis - inflammation of the ligaments that support the tooth and the upper jaw. The infection spreads quickly to soft fabrics. Lack of treatment for an abscess of the upper palate leads to osteomyelitis - suppuration and death of the bone. With a palatal abscess, there is a high risk of infection of the nasal sinuses and the appearance of odontogenic sinusitis.
4. Less commonly, a cheek abscess occurs. Inflammation of this area is dangerous because it can affect the nerves of the face. Advanced cases of cheek phlegmon lead to muscle paralysis. An abscess on the tongue is an equally serious threat. It not only interferes with eating and speaking, but also leads to suffocation if located close to the larynx.

The main symptoms of a purulent abscess:

• Rapid development of the disease. The first sign is sharp pain in the area of ​​one of the teeth, which intensifies when eating. A little later, a solid tumor appears in this place, increasing in size over time. Some boils reach the size of a walnut.
• General deterioration in health. Education large quantity pus leads to toxin poisoning. The patient develops lethargy, apathy, insomnia, loss of appetite, and fever. When examining an oral abscess, redness of the infected area is detected.
• Breakthrough of purulent mass. As it grows, the outer shell of the abscess cannot withstand it and ruptures. At the same time, pain disappears, swelling decreases, and the temperature returns to normal. When this happens, you should immediately consult a doctor to prevent infection of nearby tissues in the mouth.

If you ignore an abscess, you can seriously harm your health. An oral abscess leads to loss of teeth, death of jaw tissue, infection of the respiratory and vision organs, paralysis of the facial nerves, and intoxication of the body.

Diagnostic methods

To assess the extent of the damage, use modern methods diagnostics With their help, a complete picture of the disease is compiled and the optimal solution is selected.

Diagnosis methods:

• CTG and radiography;
• collecting a sample of pus and pharyngoscopy;

For appointment effective therapy phlegmon, purulent fluid is analyzed. It shows which groups of antibiotics bacteria are resistant to and which they are not.

Treatment of abscesses in the mouth

Depending on the severity of the disease, one of the proven treatment methods is used: surgery, antibacterial therapy, and anti-inflammatory drugs. The doctor should prescribe therapy based on the data obtained after collecting anamnesis, receiving test results and undergoing all diagnostic procedures.

Surgical intervention

In most cases, doctors resort to surgical opening of the oral abscess. This method allows you to avoid many complications that arise when a spontaneous breakthrough occurs. During the operation, local anesthesia is used and a needle is inserted directly into the palate or gum. For additional pain relief, tissue can be treated with an aerosol containing Lidocaine. This allows you to maintain the expectoration reflex and helps rid the oral cavity of pus and blood flowing from the abscess.

To avoid infection of surrounding tissues, after opening the abscess, the patient tilts his head down and spits out all the contents. During the recovery period, the doctor prescribes a course of antibiotics.

Drug therapy

The combination of surgery and medications can achieve a positive result. This helps prevent the reoccurrence of an oral abscess.

Medicines:

• Fluocinonide. Gel local application, which has anti-edematous and analgesic effects. Because active substances are corticosteroids (steroid hormones produced by the adrenal cortex), the drug is contraindicated during pregnancy, lactation, and in the presence of autoimmune diseases.
• Chlorhexidine gluconate 0.05%. The solution is used to rinse the mouth and the area where the abscess has formed. Due to the possibility of ingestion of the drug, it is not recommended for use in children.
• Ibuprofen. A substance that relieves inflammation and eliminates pain. To save the patient from unpleasant symptoms and to avoid the spread of infection, you must take it orally 2-3 times a day.

If drug treatment is prescribed in a timely manner, surgical intervention may not be required. Therefore, it is important to visit the dentist as soon as possible.

Folk remedies

All traditional medicine recipes for purulent abscess are aimed at suppressing inflammatory processes and reducing pain. Healing herbs You should rinse your mouth 2-3 times a day after meals.

Traditional recipes:

• Dissolve 1 part of echinacea flower tincture in 5 parts of water;
• 2 tbsp. l. eucalyptus leaves pour 200 ml of hot water and leave for 20 minutes;
• 3 tbsp. l. caraway inflorescences pour 200 ml of hot water and leave for 30 minutes;
• 4 tbsp. l. horsetail pour 200 ml of hot water and leave for 20 minutes.

With a palatal abscess or phlegmon of the cheek that has spread outward:

• douse cabbage leaf boiling water, cool and apply to the abscess for 15 minutes every 6 hours;
• Mix the crumb of black bread with honey and apply it to the inflammation on the cheek until the pain disappears.

Before use traditional methods, you should consult your doctor. He can recommend the most effective method treatment.

Preventive measures

Prevention of purulent abscesses:

• using toothpaste and mouthwash at least 2 times a day;
• cleaning the tongue 2 times a day;
• flossing every time after eating;
• inclusion in the diet of fruits and vegetables rich in vitamins;
• getting rid of nicotine addiction;
• refusal of alcohol;
• exclusion of eating solid foods (crackers, nuts, candies);
• timely treatment of diseases of teeth and gums.

These simple tips will help you avoid serious complications in the future. The beauty of your smile depends on the health of your oral cavity.

Causes of flux

In most cases, the occurrence of inflammation and the development of periostitis is caused by an infection that has spread in the root canal and caused inflammation of the gum pocket - the space between the tooth and the gum (typical flux - photo 1). As a rule, the penetration of pathogenic microorganisms into the tooth canals occurs when running forms caries or pulpitis.

The pus that accumulates in the gums penetrates through the root canals through the top of the tooth to the tissues of the periosteum of the lower or upper jaw, as a result of which flux appears on the cheek - a painful swelling. Lack of treatment leads to a worsening of the condition: inflammation spreads to the periosteum, developing into an abscess, and then into phlegmon. Considering the localization of the inflammatory process, close to the nerve nodes, large blood vessels and the brain, the consequence of untreated flux can be fatal.

Flux, symptoms and stages of disease development

As a rule, it is almost impossible to make an incorrect diagnosis of periostitis, since the disease has a specific clinical picture. Flux symptoms are distinguished by the following:

• the formation of a hard seal on the gum, painful to the touch and rapidly increasing in size;
• increased pain, the occurrence of acute throbbing pain radiating to the ear;
• swelling of the cheek resulting from infection with purulent contents of the inflammatory formation of adjacent soft tissues of the face;
• deterioration in general health and increase in body temperature.

There are two stages of disease development:

• early stage - characterized by the presence of pain and the absence of a formed abscess, depending on the degree of damage to the tooth, a decision is made on its treatment or removal, painkillers are prescribed to relieve pain, anti-inflammatory drugs, antibiotics are prescribed;
• purulent stage - accompanied by full symptoms and requires surgical intervention - the abscess is removed surgically and antiseptic treatment of the inflammation zone (purulent flux - photo 2). Painkillers and antibiotics are prescribed according to individual indications.

Rules for the treatment of periostitis

It is strictly forbidden to apply a warm compress to the cheek - exposure to heat causes a rush of blood to the site of inflammation, accelerates the proliferation of pathogenic microorganisms and their spread throughout the body.
You should not take antibiotics and painkillers without a doctor’s prescription - the effect of the medications “blurs” the clinical picture, making it difficult to make a diagnosis and prescribe treatment.
Aspirin provokes increased bleeding, so its use is contraindicated after opening an abscess.

How does flux appear?

When a tooth is damaged by caries, bacteria penetrate into the tooth cavity. If at first it causes severe pain, then when the tooth tissue begins to die it goes away. The patient calms down and does not go to the doctor to treat the disease. The inflammation becomes chronic. The infection continues to multiply and reaches the periosteum. The gum becomes inflamed, and purulent masses accumulate in it, coming out in the form of a lump.

Reasons for the appearance of flux

• Tooth injury.
• Advanced form of caries.
• Violation of oral hygiene rules.
• Inflammation in the gum pocket (the space between the gum and tooth).
• Spread of infection through the bloodstream during inflammatory diseases of the body (angina, furunculosis).
• A temporary filling with arsenic, which was not replaced in time.
• Tooth cyst.

Diagnosis of the disease

The doctor examines the oral cavity and listens to the patient’s complaints. To clarify the diagnosis, an x-ray examination of the diseased tooth is performed. If the flux is on the upper jaw, then the lip and lower eyelid swell, and the pain can radiate to the ear. When the lump is localized on the lower jaw, the cheek and nearby lymph nodes swell. A headache can also be added to a toothache. Treatment methods depend on the stage of the disease and the cause of its occurrence. The dentist determines whether the tooth can be saved or should be removed.

Flux symptoms

• Toothache, worse when eating and when pressing.
• Formation of a purulent sac on the gum.
• Swelling of the tissues surrounding the tooth.
• Tumor of the cheeks, lips, lower eyelids, chin area, submandibular lymph nodes.
• Increased body temperature - 37˚ - 38˚С.

Typically, children and older people tolerate the manifestations of periostitis more easily.

Flux stages

• In the initial stages, pain appears in the tooth or gum. There may be no purulent manifestations. Treatment consists of taking antibiotics, physical procedures, and rinsing the mouth.
• If your cheek or nasolabial area is already swollen, or gumboil has appeared, what should you do? You cannot do without treatment from a dental surgeon. The abscess is opened and temporary drainage is placed. The inflamed area is treated with disinfectant solutions and a course of antibiotics is prescribed. If necessary, take painkillers.
  When gumboil appears and the cheek is swollen, what should not be done? Warming lotions or compresses are prohibited; heat supports the development of the inflammatory process. It is strictly forbidden to take antibiotics on your own. Medicines are taken only as prescribed by a doctor. 3 hours before visiting the dentist, you should not use painkillers to ensure a clear clinical picture. If you have opened an abscess, you should not take aspirin, it promotes bleeding.

Possible complications

What to do if tooth flux is in progress? If not treated promptly, the pus can spread into the soft tissue and cause an abscess to form. Next, the purulent masses enter the facial section, neck or internal organs– phlegmon develops. This condition is life-threatening and very difficult to treat. Death cannot be ruled out.

First aid

If your cheek is swollen, flux has come out, and there is no way to see a doctor right away, what should you do? You need to apply ice or a cold heating pad to your cheek, this will relieve the pain a little. The drugs “Tempalgin”, “Analgin”, “Paracetamol” will also help. Rinsing the mouth should be done with Chlorhexidine, Furacilin and a solution of potassium permaganate. But these procedures will not be able to cure periostitis, but will only provide temporary relief.

Drug treatment

It is impossible to cure purulent flux at home. But what to do if purulent flux comes out? The sooner you visit a doctor, the easier the treatment will be. The doctor will explain what to do in case of flux. An individual approach is applied to each patient. Anti-inflammatory drugs, antibiotics, antibacterial drugs, compresses and lotions with ointments are prescribed medicinally.

Anti-inflammatory drugs help reduce swelling, have an analgesic effect, and some reduce fever. These are “Diclofenac” and “Nimesil”, “Diazolin”.

After opening the flux, the oral cavity is rinsed with Rotokan, Chlorhexedine, Furacilin or soda solution. This procedure should be done after every meal.

Treating the disease with antibiotics is effective in the early stages and in the postoperative period. They should be taken for the entire prescribed course, from 5 to 10 days. The most commonly prescribed drugs are Doxycycline, Ampiox, Tsifran, and Linkamycin.

Ointments are used as compresses on the sore spot. A small amount of ointment or gel is applied to the bandage and applied to the inflamed gum where the flux has come out. You can use Levomikol, Metrogil Denta, Demixid.

What should be done if gumboil appears on the cheek can only be determined by a dentist. But even after treatment has begun, the gumboil on the cheek will not go away immediately; the swelling will go away gradually.

Treatment of flux in children

If there is gumboil on a child's cheek, you should contact pediatric dentist to find out what to do about it. Previously, baby teeth were removed immediately; nowadays, whenever possible, healing procedures. Antibiotic treatment and physiotherapeutic procedures are prescribed.

Premature tooth extraction can disrupt the formation of bite in children.

The doctor will determine how best to cure gumboil on a child’s cheek.

ethnoscience

Traditional medicine can come to the rescue when gumboil is inflated and you don’t know what to do. Decoctions of medicinal herbs will help relieve inflammation and help heal wounds. Some plants can reduce toothache. But they can only be used in complex treatment with drug therapy. Here are some of them:

• infusion of oak bark, sage and St. John's wort;
• brewing green tea and sage, plus salt;
• decoction of calamus root;
• lubricating the gums with propolis extract or honey.

What to do if the flux bursts?

Sometimes the ulcers open spontaneously and the pain goes away. But this is not a reason to put off visiting the dentist. After a while, the lump will again fill with pus, and discomfort will recur with complications.

Prevention

To prevent the occurrence of periostitis, the following rules must be followed:

• Treat your teeth in a timely manner.
• Maintain oral hygiene.
• Remove tartar. Pathogenic microbes accumulate under it.
• Rinse your mouth after eating.
• Use a soft toothbrush.
• Eat more fresh vegetables and fruits.
• Visit your dentist regularly.

Aphthous stomatitis

External manifestations of aphthous stomatitis are painful small ulcers on the oral mucosa, which affect almost 20% of people to varying degrees of severity at different periods of life. Other medical names for this disease are aphtoid or gangrenous ulcers. Statistics show that women and adolescents are more likely to suffer from this disease, which is periodic in nature. Aphthous stomatitis (oral ulcers) can occur at any age, most often in adolescence.

Experts note three groups of aphthous stomatitis, differing in the size of gangrenous ulcers - from small (up to 10 mm in diameter) to large ones, when an ulcer in the mouth on the cheek or tongue reaches more than 10 mm. The first group is more common (up to 80% total number diseases), their treatment may take 7-10 days. Diseases of the second group are more difficult to cure and take longer a long period(from 10 days to one month), after treatment in such cases, scars may remain. The third group of diseases (10% of cases) includes cases when in the process groups of many herpetiform small (less than 3 mm) ulcers appear, the treatment of which takes up to 7-10 days.

Symptoms

The moving parts of the oral cavity (cheeks, tongue, surfaces at the base of the gums) are the main places where ulcers appear, one or more. Initially, inflammation appears in the mouth on the cheek, then - tubercles, which during the day gradually turn into ulcers, on which you can see a thin white film, with redness around the edges. How to get rid of mouth ulcers? After treatment, which can last up to two weeks, the ulcers disappear almost without a trace. Sometimes (rarely) an increase in temperature may occur, but no associated diseases are observed.

The population groups aged 10-20 years are considered to be the most susceptible to aphthous stomatitis. There is also a risk of disease for two-year-old children. There is no specific frequency of the disease - for some people it is 1-2 times a year, for others an ulcer on the inside of the cheek appears and worries constantly.

Causes of the disease

Why do mouth ulcers appear? There may be several causes of aphthous stomatitis, including in the same people. Experts exclude viruses and bacteria as the cause of the disease. One of the most likely is an allergic reaction to certain types bacteria present in the oral cavity on certain types of foods. A separate version is that an ulcer in the mouth on the cheek can appear as a result of disturbances in the body’s immune system, which reacts to harmless microorganisms and, as a result, causes the appearance of ulcers on the surface of the mucous membrane of the mouth and tongue.

Scientists in Britain determined that the cause of aphthous stomatitis may be the lack of substances necessary for the body such as iron and folic acid, as well as vitamin B12; the same version was supported by researchers in the USA. Sometimes the reason why a sore in the mouth on the cheek may appear may be disturbances in gastrointestinal tract, such as the lack of ability to digest grain products. The lack of vitamin C in the body can also cause aphthous stomatitis in some categories of patients.

The cause of this insidious disease can be stressful situations. Particularly dangerous for people at risk diseases, minor injuries to the soft tissues of the oral cavity, as a result of which appears on the cheek with inside white sore. Small scratches caused by toothbrushes, dentures, and braces become in such cases a source of painful ulcers. Excessively hot food can also be a risk factor. Smokers are also at risk of suffering from aphthous stomatitis. For some people unpleasant consequences caused by toothpastes with sodium lauryl sulfate, as evidenced by studies conducted by medical centers, but this factor also does not affect all users and admirers of this type of toothpaste.

Aphthous stomatitis can also be caused by certain diseases that cause autoimmune disorders. Such diseases include Corn's disease, Behçet's disease, and systemic lupus erythematosus, in which the immune system reacts with swelling and inflammation of body tissues.

These data served as the basis for successful use hormone therapy in the treatment of aphthous stomatitis in certain categories of women.

It may seem that there are no significant differences between canker sores and herpetic fever. This is wrong. Herpetic fever (herpes simplex) is a viral contagious infection that can appear on the outside of the mouth and lips. Aphthous stomatitis is characterized by the appearance of ulcers on the internal soft tissues of the oral cavity, and, in addition, this disease is not contagious.

Manifestations and treatment of the disease

Numerous painful symptoms greatly complicate the course of the disease. This also applies to painful sensations when eating, and bleeding and swelling on the mucous membrane of the gums, and increased salivation, And unpleasant odor from the mouth, and in some cases even an increase in temperature. All these painful phenomena that accompany the course of the disease complicate its treatment, which is prescribed depending on the patient’s condition, as well as on the types of stomatitis that form ulcers.

Treatment methods are seriously influenced by the severity of the disease, the characteristics of the ulcers and their location. If an ulcer appears in the oral cavity, treatment is carried out with broad-spectrum antibiotics. Another complicating factor may be the patient's increased sensitivity to medicines. In such cases, the doctor prescribes antiallergic medications.

During treatment, it is important to follow a high-calorie diet in combination with vitamins C and P. If necessary, as local treatment necrotic tissue is removed using anesthesia. Having received general information about the course and treatment of aphthous stomatitis, it will be much easier for you to cope with this insidious disease. Good health to you!

What to do if symptoms of aphthous stomatitis appear

To ease the course of the disease and eliminate factors that aggravate its course, try to follow the following recommendations specialists:

1. Eliminate from your diet sour and spicy foods, rough foods (for example, chips), which irritate the oral mucosa and deepen ulcers.
2. Use soft toothbrushes - this will help avoid tissue injury.
3. Choose a toothpaste that does not contain lauryl sulfate and other ingredients that can negatively affect the condition of the mucous membrane. Use pastes that prevent and inhibit the formation of irritating plaque. It is quite possible that the right toothpaste will help get rid of mouth ulcers.
4. Don't worry about infecting your loved ones - aphthous stomatitis is not contagious.

Can mouth ulcers be cured?

Often the symptoms of aphthous stomatitis disappear without use. medicinal products. But it is possible to speed up the healing process of ulcers and reduce pain if you use accepted treatment methods associated with the use of medications for the oral cavity, rinses, and wound healing.

How to anoint a mouth ulcer, what medications can help with aphthous somatitis? Among the effective means for local action on ulcers, there are special preparations, including:

1. Ointments(such as over-the-counter benzocaine) that cause local anesthesia(numbness) when applied directly to an ulcer. The ointment reduces the irritating effects of foods and toothpastes. However, research conducted in the United States regarding the effects of benzocaine led that country's Food and Drug Administration to issue a warning that this drug may contribute to the development of methemoglobinemia, which interferes with the delivery of oxygen to tissues. In this regard, children under 2 years of age are recommended to use the drug only with a prescription and under the supervision of a doctor. Adults must strictly adhere to the instructions for use of the medicine and the recommendations of the attending physician. Store medications containing benzocaine out of the reach of children.
2. Gels– 2% xycaine, which soothes pain. Xicaine is toxic and therefore not recommended for use in children. The medicine is available on prescription from dentists or physicians and contains anti-inflammatory corcosteroids and triamcinolone.
3. Antibiotics, which are also an effective means of combating the disease, often prescribed by the attending physician.
4. Injections- the most effective method that relieves pain thanks to local anesthesia, but, unfortunately, the pain does not go away for long.

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Inflammation of tissues and accumulation of pus in any part of the body causes a person many problems - from constant pain and heat to the risk of infection spreading throughout the body. Particular discomfort occurs when the gums become inflamed, since an abscess in the mouth interferes with normal eating and talking. Treatment of diseases accompanied by the release of pus from the gums near the tooth should be carried out under the supervision of a dentist, but therapy can also be supplemented with traditional medicine methods.

The process of suppuration and symptoms

If an infection gets into the gums, the body develops a protective response – inflammation. It is accompanied by increased blood flow to the affected area so that immune cells can concentrate around the accumulation of pathogens. Because of this, the tissues swell, turn red, and cause pain. As killed pathogenic microorganisms and dead immune cells accumulate, pus accumulates in the inflamed area.

An abscess in the gum becomes noticeable in the early stages of its formation. At this time, a person may notice that:

• Painful sensations appeared; the gums hurt especially badly when chewing food and brushing teeth.
• Pus and blood are released from the abscess when pressing on the gum or when brushing the teeth.
• The gums are swollen and red, and the abscess may be visible on the surface as a whitish tumor.
• Cheek swollen.
• As purulent inflammation intensifies, the overall body temperature may increase.
• Violent inflammation can make the tooth loose and lead to its loss.

Despite all discomfort, the inflammatory response is necessary to neutralize dangerous microbes. But in many cases, the immune system is not able to completely suppress the infection without the risk of complications, so this pathological process should be treated.

For successful treatment It is necessary to identify the cause of gum decay and make a diagnosis, which is only possible by visiting a dentist. Even if the abscess has opened on its own and pus comes out of the gums, it can accumulate again, so you will still have to be treated by a doctor.

Why do gums fester?

It is impossible to determine on your own why a tooth has festered or the gums are rotting, because this pathological process is nonspecific and can manifest itself in a variety of dental diseases. Among them the most famous are:

Gum injury sharp object, an uncomfortable denture, when visiting the dentist or when brushing your teeth carelessly is one of the main reasons for its infection, and failure to maintain oral hygiene increases the risk of infection getting into the wound.

The likelihood of developing gingivitis, periodontitis and other diseases is increased by metabolic and hormonal disorders, as well as weak immunity and malnutrition.

Treatment in dentistry

Treatment of purulent inflammation of the gums includes the following steps:

1. A thorough examination; if necessary, you will have to take an x-ray of the jaw.
2. Cleaning gums and teeth from food debris and tartar.
3. Opening the gums in the area of ​​inflammation to remove pus.

When pus comes out of the gums, the patient is prescribed a course of drug therapy to prevent its re-accumulation. It includes taking antibiotics and anti-inflammatory drugs, as well as rinsing.

If pus comes out when pressing on a sealed tooth, you will have to remove the fillings and clean the sealed canals to remove purulent discharge. Carious cavities must be cleaned out, as they also accumulate infection. The dentist can install temporary fillings, which, if the accumulation of pus recurs, can be removed to re-clean the canals. Permanent fillings and crowns are installed only when it is possible to pull out the pus from the tooth, and after an x-ray that shows the absence of inflammation.

Surgery

If the gums have festered due to improper filling of the canals, and the problem areas are at the very top of the root, it can be cut off surgically– resection. This method can quickly get rid of a small abscess that does not spread to the entire space near the tooth. During the operation, the abscess is first opened so that the pus comes out of it, and therapeutic measures are taken to relieve the inflammatory process, and then the removal itself is performed.

Additional procedures

If the tissues of the jaw become inflamed and begin to fester, in addition to treatment at the dentist's office, auxiliary therapy may be needed:

• Ultrasonic.
• Laser.
• Electrophoresis.

Such procedures quickly remove swelling, help fight suppuration and get rid of pain. For elimination acute symptoms Usually five procedures are enough, but the course is prescribed individually.

Pus in the gums: what can be done at home

Full treatment using folk remedies at home is impossible, but some methods can be used to relieve symptoms and facilitate healing, and then for the purpose of prevention. When visiting a dentist, you should consult what procedures can be carried out for pus in a tooth yourself at home and what you can use to rinse your mouth. The following means are well known:

• Cold helps relieve swelling and pain. Compresses with ice wrapped in a towel or scarf are used. It is strictly forbidden to apply heat - when the local temperature the tissue swells and rots even more actively, and bleeding may develop.
• If gingivitis or periodontitis develops, you can rinse your mouth with hydrogen peroxide, soda-saline solution, or Chlorhexidine. You can use freshly brewed black tea, chamomile and sage infusions. The rinse should not be hot, otherwise it will cause increased suppuration. The solution temperature should be room temperature.
• The inflamed area can be lubricated with fresh aloe juice (if there are no contraindications).

How to draw out and remove pus from the gums

There is no question of opening a blister with purulent contents, since opening it on your own will certainly lead to serious complications. Doctors remove purulent discharge with special sterilized instruments using suitable antiseptics. After independent attempts to squeeze out the pus, curing the disease becomes much more difficult.

However, there are ways that allow you to pull out pus from the gums at home without opening it. They help weaken the process of suppuration and reduce the size of the abscess. The following recipes are popular:

• A compress made from a piece of peeled and thoroughly washed ginger root, applied to the inflamed area.
• Compress from a pre-frozen piece of lard.
• Lubricating the abscess with ointment made from propolis and olive oil (in a ratio of 1:10).

When using any recipe, you should pay attention to the body’s sensitivity to the components of the compresses. If allergies, burning, itching develop, you need to discard the inappropriate product.

Suppuration on the gums of a child

If the gums near a tooth fester in a child, you should urgently contact a pediatric dentist. Children's immunity is most often weak, so complications may appear even earlier than in adults.

In the presence of milk teeth, gum suppuration has a specific danger: if the pus spreads deep into the jaw, the rudiments of the molars may be destroyed, after which the full formation of the dentofacial apparatus becomes impossible.

You should not even try to remove pus from the gums yourself, since using antiseptic conditions at home this can threaten the baby’s life. Before visiting the dentist, it is only allowed to rinse the mouth with a soda-salt solution (1 teaspoon of each component in a glass of water at room temperature), but only if the child is already old enough and understands how to rinse the teeth and not swallow the liquid.

Complications after suppuration

If a person presses on the gum pus is coming, and it does not cure the disease, it can lead to serious complications that pose a danger not only to the dental apparatus, but also to life:

• Loss of teeth located near inflamed gum tissue.
• Development of bleeding.
• Severe tissue swelling.
• Purulent melting of tissues.
• Spread of infection to other organs.
• Blood poisoning.
• Formation of a cyst or granuloma.

To avoid such negative consequences You should always consult a doctor if pus appears in the tooth, the gums become infected, or other dangerous symptoms occur. It is imperative to follow the procedures prescribed by your doctor and take medications strictly according to the prescribed regimen. Treatment should only be carried out by qualified, experienced dentists, otherwise complications may arise due to careless actions and unsanitary conditions during the extraction of pus.

Prevention

To avoid the occurrence of pus in the gums, you can do the following manipulations at home:

• Don't ignore daily brushing of your teeth after sleep and before bed.
• Avoid using a toothbrush with bristles that are too hard, especially if you have gum problems.
• Rinse your teeth not only after brushing, but also after eating, using herbal decoctions or pharmaceutical solutions to strengthen the gums and disinfect the oral cavity.
• If there are no contraindications, you should periodically massage the gums next to the teeth with clean fingertips.
• Monitor your diet by adding sufficient quantity fresh plant foods, dairy products.
• You should give up the habit of chewing various items and use available non-sterile products as toothpicks.
• It is advisable to give up smoking and alcohol.

In order not to miss the appearance of the first symptoms dental diseases, you need to regularly examine your oral cavity yourself and be examined by a dentist twice a year. If any abnormalities appear, you should go to the dentist at the first opportunity.

The first thing that all patients who experience pus when pressing on their gums should do is make an appointment with an experienced dentist. Treatment of inflammation in the early stages is much faster, easier and less painful than with advanced pathology and the presence of complications. A condition where the gums are swollen and very painful causes a person a lot of suffering and harms his health, which is why it is unacceptable to endure such symptoms. And squeezing out an abscess on your own is extremely dangerous.

There are many reasons that can cause cheek inflammation. Among them, in first place in frequency - pathological conditions caused by dental problems, infectious diseases and processes occurring in nearby lymph nodes. The first symptom that causes concern is always the swelling and discomfort experienced by the sick person. These may be accompanied by disturbances in facial expressions, toothache, accumulation of pus and other symptoms associated with the source of inflammation.

Causes of inflammation

A swollen cheek without a pronounced toothache - people most often turn to dentists with this complaint. But this condition does not always indicate a dental problem. In some cases, the cause should be sought in an infection that has entered the body, allergic reaction or injury.

Acute pulpitis

This disease occurs when the inflammatory process spreads to the dental nerve. It may be the result of advanced caries. In some cases, the problem is caused by the actions of the dentist - installing a low-quality filling, incorrect actions in the process of preparing for the installation of a pin or a dental crown. Pulpitis also occurs after operations performed on the tissues surrounding the tooth.

Acute throbbing pain with pulpitis becomes more intense at night. Swelling of the gums, cheeks, and bad breath appears. The purulent process, spreading to the tooth, melts its tissue, as a result of which the exudate finds its way into the oral cavity. The pain decreases, but the process continues. Therefore, visiting a dentist is necessary.

Odontogenic periostitis

Inflammation of the periosteum (odontogenic periostitis) is often called gumboil. Its symptoms are difficult to confuse with manifestations of another pathology:

• increasing toothache;
• inflammation and swelling of the gums and tissues in the mouth;
• increase in body temperature to 38°C and above;
• general malaise;
• the appearance of a purulent sac on the gum.

It is characteristic that the pain affecting the tissues of the oral cavity intensifies sharply when touching them. Sharp unpleasant sensations can radiate to the ear and eye areas, and swelling can affect the entire affected side of the face.

There are several factors contributing to the appearance of periostitis. Among them are untreated carious teeth and violation of the integrity of the oral mucosa. Often, inflammation of the periosteum can be provoked by viral or viral diseases that have not been completely cured. infectious nature(sore throat, flu).

Wisdom tooth

Chewing molars (eights) are commonly called wisdom teeth. They erupt in adults aged 15 to 30 years. Their appearance is rarely painless. Most often, there is not enough space for them in the formed dentition. Therefore, wisdom teeth are hidden in the gums, and a mucous hood is formed above them. This is where food and pathogenic microbes collect, causing inflammation. Pus accumulates under the hood, swelling of the gum mucosa appears, and the cheek swells.

Patients with pericoronitis complain of pain when chewing food, severe pain, high fever and general weakness. The swelling on the cheek makes it difficult to open your mouth and talk. The surgeon can alleviate the condition by making an incision and freeing up space in the gum for the tooth. But most dentists advise removing them at the first problems with wisdom teeth.

Gum problems

The cheek and gums are swollen, but the teeth do not hurt - these are the symptoms that are characteristic of several diseases affecting the soft tissues surrounding the teeth:

• gingivitis (the edge of the gum and papillae between the teeth swell and bleed);
• periodontal disease (the tissue around the tooth peels off, the ligaments that fix it in the socket are weakened);
• periodontitis (teeth become mobile, pus and soreness appear in the gums).

These dental pathologies can cause tooth loss. Such problems are caused by insufficient care for them, disorders of the hormonal system, diabetes. Atherosclerosis can also provoke gum disease, in which blood flow to the gums deteriorates due to a decrease in the lumen of blood vessels.

Often, problems with gums occur when the body’s immune defense is reduced, hypovitaminosis, or diseases of the gastrointestinal tract.

To prevent tooth loss, it is necessary to contact a periodontist or dental surgeon at the first problem with your gums. The doctor selects treatment individually, focusing on the reasons that provoked the disease.

Purulent lymphadenitis

The cheek may become inflamed due to a purulent process developing in the lymph nodes located close to it. Swelling on the inner surface of the cheek increases gradually, within 1-2 weeks after the onset of the disease. Along with it, the painful sensations when touching the site of swelling also intensify. In addition, other symptoms appear:

• temperature rises to 38°c (above);
• the skin over the lymph node becomes red;
• apathy and lethargy appear;
• sleep and appetite worsen;
• A blood test reveals an increase in the number of leukocytes and ESR.

To confirm the diagnosis, doctors may resort to puncture or ultrasound inflamed lymph node. The condition of an adult patient with this pathology is often satisfactory. But young and middle-aged children have a rather difficult time with purulent lymphadenitis in the cheek area.

Inflammation of the salivary glands

Siloadenitis is an inflammatory process that affects the submandibular, sublingual or parotid salivary glands. In the latter case, the disease is usually called paratitis. He is the one who is most dangerous form diseases, since the virus (the main cause of inflammation) quickly spreads throughout the body and causes complications, disrupting the functioning of other endocrine glands.

Mumps manifests itself severe dryness in the mouth, which occurs due to a reduction in the amount of saliva secreted. In addition, it feels bad taste in the mouth, which occurs when pus is released.

Pain in the cheek on the inside is localized directly above the inflamed gland, sometimes it radiates to the neck, ear and intensifies during chewing (swallowing) and talking.

Redness of the skin is observed above the inflamed gland, and a painful lump can be felt. Many patients complain of bloating or a feeling of pressure from the inside, which indicates the accumulation of pus. The disease is accompanied by a significant increase in temperature (39-40 degrees), weakness, lack of appetite and other signs of intoxication.

Injuries and insect bites

Inflammation and swelling of the cheek after an insect bite is a common occurrence, especially in the warm season. How pronounced the consequences of the attack will be depends on the individual reaction of the human body. The symptoms that are most often observed include:

• redness, swelling and increased temperature in the bitten area;
• compaction that resolves within a few weeks;
• soreness immediately after the bite, which later turns into itching.

If the swelling spreads over most of the face and spreads to the neck, you should immediately consult a doctor. You should also do this if your body temperature rises sharply. These symptoms may indicate a severe allergic reaction.

Often the cause of cheek inflammation is a bruise. Swelling that appears several hours after the incident usually goes away after a few days. There is usually a bruise at the site of the blow.

Atheroma

A sebaceous gland cyst (atheroma) that appears on the face in the cheek area may not manifest itself at first. As the secretion accumulates, it increases and can reach the size of a chicken egg.

If an infection gets into the tumor, it begins to fester. Then the skin of the cheek takes on a swollen appearance, as well as:

• the cyst becomes painful to the touch;
• the inflamed area takes on a red tint;
• body temperature rises.

If such manifestations are present, it is necessary to consult a doctor, otherwise the atheroma capsule will burst and the contents will spill into the subcutaneous layer.

Treatment

You can get rid of inflammation and swelling of the cheek by consulting a doctor. He will determine the cause and prescribe treatment that is suitable for a particular situation. Before visiting a specialist, it is not advisable to take any medications, including pain medications.

It is quite possible that a specialist will prescribe medications containing antibiotics, hormones and anti-inflammatory components for treatment. In some cases, the help of a surgeon may be needed. Therapy will be aimed at strengthening the immune system, relieving symptoms of intoxication and allergic reactions.

However, there are ways that you can use to alleviate the condition. Apply cold to the inflamed side if the problem arose as a result of a bite or tooth extraction. But use this remedy when high temperature it is forbidden.

A compress with soda and an anti-allergy tablet will help in case of a bite. And if the pain is caused by the growth of a wisdom tooth, then it is better to use an anesthetic and a special gel, which is prescribed to children when baby teeth appear.

For gum diseases, rinsing with antiseptics - Chlorhexidine, Miramistin - helps a lot. You can use anti-inflammatory solutions based on plant extracts– Chlorophyllipt, Stomatophyte and others.

Abscesses and cellulitis upper section The floors of the oral cavity (the sublingual region located above the mylohyoid muscle) develop as a result of infection from the lower large and small molars. The mylohyoid muscle (diaphragm of the floor of the mouth) serves as the bottom of the cellular space; it is separated from the oral cavity only by the mucous membrane. The side walls are internal surfaces the bodies of the lower jaw and the sublingual salivary glands located here; The tissue bed is divided into two symmetrical halves by a median suture, which is also facilitated by two pairs of muscles located close to the midline - the genioglossus and the geniohyoid, but this division is incomplete, as a result of which the abscess can spread to the other side. Rear wall the space is served by the muscles extending from the styloid process: styloid-lingual, styloid-hyoid and stylopharyngeal; here this wall is supplemented by the posterior belly of the digastric muscle and the hyoid-glossus muscle, which are attached to the hyoid bone. The sublingual area communicates with several adjacent cellular spaces, as a result of which the abscess can spread along salivary duct in the submandibular triangle, along the extension into the maxillo-lingual groove, almost unhindered also along the extension into the intermuscular slit-like space of the root of the tongue and along the vessels and nerves in the distal diaphragm of the floor of the mouth into the peripharyngeal space. The clinical course of phlegmon of the sublingual region is characterized by the severe general condition of the patient and significantly severe intoxication; the mouth is half-open, the bottom of the mouth is bulging, the tongue is dry, covered with a white coating, “although it is almost not enlarged, it is significantly pushed upward, its movements are painful, saliva flows from the mouth; speech is slurred, swallowing is impaired, the voice is hoarse. There is slight swelling in the submental area, there is no tissue infiltration. If the abscess spreads significantly in the distal direction, there may be signs of difficulty breathing due to swelling of the epiglottis. Surgical opening of phlegmon of the sublingual area of ​​the mouth is difficult, since drainage through the incision of the mucous membrane is usually insufficient, due to the fact that the level of the abscess remains below the incision , and only shallow ulcers (abscesses) can be opened from the oral cavity. The approach to the abscess through a midline skin incision in the submental area also does not always lead to the desired results: only a limited purulent focus located closer to the midline of the floor of the mouth can be opened with this approach. The wound channel is deep, passes through the muscles, so full drainage can only be carried out with a volumetric drainage tube. If the phlegmon is widespread, we can only recommend wide incisions parallel to the edge of the lower jaw, 2 cm away from it. This incision can be made according to indications of any length, up to the “collar” with partial cutting off the attachment of the mylohyoid muscle on both sides. If a diffuse abscess has descended far, it can be opened with another “collar” incision in the area of ​​its lower edge, passing along the upper cervical skin fold. Both methods of opening provide good drainage and comply with the laws of purulent surgery. In order to obtain a cosmetically complete scar, on the 7-10th day after surgery, after the cessation of purulent exudation, you can apply secondary seams leaving rubber drainage strips. Abscesses of the maxillo-lingual groove. The maxillo-lingual groove is part of the hyoid region and is limited by the body of the lower jaw and the muscles of the root of the tongue at the level of the large molars, distally limited by the descending muscles of the styloid group, in front it opens freely into sublingual area. It is separated from the oral cavity by the mucous membrane, its bottom is the diaphragm of the floor of the mouth (mylohyoid muscles). The infection penetrates into the maxillo-lingual groove during exacerbation of periapical foci of inflammation of the lower molars or during exacerbation of inflammatory complications due to difficult eruption of the lower wisdom tooth. Despite small sizes groove, the clinical course of the abscess cannot be characterized as mild. This is due to the fact that its fiber communicates widely with almost all surrounding cellular spaces, which explains the rapid absorption of toxins and the possibility of rapid spread of the abscess to the submandibular triangle, the root of the tongue, and the maxillary fossa.

Shaping the nose and lip skin

Causes of oral abscess

Classification of abscesses

Symptoms of an oral abscess

Diagnostics

Treatment of oral abscess

Prognosis and prevention

An abscess on the face is a limited purulent-inflammatory process in the facial area that can affect the skin, subcutaneous tissue, muscles, bones and other organs. Some types of the disease have their own peak incidence. Abscess of the zygomatic, nasal or buccal area can occur in absolutely any person, regardless of age, gender and type of activity.

Causes

Most often, staphylococci, streptococci, E. coli, bacteroids and others lead to purulent melting of tissues. pathogenic microorganisms. As a rule, the penetration of pathogens of purulent infection occurs from the outside. However, according to the characteristics of the initial implementation infectious agents allocate the following types abscesses on the face:

• Odontogenic. The infection enters the body through defects in the teeth, marginal periodontium and gums at the site of teething.
• Non-odontogenic. Often tissue infection is caused by mechanical injuries oral mucosa or facial skin. The introduction of the pathogen is also possible when performing injections in the facial area.

In some patients, before the formation of an abscess, local inflammatory processes are observed in the form of stomatitis, cheilitis, boils, eczema, etc. Odontogenic abscesses are characterized by peaks in incidence. The first jump is observed during a change in occlusion at the age of 8-12 years. The second rise falls between the ages of 22 and 35, when the third lower molars erupt and permanent teeth are actively affected by caries. In addition, an increase in incidence is recorded in the summer and autumn.

An abscess on the face is a surgical pathology that requires surgical treatment.

Clinical picture

Depending on the localization of the purulent-inflammatory process (zygomatic, nasal or buccal area), the clinical picture of the disease will have its own characteristics. At the same time, during the development of infection, typical general symptoms. Common manifestations of an abscess include:

• A sharp rise in temperature to high numbers.
• There is a feeling of weakness, malaise, and fatigue.
• Decreased appetite.
• Headaches bother me.
• Local symptoms (pain, swelling, induration and redness in the area of ​​abscess formation).

Lip abscess

The presence of folliculitis, boils, carbuncles or infected wounds can cause an abscess in the lip area. The following clinical picture is observed:

• The patient complains of local pain in the area where the abscess is located.
• Increased pain is noted during conversation, chewing and simply when moving the lips.
• During a purulent-inflammatory process, it is difficult not to notice the pronounced swelling of the lips and the smoothness of the nasolabial folds.
• Edema tends to spread to the orbital region and lower eyelid.
• The skin over the abscess is bright red.
• A dense, painful infiltrate can be felt.

Abscess of the zygomatic region

In most cases, the development of an abscess in the zygomatic region occurs due to foci of infection in the teeth and gums, infected wounds and purulent processes. The patient feels pain in the cheekbones. Facial asymmetry, redness of the skin, and painful compaction in the form of infiltration are revealed. If the abscess is not opened in time, the pathological process can spread and significantly worsen Current state patient.

Nasal abscess

Purulent inflammation in this area is secondary. The source of infection can be boils, folliculitis and purulent wounds. The purulent-inflammatory process causes severe pain. There is difficulty breathing through the nose. The asymmetry of the face is determined, the affected half of the nose looks swollen, the nasolabial folds are smoothed. The compaction is palpable in the form of a painful infiltrate. Opening the abscess alleviates the general condition of the patient.

Cheek abscess

If a purulent-inflammatory process occurs in the cheek area, pronounced swelling is immediately noticeable, which makes the face asymmetrical. Patients complain of local pain. As a rule, all the classics are present clinical symptoms, indicating the presence of infection (fever, headaches, weakness, fatigue, etc.). If the patient opens his mouth, chews or moves his jaw to the side, only increased pain is observed. Severe swelling of the cheek gives the face asymmetry. The skin over the inflamed area is hyperemic (red) and tense. A painful infiltrate can be felt.

If you suspect a facial abscess, you should immediately go to the hospital.

Diagnostics

Efficiency surgical treatment abscesses will depend on the exact determination of the localization of the purulent-inflammatory process. Scientifically, this is called topical diagnosis. Local clinical symptoms make it possible to determine the location of the pathological focus. Additional Methods diagnostics:

• Puncture of a purulent-inflammatory focus.
• Thermography.
• Ultrasound examination.
• CT scan.
• Magnetic resonance imaging study.

For example, thanks to puncture, it is possible to establish both the exact localization and the nature of the inflammation, which can be serous, purulent or mixed. The nature of the inflammatory process determines the feasibility of surgical treatment. Because one of the main principles of surgical intervention is that if pus is found, it must be removed.

Treatment

The main goal of treating a patient with an abscess on the face is to eliminate the purulent-inflammatory process and achieve complete recovery in an extremely short period of time. An integrated approach to treatment ensures the realization of this goal. What to consider when choosing a treatment program:

• Stage of the disease.
• General condition of the patient.
• Localization and nature of purulent inflammation.
• The body's response to an infectious process.
• Concomitant pathology.
• Patient's age.

In the acute phase of the disease, characterized by an increase in inflammation and progression of symptoms of tissue damage, it is necessary to take all measures to prevent the spread of infection. This is achieved through antibiotic therapy and correction of the immune system.

Untimely elimination of an abscess on the face can lead to extremely serious consequences.

Features of surgical treatment

It is possible to completely get rid of an abscess on the face or any other location only through surgery. Surgical intervention includes the following points:

• A purulent-inflammatory focus is opened.
• The purulent contents are removed and the affected tissues are excised.
• The surgical wound is drained to facilitate the evacuation of pus.
• If the abscess is odontogenic, it is necessary to remove the “causative tooth” and drain the purulent-inflammatory area in the jaw.

You can open a purulent lesion on the face either through the oral cavity or from the outside. Basic principles that will help you choose operational access:

• It is necessary to find the shortest path to the abscess. In other words, choose a place for the incision that will allow you to quickly get to the purulent-inflammatory focus.
• When cutting tissue, the likelihood of damage to nearby organs and anatomical structures (blood vessels, nerves) should be minimal.
• The scar on the face after surgery should be almost invisible.
• Provide conditions for the outflow of pus.

If dead tissue is found, it should be excised. To speed up the process of cleansing the affected area from non-viable tissues, it is recommended medications containing proteolytic enzymes. Apply topically in the form of solutions. Can be combined with antibacterial and antiseptic agents.

To improve the healing and restoration of the wound after removal of the abscess and elimination of the purulent-inflammatory focus, secondary sutures can be applied.

Antibiotic therapy

One of the most important components of complex treatment of patients with facial abscess is antibiotic therapy. Before obtaining the results of a microbiological study and identifying the causative agent of the infection, select drugs are used, which include:

• Amoxiclav (amoxicillin and clavulanic acid).
• Ampicillin and Sulbactam.
• New generation cephalosporins (for example, Ceftriaxone).

Antibiotics are prescribed intravenously in high dosages. The choice of drug and the therapeutic course regimen are determined by the attending physician, taking into account the patient’s condition and the severity of the underlying disease. Vancomycin is considered an alternative antibacterial drug. For the treatment of young children (up to two years old), they may resort to prescribing Cotrimoxazole and Chloramphenicol.

It should be noted that if a patient begins to take antibiotics on his own without the supervision of a doctor, this often leads to a worsening of the condition and the development of more severe complications.

Physiotherapy

The comprehensive treatment of patients with facial abscesses also includes physiotherapeutic procedures. In most cases, physiotherapy is used after opening the purulent-inflammatory focus. This treatment method helps cleanse the wound of non-viable tissue, accelerates the healing process and prevents the formation of rough scars on the face. Today, the most commonly prescribed physiotherapeutic procedures for abscesses are:

• UHF (ultra high frequency therapy).
• Ultraviolet irradiation.
• Ultrasound.
• Electrophoresis with drugs.
• Laser.

Treatment of mild forms

If the patient's condition is satisfactory, the main treatment strategy consists of surgery. The abscess on the face is opened and the infectious and inflammatory focus is drained. In case of odontogenic abscess, it is necessary to remove the causative tooth. It is not recommended to adhere to saving tactics in relation to the “causal” tooth, since it is quite difficult to ensure good drainage of the source of infection. Nevertheless, if possible, they try to save single-rooted teeth.

If the patient's condition is satisfactory and there are no concomitant diseases, as a rule, the prescription of antibacterial drugs is not required. Limited to holding symptomatic therapy. Non-steroidal anti-inflammatory drugs, such as Ibuprofen, Naklofen, Indomethacin, etc., come to the rescue. In case of a severe inflammatory reaction, which is mainly observed in childhood and adolescence, they resort to antihistamines. Cope with residual effects inflammation and speed up healing processes postoperative wound Various physiotherapeutic procedures help.

In common parlance, an abscess on the face or other part of the body is often called an abscess or abscess.

Treatment of a moderately severe patient

Surgical treatment of patients with average degree severity is supplemented with optimal antibacterial therapy. The primary task is to completely remove the purulent-inflammatory focus with careful drainage of the affected area. Antibiotic therapy begins with the prescription of drugs of choice, taking into account the suspected causative agents of infection. Correction of the antibacterial course is carried out after receiving the results bacteriological analysis discharge from a purulent-inflammatory focus. In most cases, moderate therapeutic dosages of antibiotics are used.

Nonsteroidal anti-inflammatory drugs (Paracetamol, Ibuprofen, Ketonal, etc.) will help reduce the inflammatory reaction. It is considered quite appropriate to assign antihistamines, in particular, Suprastin, Tavegil. Criteria that indicate a pronounced reaction (hyperergic) of the body to the presence of a purulent-inflammatory focus:

• The disease begins acutely and develops quite rapidly (over 24-72 hours).
• Very pronounced local symptoms inflammation.
• A sharp increase in the number of leukocytes and ESR in the blood.

If, on the contrary, the body’s reaction is reduced, the immune system should be corrected. In such situations, immunostimulating therapy is used in the form of:

• Prodigiozana.
• Pyrogenala.
• Levamisole.
• Sodium Nucleinate.
• Vitamin complexes containing ascorbic acid, riboflavin, tocopherol, etc.

It is appropriate to prescribe various physiotherapeutic procedures, such as UHF, microwave, helium-neon laser. Regardless of the patient’s body’s response to the presence of infection, it is recommended to use drugs from the group of adaptogens that have immunomodulatory properties (for example, Eleutherococcus, Chinese Schisandra).

At pronounced signs intoxication, along with antibiotic and immunotherapy, active detoxification treatment is carried out. The patient is administered saline solutions, glucose, Aminocrovin, Hemodez, etc. To ensure normal removal of fluid from the body, diuretics (Lasix) are used.

Treatment of a seriously ill patient

If diagnosed severe course diseases, it is necessary to act quite quickly and effectively. As soon as the patient is admitted to the hospital, they begin to administer antibiotics and simultaneously carry out detoxification therapy to prevent the development of bacterial shock. Against the background of intensive treatment, the abscess is opened and the infectious focus is drained. Antibacterial drugs are prescribed in a “shock” dosage and exclusively intravenously. First, the drugs of choice are used, taking into account the possible pathogen. If ineffective, move on to more strong antibiotics(for example, new generation cephalosporins).

A good therapeutic effect is observed in patients with anaerobic infection, in the complex treatment of which hyperbaric oxygenation was used. If there is a severe purulent staphylococcal infection, active immunization is indicated. To do this, the patient is injected with a staphylococcal vaccine, toxoid or hyperimmune plasma.

An abscess of the zygomatic, nasal or cheek area can be eliminated exclusively by surgery.