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A simple caries can, in certain cases, spread to surrounding tissues. The infection is no longer limited to the enamel or the pulp: it can extend to the gums, the cheek, or even the face. This is called dental cellulitis, a bacterial infection that must be taken care of quickly to avoid complications. What symptoms should alert you? And above all, how to react? Insights from Dr. Linda Martin, dental surgeon.
Definition: what is dental cellulite?
The term can be confusing. Nothing to do with the skin cellulite aesthetic! Dental cellulite corresponds to inflammation of the tissues around the tooth, linked to a bacterial infection.
“More precisely, it is a facial soft tissue infection (cheek, gum, muscle spaces) which occurs when bacteria from an infected tooth leave their point of origin to spread into neighboring tissues,” explains Dr. Martin.
The mechanism is always the same:
- An untreated cavity progresses deeper.
- It reaches the pulp, which contains the nerves, arteries and veins.
- Bacteria multiply there and produce toxins.
- The infection spreads to the root tips.
- It comes out of the tooth and spreads into the tissues of the face.
What is the difference between an abscess and dental cellulitis?
L’dental abscess is an infection localized around a tooth. It is recognized by the formation of a well-demarcated pocket of puswhich explains the intense, but focused pain. “This infection remains contained and can be drained, either by incision or by opening the tooth,” specifies Dr. Martin.
Dental celluliteit is a diffuse and widespread infection. It does not remain limited to a specific area and spreads to the soft tissues of the face. Unlike an abscess, there is no accessible pocket of pus: drainage is initially impossible. “We can’t press and drill. The infection circulates between the cells,” underlines the surgeon.
In summary, dental cellulite is more extensive, more serious, and more difficult to treat than a dental abscess.
What are the causes of dental cellulite and the teeth affected?
Dental cellulitis is always linked to an infection of dental origin. In the vast majority of cases, the starting point is untreated decay which progresses in depth until reaching the pulp, the living part of the tooth. Once this area is infected, bacteria can spread beyond the tooth.
« All teeth can be affected. That said, molars are more vulnerable, as they are more exposed to food debris and difficult to clean. THE wisdom teeth can also be the cause of dental cellulitis, particularly when they grow poorly or remain partially impacted. In this case, a small space forms between the tooth and the gum, favoring the accumulation of bacteria and infection of the surrounding tissues,” warns Dr. Martin.
Finally, certain situations can accelerate the progression of the infection:
Warning signs: what are the symptoms of dental cellulite?
The symptoms of dental cellulite are often impressive and progress quickly.
Local signs
Several symptoms should alert you in the face and mouth:
- And significant swelling of the face. The cheek, jaw or even neck can swell quickly.
- A marked asymmetry. The face appears distorted, with one side more swollen than the other.
- A hard area on palpation. The skin is tight, sometimes difficult to palpate.
- A feeling of local heatwhich signals inflammation.
- Of the difficulty opening the mouth (lockjaw). Eating or speaking becomes difficult, sometimes painful.
- A throbbing pain. “You can almost feel the heart beating in the area,” describes Dr. Martin.
General signs
The infection does not always remain localized. It can affect the entire body:
- Fever.
- Important fatigue.
- Swollen neck lymph nodes.
An essential point: “Dental pain can disappear… But the infection continues to progress in depth. This can give the impression that the situation is getting better, when in fact it is getting worse! », alerts the surgeon.
Why is dental cellulite dangerous?
Dental cellulitis is a medical emergency! Without prompt treatment, the infection can spread:
- Towards the neck (this becomes painful and can hinder movement).
- Towards the respiratory tract (swelling can block the passage of air).
- Towards the brain (infection can cause serious complications such as meningitis).
- Or in bloodwhich entails a risk of sepsisa very serious generalized infection.
What to do concretely?
- Don’t take the situation lightlyeven if the pain seems bearable.
- Call your dentist immediately and describe your symptoms precisely.
- In case of doubt or worseninggo quickly to the nearest emergency room.
Who are the people most at risk of dental cellulite?
Dental cellulite can affect anyone. But certain situations clearly increase the risk.
- A poor oral hygiene.
- And weakened immune system. In this case, the body fights bacteria less well and the infection progresses more quickly.
- The alcohol and tobacco consumptionwhich weaken the gums and alter the natural defense mechanisms against infections.
- Waiting despite the pain. This is a key factor. Thinking that the pain “will go away” delays treatment. Result: the infection has time to spread.
« Children can also be affectedespecially when permanent teeth are erupting,” warns Dr. Martin.
How to treat dental cellulite? What treatments should be preferred?
Good news: there are effective treatments. But the treatment is done in several stages: contrary to what one might think, we can’t intervene right away.
Why can’t we always intervene right away?
“It’s often surprising to patients, but we don’t treat the tooth immediately,” explains Dr. Martin.
At the cellulite stage:
- The fabrics are very inflamed.
- There are a lot of fluid (edema) and pressure.
- Inject an anesthetic could make the situation worse. This would add fluid to an area already under tension (“pressure cooker” effect). The pain may increase and the infection may spread further.
Support is done in two stages
1. Calmer l’infection
First, the infection must be stopped and the pain relieved. The healthcare professional can prescribe:
- And antibiotic (oral or sometimes injectable).
- Et of the painkillers to relieve pain.
- Si possible, drainage of the abscess to evacuate pus
2. Treat the responsible tooth
Once the inflammation is under control, we attack the cause. Two main options:
- The devitalization (root treatment). The inside of the tooth is cleaned to eliminate bacteria.
- L’extraction. If the tooth is too damaged to be saved. “Sometimes the infection has already weakened the bone around the tooth. In this case, it is unfortunately no longer possible to save her,” comments Dr. Martin.
Which antibiotic to use for dental cellulitis?
The choice depends on each situation (age, allergies, severity, etc.). It is always done by a healthcare professional.
The most used antibiotics are:
- Amoxicillinoften as a first intention.
- Amoxicillin + clavulanic acid if the infection is more severe.
- Clindamycine in case of allergy to penicillin.
- Sometimes the metronidazole in addition.
At any rate :
- Never take antibiotics without medical advice.
- Strictly respect the prescribed duration.
- Do not stop treatment as soon as the pain subsides.
Even if you feel better, it is essential to go through to the end to avoid a relapse or complications, insists the surgeon.
Prevention: how to avoid dental cellulite?
Good news: in the majority of cases, dental cellulite can be avoided!
- Brush your teeth 2 times a day minimumto eliminate dental plaque, the main cause of cavities.
- Use dental floss or interdental brushes to dislodge bacteria lodged in small interstices.
- Limit sugars (candies, sodas, but also white bread, biscuits or industrial dishes), which promote cavities.
- Consult your dentist at least once a year. This makes it possible to detect early caries.
- Never let dental pain drag on! Sensitivity to hot, cold or chewing is never trivial. The sooner you consult, the simpler the care.
In summary, dental cellulite is impressive, but it can be managed effectively if treated quickly. The right reflex: don’t wait. Facial swelling with pain and fever should alert you immediately. With rapid treatment and regular follow-up with the dentist, this type of complication remains largely avoidable!
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