If you have noticed a small pimple or bump on your gum that drains, shrinks and then comes back, you may have a dental fistula. It is sometimes called a gum boil or, more precisely, a sinus tract. It is your body's way of draining an infection, and it almost always means a tooth or the gum around it needs treatment.
What is a dental fistula?
When infection builds up at the tip of a tooth root or in the gum, pressure forces it to find a way out. A fistula is the small channel that forms between the infection and the surface of the gum. The opening often looks like a yellow, white or red pimple near the affected tooth and may release pus or a salty, bad taste.
What causes a gum boil?
- An infected or dying nerve inside a tooth, often from deep decay, a crack or old trauma
- A tooth that had a root canal that has become reinfected
- A cracked tooth or cracked root
- Advanced gum disease with a periodontal abscess
Is a dental fistula serious?
Yes, even if it does not hurt. Many people notice that pain decreases once a fistula forms, because pressure is being released. That does not mean the infection is gone. Left untreated, a dental infection can damage the bone around the tooth, lead to tooth loss and, in some cases, spread. Seek urgent care if you develop facial swelling, a fever or difficulty swallowing; see toothache with a fever.
Can a gum fistula be cancer?
The vast majority of draining bumps on the gum are caused by dental infections. However, any sore that persists, especially one that remains after the tooth has been treated, should be evaluated to rule out other causes. Learn more about our oral cancer screening examination.
How is a dental fistula diagnosed and treated?
Your dentist will examine the area and take X-rays to locate the source. Sometimes a thin, flexible marker is gently placed into the opening and an X-ray shows which tooth it leads to. Treatment targets the cause:
- Root canal treatment to remove the infection from inside the tooth
- Retreatment of a previous root canal
- Extraction when the tooth cannot be saved
- Periodontal treatment for a gum abscess
Once the source is treated, the fistula usually closes on its own within a few weeks.
What should I avoid?
Do not squeeze or pop a gum boil, and do not rely on antibiotics alone. Antibiotics may calm the infection temporarily, but the fistula usually returns until the tooth is treated.
Gum boil treatment in Palo Alto
If you have a bump on your gum, Palo Alto Oral Health can identify the source and explain your options. We see patients from Palo Alto, Menlo Park, Los Altos and Stanford at our Middlefield Road office. Call (650) 321-9693 or request an appointment.
Sources
American Association of Endodontists: Root Canal Treatment
This article provides general education and does not replace an examination.
