An external dental fistula is a drainage channel formed on the facial skin because of chronic pyogenic inflammation of odontogenic origin. Most sinus tracts appear in the gingiva and are therefore treated immediately by a dentist.
On the other hand, external dental fistulas are rarely seen first during a dental visit because they are not accompanied by dental pain. Because external dental fistulas appear on the facial skin, they are very often seen first at another medical facility, and delay dental visits until later.
In recent years, external dental fistulas have been encountered infrequently, and are difficult to diagnose because there are many diseases that need to be differentiated from each other. Incisional drainage without dental treatment of the causative tooth does not eliminate the infection, and this results in repeated drainage of pus.
So if an external dental fistula is suspected in a medical patient, the patient should be referred to a dentist. Pulp viability is diagnosed by radiographic examination, electric pulp test and thermal pulp test; and after identifying the causative tooth, an infected root canal treatment is performed to remove the infection in the root canal and fill the canal. If the external dental fistula does not heal, an apicoectomy is performed to preserve the tooth. But extraction is the last method in eliminating infection and should be avoided as much as possible.
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