Cutaneous dental sinus tracts

Cutaneous dental sinus tracts are uncommon and can result from an apical abscess that forms because of dental caries that cause periapical inflammation and suppuration.

Cutaneous sinus tracts are associated with mandibular teeth in 80% of patients and with maxillary teeth in 20%.

They typically exit onto the chin or lower jaw and can also be found in the cheek, perinasal, or neck regions.

Patients with acute disease present with pain and swelling.

In contrast, patients with chronic cutaneous sinus tracts are usually asymptomatic, as the tract acts as an outlet for discharge from the infected tooth.

A dental cause is important to consider any time there is a chronic suppurative lesions on the head and neck.

X-rays are necessary to diagnose the underlying cause, such that a carious tooth or periapical radiolucency suggests a dental source of infection.

Treatment consists of a root canal or extraction of the affected tooth.

After extraction or root canal surgery, healing of the face or neck lesion and tract occurs within 5 to 14 days.

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