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What is dental focus?

Chronic apical periodontitis (dental focus) is an enclosed chronic inflammation at the tip of the dental root in the jawbone. The two most frequent causes are a dead and untreated dental nerve, called pulp gangrene and/or a badly done root treatment. If the dental nerve is infected, due to severe caries for example, it dies and the rotting remains produce an inflammation in the bone at the tip of the root. If a root treatment isn’t done cleanly bacteria may thus intrude into the bone. Due to its slow development the patient often doesn’t feel anything.

Some develop typical symptoms such as

  • eine pain caused by pressure on the tooth
  • eine a fistula in the gums
  • movement of the tooth out of place
  • a granuloma in the gums

We should distinguish between dental focus and a radicular cyst and a periodontal abcess. In order to avoid such complications the tooth should be drilled as little as possible as every time the tooth is drilled and/or with large fillings there is a risk of damage to the dental nerve and the development of dental focus.

Risk factors for chronic apical periodontitis are

  • badly done root treatment
  • dead dental nerve

The diagnosis of apical periodontitis is usually achieved with the help of x-rays.

The treatment of dental focus consists in the root canal treatment (RT) and/or a root tip resection. This should always be either orthograde or retrograde.

What is tongue cancer?

Lingual carcinoma (tongue cancer) is a malignant change in the tongue. Fortunately this is a very rare illness and mostly occurs in advanced age, predominantly in smokers and/or alcoholics. The patients often are not aware of any symptoms for a long time due to its very slow development.

Early symptoms in the tongue include

  • eine a wound that doesn’t heal
  • eine ulceration
  • eine hardening

We should distinguish between tongue cancer and a simple wound infection caused by biting one’s tongue. This will normally heal within a few days. And also between an abscess in the tongue for example, which could make the whole tongue hard and stiff.

Risk factors for tongue cancers, just as for cancer in general, are

  • smoking
  • alcohol consumption
  • poor oral hygiene
  • poor dentition
  • chronic irritation of the oral mucosa

A lingual carcinoma is treated by surgical removal (resection of the tumour).

Bone Inflammation?

Osteomyelitis (ostitis) is an inflammation of the bone; if the jawbone is affected then we often speak of maxillitis. Due to its slow development the patient often doesn’t feel anything for a long time. Early symptoms of osteomyelitis are
  • eine swelling of the jaw
  • eine ulceration of the oral mucosa
  • swelling of the lymph nodes in the neck
  • movement of teeth out of place
  • disturbances in sensation in the lower lip

Osteomyelitis should not be confused with a simple alveolitis following a tooth extraction. Smokers in particular are prone to unspecific wound infections following extraction. The classic symptom of such alveolitis are pains in the wound on the third day after extraction.

Risk factors for osteomyelitis are

  • unclean conditions in the clinic
  • not following the code of behaviour
  • interventions when in a poor general physical state

Diagnosis of osteomyelitis is done with the help of x-ray and bone scans.

The treatment of osteomyelitis consists of of bone abrasion (bone resection) and/or the administration of antibiotics and/or oxygen treatment.