What is Dental Fistula? Identification, Treatment, & Prevention

If you have ever experienced dental issues, you know the pain and discomfort it brings along with several other symptoms. Dental infections are a common occurrence both inside and outside of the oral cavity. A dental fistula is an open canal which develops to drain the infection from a tooth abscess. It is a little different from the sinus tract which has only one end. (1)

Sinus tract originates at the point of infection, and the canal is blindsided. A dental fistula is more or less sinus tract infections. A dental fistula can take up any form and shape during its formation. The cause and location of dental fistula determine the course of treatment. Clinically, dental fistula can be noticed as a small lump on the surface of the gums. This article will highlight the formation of dental fistulas in the mouth and specific treatments that can help to heal the infection.


What is a dental fistula?

A dental fistula is a canal, usually small in size, that originates from a tooth infection and opens out into the oral cavity near the gums. The canal passage acts as a reservoir to drain the pus and infectious discharge that has been building up around the infected tooth. With time, as the fistula fills up, it forms a small lump on the surface of the gums. (2) With excessive pus collection, the bump bursts out to drain the pus into the oral cavity.

What causes fistula in the mouth?

A dental fistula is commonly associated with an abscess that may have developed as a result of the following events –

  • Trauma or injury to the mouth
  • Bacterial accumulation
  • Post-surgical infection
  • Extraction of molars(3)
  • Congenital disease
  • Failed root canal treatment

The abscess can originate from gums or the tooth. Often abscess leads to infection of the surrounding tissue. The pus formed during infection builds up and pushes its way through the gums to drain the area.

What are the clinical signs and symptoms of dental fistula?

Typical signs of dental fistula can be seen as a small swelling or bump on the surface of the gingival tissue. Often this condition is referred to as gum boil. In some cases, the bump can be in proximity to the abscessed tooth. Most of the times, the pus discharge through fistula can be indicated by frequent appearance and disappearance of the gum boil.

Formation of the dental fistula is not a painful condition as it involves the release of pressure by pus discharge. One of the common symptoms reported many patients is an unpleasant taste in the mouth. Daily activities like brushing and flossing may cause slight discomfort in the affected area.

How is it diagnosed?

Dental fistula formation is a painless condition. This is one of the prime reason the patient ignores dental fistulas. Abnormal pus discharge in the mouth is a warning sign of an oral infection that needs attention and treatment. Often a dental fistula can be seen as a bump on the gums that discharges a whitish material called pus.

A dentist may help to detect this oral condition on a routine dental examination. Dental x-rays help to find the location and source of the problem.

What is the treatment for a dental fistula?

Dental fistulas are closely related to tooth infections and gum diseases. The treatment of a dental fistula depends on the cause of the infection.

  • If the source of infection is an infected tooth, a root canal treatment is suggested to drain the infection and save the tooth. In some cases, the opening of the fistula is slightly widened to allow pus discharge and accelerate healing. (4)
  • If the source of infection is gum infection, the dentist will deeply clean the affected area of the gums to drain the pus and prescribe antibiotics usually for two weeks. An antibacterial mouth rinse is suggested to be used regularly to minimize bacterial overload.

A follow-up examination is scheduled after one week to check the rate of healing and plan further treatments if required.

What can you do to prevent it?

Consistent oral hygiene practice is the key to prevent oral infections especially dental fistulas.

  • Brush your teeth regularly, twice a day
  • Floss your teeth at least once after brushing
  • Rinse your mouth with an antibacterial mouthwash
  • Warm salt water solution can also be used to rinse your mouth

A dental fistula may seem like a simple dental problem but requires prompt management. Prognosis of the dental fistula is usually favorable, provided you follow all the instructions carefully.

The site may heal within a few weeks and months. Routine dental visits and regular check on your oral health care practice will take you a long way in maintaining your oral health.

Take away message

A dental fistula is a unique open-ended canal that originated at the point of infections and opened out into the oral cavity near the gums. Dental fistula arises as a result of a long term dental infection. It becomes a means of pus drainage that builds up within the oral tissues with time.


Often dental fistulas are painless and are ignored by the patient. A dentist can detect the presence of fistula through dental examination and x-rays. The best way to manage a dental fistula is to find out the source of the infection and treat it. Prompt attention and good oral care will help to ensure a successful result. One of the best ways to stay away from oral infection is to follow a good oral healthcare routine to maintain your oral hygiene. Keep these instructions in mind and live a healthy life.


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