Dental Cysts: Why They Appear and How to Treat Them
Dental cysts, also known as a dentigerous cyst or odontogenic cyst, is a fluid-filled sac that develops in the jaw bone – in principle in a tooth that hasn’t yet erupted. They’re very common, and almost always manifest in the molars and canines. They don’t always generate symptoms, as they’re only visible when the cyst exceeds 1.5 centimeters (just over half an inch) in diameter.
Dental cysts are benign, but some can cause infectious complications. Almost always, they are diagnosed by chance during a routine examination. They’re more common in men than in women, and most cases are reported between the second and third decade of life. We’ll show you everything you need to know about dental cysts according to the experts.
Main causes of dental cysts
From a clinical point of view, researchers point to the alteration of the enamel epithelium – which reduces after the completion of amelogenesis – as the main cause of dental cysts, which produces an accumulation of fluid between the epithelium and the crown of the tooth. As a result, a lump or a sac of liquid is produced, which totally or partially prevents the eruption of the tooth.
Two types of dental cysts are distinguished: developmental and inflammatory. The former have the characteristics indicated in the previous section, and are a consequence of the process of a tooth’s development and eruption.
The second is due to underlying inflammatory pathogenesis, which leads to the development of the cyst. Specialists warn that it isn’t always possible to distinguish whether the inflammatory component is a cause or a consequence of the cyst.
Most cysts are detected by panoramic x-rays taken for general dental treatment, so they almost always go undetected. All are associated with the crown of an impacted, embedded, or unerupted permanent tooth.
There’s no way to prevent this phenomenon, and much remains to be understood as to why it develops in some cases and not in others.
Symptoms of dental cysts
As we have already mentioned, most cysts don’t produce symptoms. This is due to their nature; they’re benign, and unless they grow excessively or become infected, the person won’t notice them.
They will affect only one tooth, and it’s almost always either the mandibular third molar or maxillary canine. When the cyst grows more than 1.5 centimeters (just over an inch), the following symptoms may occur:
- Tooth sensitivity
- Swelling
- Displacements of the teeth
- Mild or moderate deformation of the face
When the person looks inside their mouth, they will detect a small bulge that has formed in the space of a tooth. In some cases, the cyst can become infected, cause malformation or fracture of the jaw bone, and even cause tooth loss. These complications are rare and generally only occur when the lump grows larger than 1.5 centimeters.
Cysts of this type only occur in the secondary dentition, so they are rare in children. However, cases have been reported in this age group, so parents should be aware of the symptoms and characteristics. Some severe cases lead to ameloblastoma, a benign type of jaw tumor.
Treatment for dental cysts
Treatment for dental cysts is chosen based on their size. For smaller cysts, enucleation (removal of the cyst) is chosen, accompanied by the extraction of the affected tooth or teeth.
If the specialist considers that the eruption of the tooth is possible, he will choose to leave it after removing the lump. It isn’t uncommon for this to be complemented with orthodontic treatment to correct the possible consequences of cyst development.
The most severe cases are treated through a process known as marsupialization. It involves cutting the cyst, draining the fluid, and adding stitches to the edges of the incision to keep it open.
The latter is done to prevent the cyst from growing back. Recurrence is rare, and the overall prognosis is excellent. If the patient requires it, reconstruction surgery can be considered to restore the jaw.
All cysts must be treated when they are detected, as there’s no guarantee there won’t be future complications. The treatment is effective and there aren’t usually any major complications.
If you have noticed a lump that has appeared near a tooth or you have already been diagnosed with the cyst, talk to a specialist about the best options to remove it. We reiterate that all of them are benign and can be easily addressed.
- G A, Varma B, P U. Management of a Dentigerous Cyst: A Two-Year Review. Int J Clin Pediatr Dent. 2011;4(2):147-151.
- Shetty RM, Dixit U. Dentigerous Cyst of Inflammatory Origin. Int J Clin Pediatr Dent. 2010;3(3):195-198.
- Terauchi M, Akiya S, Kumagai J, Ohyama Y, Yamaguchi S. An Analysis of Dentigerous Cysts Developed around a Mandibular Third Molar by Panoramic Radiographs. Dent J (Basel). 2019;7(1):13.