How to treat white pustules on the gums

The growth of white pustules on the gums is closely related to pulp disease and periodontitis. It must be treated in time. There are many treatment methods. Generally, pulp drainage is used to open the apical foramen to relieve the pressure inside and expel the purulent inflammatory fluid. This is the only way to avoid further aggravation of the inflammation. Develop good oral hygiene habits to avoid aggravation of infection.

(1) Emergency treatment:

① Open pulp drainage. In case of acute pulpitis or apical periodontitis, the pulp cavity must be opened. The latter also requires cleaning of the root canal and opening of the apical foramen to reduce internal pressure, drain inflammatory exudate, and relieve acute pain. ②Incision and drainage. In case of subperiosteal abscess or submucosal abscess, local incision and drainage strip should be placed. ③Pain relief with drugs. Commonly used cotton wool such as clove oil or eugenol is placed in the caries cavity, or analgesic powder is placed in the nostrils for nasal inhalation, or analgesics can be taken orally.

(2) Indirect pulp capping:

It is suitable for patients with deep caries close to the pulp or with mild pulp lesions that have not yet penetrated the pulp. Prepare the cavity shape, remove the carious tissue, disinfect the cavity, cover the cavity bottom with pulp capping agent, use zinc phosphate cement as the base, and fill with silver-mercury alloy or composite resin. Commonly used pulp capping agents include calcium hydroxide and its preparations, clove oil, zinc oxide cement, etc.

(3) Direct pulp capping :

It is suitable for accidental medullary perforation caused by trauma or hole making, where the diameter of the penetration point is less than 1mm. Pay attention to moisture prevention, perform local disinfection after making the hole, cover the puncture site with pulp capping agent, and fill the cavity after padding the base. Pay attention to follow-up observation and check whether it is alive.

(4) Pulpotomy:

It is suitable for those whose pulp lesions are relatively mild and whose vital pulp cannot be preserved completely. It is especially suitable for young permanent teeth whose roots have not yet fully developed. Under local anesthesia, the cavity is removed and the pulp is opened after cleaning and disinfection. The coronal pulp is removed, bleeding is stopped thoroughly, the root canal opening is covered with calcium hydroxide preparations, and the base is laid before filling. If spontaneous pain occurs after surgery, dry pulp surgery or pulpectomy can be performed instead.

(5) Dry pulp surgery:

It is suitable for pulp lesions with partial necrosis of the coronal pulp, or for patients who need pulp chamber retention and other patients who need pulp devitalization. It is mainly used for posterior teeth. First devitalization: expand the cavity to remove caries, place the devitalizing agent during pulp perforation, and seal the cavity with zinc oxide-eugenol cement to prevent the devitalizing agent from overflowing and burning the periodontal tissue, but avoid applying pressure during the operation. Second pulp filling: After removing the devitalizing agent and cleaning the carious tissue, the coronal pulp is removed. Dry the pulp chamber with anhydrous ethanol cotton balls or place a cotton ball with formaldehyde-cresol mixture at the root canal opening for 1 minute, then place a pulp dryer about 1 mm thick at the root canal opening to fill the bottom, and pay attention to the lowering to prevent tooth fracture. If symptoms occur after surgery, pulpectomy or root canal treatment can be performed instead.

One-time dry pulp surgery: Indications are the same as dry pulp surgery, but it is completed in one time. That is, under local anesthesia or rapid inactivation of toad venom, the coronal pulp is removed, covered with a pulp drying agent, and the bottom is filled. The dosage of analgesics and paraformaldehyde should be appropriately increased for the pulp stem used to reduce postoperative pain, and adequate hemostasis must be achieved before covering the pulp stem.

(6 ) Pulp surgery for variant deciduous teeth:

Suitable for pulp necrosis or apical periodontitis of deciduous teeth. ① Remove caries and cavities and remove dead pulp from the crown. Place a cotton ball containing formaldehyde-cresol mixture in the pulp chamber and seal it with zinc oxide-eugenol cement for 3 to 7 days. ② If there is no swelling or pain after sealing, the sealing medicine can be removed, and the root canal opening can be covered with pulp drying agent and filled at the bottom.