Tooth eruption cyst

November 12, 2023

  

The eruption of teeth in the oral cavity is a complex and a dynamic process. Humans acquire two dentitions in their lifetime. One is a primary or a deciduous dentition comprising of 20 teeth and the other is a permanent dentition comprising of 32 teeth. Between the age range of 6 years to 14 years, the deciduous teeth begin to shed and are replaced by the permanent teeth.

Factors that affect tooth eruption

A tooth's eruption within the oral cavity is influenced by multiple factors. Since the tooth erupts from a bony architecture, the body's growth factors are released in a way that the bone surrounding the tooth bud is gradually resorbed as it erupts in the oral cavity. Moreover, the path of the erupting tooth will be in the area where it is least resisted by the surrounding bone. The development and growth of humans leads to an increase in the size of the jaws as well. This too contributes to the eruption of the tooth as more space is made from the permanent teeth to erupt. Forces exerted by the surrounding musculature of tongue, lips and cheeks also contribute to the eruption of the teeth. An equilibrium zone is made, when the forces of the tongue on one side are neutralised by the forces of the muscles connected with the cheeks and lips on the other side. It is in this neutral zone where the teeth erupt and place themselves in the oral cavity.

What is an eruption cyst in dentistry?

A cyst is a membrane-like cavity that can contain air, fluid or other substances. An eruption cyst is formed around an erupting tooth. It arises as a result of trauma, previous infection or lack of space for the tooth to erupt.

What are the signs and symptoms of the eruption cyst?

An eruption cyst usually appears as a bluish, reddish, purplish or blackish hue of soft tissue surrounding the erupting tooth. It is most often seen in the upper jaw bone. Eruption cyst is most commonly seen in children between 6 to 9 years of age. The cyst usually surrounds the entire width of the erupting tooth.

The eruption cyst may or may not be painful. At times pain can arise only if stimulated upon touching or chewing. It is soft in consistency when palpated. The eruption cyst cannot be appreciated on a radiograph. However, a radiograph needs to be taken to confirm the eruption cyst which presents with no abnormality of the surrounding and adjacent bone.

How do dentists treat tooth eruption cysts?

Treatment of an eruption cyst is seeked for when concerns arise based on pain and aesthetic appearance. Usually, an eruption cyst resolves itself when as the erupting tooth tears apart the cystic space. However, when it is long-standing and causing discomfort, the cyst needs to be excised.

The excision of the cyst involves deroofing the cystic space. This is done by simply putting an incision at the roof of the cyst to expose the erupting tooth. The incision is placed with a scalpel blade. Modern techniques utilize laser therapy to expose the erupting tooth. The biggest advantage of using lasers is that they do not require the concerned area to be anesthetized and the coagulation (healing) is faster. When the cyst is ruptured, the fluid drains and the lesion resolves.

What is tooth eruption hematoma cyst?

When the eruption cyst consists of blood, it is called eruption hematoma. This condition may see the lesion bleed, making it mandatory for the cystic lining to be incised as soon as possible. Eruption cysts are benign in nature and are usually harmless. These dome-shaped cysts may also occur due to genetic predisposition. The treatment plan however remains the same even in these cases.

Eruption cysts when harmless, should be left untreated. There should be no surgical intervention as most of them resolve as the erupting tooth approaches the gum line. In infants, the eruption cysts are likely to make them grumpy and at discomfort. These can be relieved by application of cold water and peppermint oil through gauze pads on the eruption cysts. They rarely last longer than four months and are resolved within three to four weeks. Thus, eruption cysts, that usually occur in the first decade of life, should be dealt with only after considering the severity of cystic growth and patient-related factors.

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