Dental cysts are relatively common. The jaws being, the most common bones in the body to develop cysts.
The x ray opposite shows a tooth which never erupted and has remained buried in the bone. The dark circle is a Follicular (Dentigerous) Cyst surrounding the crown of the tooth. Both the tooth and cyst were surgically removed under sedation.
Dental cysts are similar to fluid filled balloons, usually within the jaw bone. They are usually attached to teeth and as they expand they dissolve the surrounding bone creating a cavity within the bone.
If a cyst is left in place it will slowly grow larger and cause more damage. The larger the cyst the more post bruising and swelling its removal will cause. Once a cyst and associated tooth is removed the bony cavity that is left will refill with bone over several months.
Most cysts once removed do not come back. Some cysts may re-grow after removal so it is important to identify the type of cyst you have, for this reason all cysts are sent for histological evaluation and a pathology report will confirm the cyst type which can tell you how likely it is for the dental cyst to come back
An x ray should be taken soon after the removal of the cyst and again at 6 or 12 months. This will allow you to confirm the cyst has healed or if the cyst is coming back. If a cyst is recurring it will be detected while still small making further treatment simpler.
After a cyst is removed you should expect some pain, bruising and swelling for several days. You will be prescribed antibiotics, painkillers and mouth washes to help the area heal. There is a risk of a numb feeling persisting in the area from where the cyst was removed or the overlying skin for several months due to nerve damage in the area. This is as a result of the cyst expanding over the nerve as it grows and the nerve being left bruised after the dental cyst to enecuylated (removed).
Symptoms of a Cystic lesion
- Often none
- Swelling of the face or jaw
- Movement and loosening of teeth
- Displacement of buried teeth
- Damage to teeth, as the cyst expands it may dissolve roots of teeth
- Bone destruction due to pressure from the expanding dental cyst
- Red colour to the skin, pain, increasing swelling, enlarged glands and raised temperature when the cyst becomes infected infected
- Infection or dental abscess
- Numb/ tingling feeling in the lips or face
The usual treatment is to remove the cyst, usually with the associated tooth. Most cysts do not reoccur and once removed the problem is resolved. A small number of cysts come back ( mostly the keratocyst). For this reason all cysts are sent for histological examination to determine the exact nature of the cyst.
Cysts may be removed while you are awake or while you are under light sedation.
Numb Lips, Cheek and Tongue
As with any surgical procedure in the lower jaw there is a risk of damage to a nerve in the lower jaw which supplies sensation to your lower lip, chin, cheek and tongue. This may result in a numb feeling in your lip, chin, cheek or tongue. This altered feeling will normally resolve within several months but in rare occasions the numb feelings may be permanent.
Types of Dental Cysts
For completeness below I have listed the Dental cysts found in the jaw. The first 5 cysts are relatively similar and account for most cysts found in the Jaws and rarely come back once removed. The 6th is uncommon and does tend to re grow once removed. The 7th and 8th are rare, but again can grow back
- Radicular cyst
- Residual cyst
- Dentigerous cyst
- Lateral periodontal cyst
- Paradental cysts (Buccal bifurcation cysts)
- Odontogenic Keratocyst (OKC)
- Calcifying odontogenic cyst
- Basal cell nevus-bifid rib-OKC syndrome