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Tooth decay that is not treated will
progress through the enamel and into the dentin
(the layer of tooth with sensory innervations). Without
intervention, the disease process can proceed through
the dentin and into the pulp of the tooth.
If the infection progresses to the pulp
of the tooth, it will result in further sensitivity
and discomfort. If the infection is controlled by
early intervention, the prognosis for restoring the
tooth is good. In its earliest stages the infection
can be reversed. If left untreated the decay can progress
out of the tooth and into the surrounding bone. It
can result in the development of an intraoral or extraoral
fistula
(an abnormal passage leading from an abscess or hollow
organ to the body surface or from one hollow organ
to another and permitting passage of fluids or secretions)
that allows pus to drain into the mouth.[4]
If the infection spreads to the surrounding
tissues, a facial cellulitis
(a spreading inflammation of subcutaneous or connective
tissues) results. The site can be beneath the jaw
or on the face. Approximately half of all facial cellulitis
in children can be attributed to dental
caries. Immediate treatment of facial cellulites
is required to prevent airway blockage or systemic
illness, which can lead to death. Treatment involves
removal of the tooth (if the cellulitis is tooth-related),
antibiotics, and possibly incision and drainage.[4]
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