Dentigerous Cyst

What is a dentigerous cyst?

A dentigerous (pronounced “den-TIJ-uh-rus”) cyst is a fluid-filled sac that forms around the crown of an unerupted permanent (adult) tooth. It’s a type of dental cyst that affects your jaw.

Dentigerous cysts most commonly affect impacted wisdom teeth. But they can form around any tooth that’s still trapped in your jawbone. A dentigerous cyst attaches near the neck of your tooth (where the root meets the crown) and balloons out around its crown. On a dental X-ray, it sort of looks like a semicircle drawn around the top half of your tooth.

You can have a dentigerous cyst and not know it. Healthcare providers usually detect them on imaging tests taken for other reasons. Dentigerous cysts aren’t typically dangerous. But they can damage your surrounding jawbone and nearby teeth if they keep growing. It’s usually a good idea to treat a dentigerous cyst, even if it’s small.

How common are dentigerous cysts?

Jaw cysts are rare overall. But among them, dentigerous cysts are the most common. People usually develop them in their 20s or 30s, but anyone can get them, including children.

What are the symptoms of a dentigerous cyst?

Symptoms of dentigerous cysts may include:

• Gaps or spaces between the affected teeth.
• Shifting (displaced) teeth.
• Swollen gums.
• Teeth sensitivity.

What causes dentigerous cysts?

Dentigerous cysts happen when fluid builds up between your tooth crown and the outer layer of your tooth enamel. But experts aren’t exactly sure why this fluid accumulates to begin with.

Normally, when a tooth starts to form in your jaw, a follicle protects it until it’s ready to erupt (break through your gums). The dental follicle is kind of like an egg — a cozy little pocket for your developing tooth. It produces cells that nurture your new tooth and help it grow. Once your tooth matures, it breaks through the follicle and erupts through your gums. The follicle that once protected your tooth turns into your periodontal ligament, which anchors your tooth root to its socket.

With a dentigerous cyst, fluid builds up inside the follicle, causing it to balloon out. As a result, the tooth doesn’t erupt. It gets trapped in your jawbone.

What are the complications of this condition?

Without treatment, some dentigerous cysts can cause complications like:

• Ameloblastoma (a noncancerous jaw tumor).
• Infections.
• Jaw pain or fracture.
• Tooth loss.

In rare cases, dentigerous cysts can turn into cancerous tumors. This happens when an infected cyst causes cells in the area to change and grow out of control.

How are dentigerous cysts diagnosed?

Healthcare providers usually spot dentigerous cysts on imaging tests taken for other reasons. For instance, your dentist might discover a cyst when taking routine X-rays. If you have symptoms, like a bump on your gums, they might be able to diagnose it with a physical examination.

If your healthcare provider thinks you might have a dentigerous cyst, they’ll use radiology imaging tests to confirm a diagnosis. These tests may include:

• Panoramic X-ray: A single image that shows your teeth, upper jaw and lower jaw.
• CT scan: A series of 3D images that show the jawbone and teeth in greater detail.
• MRI: A series of 3D images (or “slices”) that show soft tissues in greater detail.

How are dentigerous cysts treated?

Oral surgery is the standard treatment for dentigerous cysts. The type of surgery you need depends on your situation. For smaller dentigerous cysts, a surgeon removes the cyst and the affected tooth. Larger cysts may require a procedure called marsupialization. Both approaches prevent a dentigerous cyst from coming back.

Your surgeon removes the entire dentigerous cyst and extracts the affected tooth. If the cyst leaves a large hole behind, your surgeon may do a dental bone graft to fill it in.

Your surgeon makes an incision (cut) in the cyst and lets it drain. Then, they stitch the edges of the cyst to the surrounding tissue. This keeps the cyst open, allowing it to drain continually.

How soon after treatment will I feel better?

Most people can return to normal routines in a few days. Even though you’ll feel better within the first week, your jawbone will continue to heal and repair itself over the next few months. You’ll need to see your healthcare provider for follow-up visits to make sure you’re healing as expected.

Can dentigerous cysts be prevented?

You can’t prevent dentigerous cysts. But if you get one, timely treatment can reduce your risk of related complications.

What can I expect if I have a dentigerous cyst?

Dentigerous cysts aren’t harmful on their own. If you have one, your dentist might monitor it to make sure it doesn’t grow. But in most cases, the best thing to do is remove it. Removal is the only way to make sure it doesn’t come back.

When should I see my healthcare provider?

You should tell your dentist if you develop sore, swollen gums. No matter what causes these symptoms, early diagnosis and treatment are always best.

In general, you should visit your dentist at least twice a year for routine exams and cleanings. If something’s going on, they may be able to catch it early.

What questions should I ask my doctor?

If you have a dentigerous cyst, here are some questions you might want to ask your healthcare provider:

• Do I need treatment now or can we monitor the cyst?
• What symptoms should I watch for?
• When should I schedule another appointment?
• Do you have recommendations in the meantime?

What’s the difference between eruption cysts and dentigerous cysts?

Dentigerous cysts aren’t the same as eruption cysts, though the two are closely related. A dentigerous cyst forms while a tooth is still in the bone. An eruption cyst forms after the tooth moves through the jawbone and just before it breaks through the gums.

Eruption cysts are far more common among children, especially those who are getting their permanent teeth.