Frequently Asked Questions and Answers about Dental Cysts

Dental and oral health is an important part of your overall health and well-being. Normally, the body's natural defenses and good oral health care habits, (such as daily brushing and flossing) can keep bacteria under control. However, poor oral hygiene can cause different oral infections (like tooth decay, gum disease) and has also been linked to other diseases like cancer, diabetes and heart disease. Even minor growths or dental pain can be the sign of a more serious issue in its earliest stages. Dental cyst is considered one of the most common dental problems that take people to the dentist for an emergency treatment. These cysts are relatively rare growths or lesions that develop in the jawbone or the soft tissues in the mouth and face. These growths are usually non-cancerous (benign) that do not get infected for a long time, as they grow slowly without any visible symptoms. Early diagnosis of dental cysts is a difficult task as in most cases the symptoms develop slowly (often over several months or years). Treatment options for cysts vary, depending on the type of growth or lesion, the stage of growth, symptoms and normally include a combination of surgery and medical therapy. Dental medical billing and coding is quite complex, as there are several rules related to reporting the procedure accurately. Dentists or oral and maxillofacial surgeons treating oral cysts should correctly document the procedures performed in the patient’s medical records. Medical billing outsourcing companies can help physicians simplify their documentation process. 

Here are some frequently asked questions and answers about dental cysts –  

A: A dental cyst is typically a closed sac of tissue in your gums that are filled with air, cells or fluid. Cysts are a reaction of the body to a condition and are relatively slow growing. It is a form of inflammation that develops after the dental pulp dies off. As the cyst develops, the bone structure around the tooth will feel an extreme amount of pressure and get weakened. A dental cyst left to grow without treatment can lead to severe infections or other problems affecting your oral health.

A: Typically, a dental cyst can form at the tip of the roots of dead teeth and also around the crowns (and roots) of buried teeth. A cyst will develop as the bacteria around the dead tooth grow. In some cases, this may be worse if a tooth has not erupted or developed properly (teeth being unable to grow into the mouth properly) as it should have. This is particularly observed with wisdom teeth. In rare cases, cysts occur due to a genetic syndrome like “Gorlin's syndrome” that has other symptoms also.  

A: Dental cysts can develop in any of the soft oral tissues in the mouth including – the gums, mucosal lining of the lips, cheeks and oral cavity, jaw bone, tooth roots, tongue, throat and salivary glands. In most cases, these cysts when they first start forming remain infection free. The inflammatory nature of a cyst becomes visible as the old dental pulp material starts to wear out at the root of your affected tooth. As the process unfolds, a great amount of pressure will be felt around the bone structure of the affected tooth, thus weakening it. 

A: There are different types of dental cysts and these include – 

A: Dental cysts that are infected may normally cause several symptoms like - ulcers, sores, or tender areas in the mouth (that do not heal after a week or two), pain or toothache, swollen gums, pain with chewing or biting, swelling of the face and cheek, and clicking of the jaw. If any of these symptoms are accompanied by a high fever and facial or neck swelling, it is important to seek emergency medical treatment.   

A: A dental abscess or tooth abscess, is a buildup of pus that forms inside the teeth or gums. The abscess typically develops from a bacterial infection - that gets accumulated in the soft pulp of the tooth. An abscess can cause acute pain, swelling of your gums or even face and cheek and sometimes cause an unpleasant smell or taste in the mouth. Abscesses can form inside or near dental cysts, which is where the confusion can occur. Dental cysts aren't necessarily infected and can grow slowly for many months or even years without any or many symptoms. 

A: Diagnosis of dental cysts may begin with a detailed analysis of symptoms and other risk factors associated with the condition. Several imaging tests like dental X-rays, MRI or CT scan will be performed to identify the type and size of cyst, severity of symptoms and extent of the cyst (especially to check if it may cause problems to the nearby teeth). The dentist will also examine the cyst to check for signs of infections. In some cases, a biopsy may be recommended wherein a sample of fluid or lining from the cyst will be removed and sent to a dental pathology lab for microscopic examination to check for abnormal cells. 

Treatment modalities for dental cysts vary depending on the location, type and size of cyst, the stage of growth, symptoms and severity of infections. Treatment for cysts generally involves surgical care. In some cases, treatment may include medical therapy or a combination of surgery and medical therapy. 

Generally, small cysts that do not cause any specific symptoms may not require immediate treatment. Since cysts can grow bigger over time, early removal is often advisable to prevent structural damage to the mouth and teeth. If the cyst is abscessed, antibiotics are normally prescribed to stop the infection. Depending on the size and location of the cyst, the most effective treatment is surgical removal. If the cyst is simply removed, it may reoccur again. Therefore, the primary goal is to remove the entire membranous sac along with its contents. This gives the surrounding tissue a chance to heal and fill in the space left by the cyst. However, in some rare cases, a bone graft may be used to fill the gap left after the removal of a large cyst in the jawbone. Reconstruction of the jawbone or other structures may also be done as part of the treatment. 

Dentists or oral and maxillofacial surgeons who provide specialized treatment for oral cysts are reimbursed for their services. Accurate medical codes must be used to document the diagnosis, screening and other procedures performed. Medical billing services offered by reputable companies can help physicians use the correct codes for their medical billing process. 

A: The following ICD-10 codes are relevant with regard to dental cysts –

A: Maintaining or practicing a high level of oral hygiene is imperative to prevent the occurrence of dental cysts. Scheduling dental check-up (at regular intervals) may help identify dental cysts early. Since the cysts are usually asymptomatic when they first develop, patients may not even know that they suffer from this condition, until they develop some problems or take a dental X-ray. Make a habit to brush your teeth twice daily with fluoride toothpaste. Floss your teeth every day. Teeth that remain healthy rarely have cysts developing or forming around or close to them. Make certain to eat a balanced diet and get regular professional dental cleanings on a schedule recommended by your dentist.  This will help preserve your dental health in the long-run.   

Medical coding for dental or oral cysts can be challenging. For accurate and timely medical billing and claims submission, healthcare practices can rely on an established dental billing company that provides the services of AAPC-certified coding specialists. 

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