Talk:Odontogenic infection

Going to turn this into a stand alone article

As per my comments here Talk:Dental_caries#Odontogenic_infection_redirects_here?, leaving odontogenic infection as a redirect to dental caries is inappropriate. Lesion (talk) 23:47, 6 April 2013 (UTC)

Acute infection:

• Systemic unwellness
• Pyrexia
• facial erythema and swelling (cellulitis rather than abscess and pus formation)
• regional lymphadenopathy

Chronic infection:

• buccal sinus
• mobile tooth
• halitosis
• discolored tooth

Treatment is to remove the cause of the infection: extirpation of the pulp or tooth extraction.

• Local drainage - via the root canal or incision and drainage.
• Difficult to drain a significant infection solely through the tooth canal
• Antibiotics if systemic involvement- not first line treatment and infection often resolves with removal of the tooth only. Usually Amoxicillin or penicillin V. Metronidazole if severe or anerobes suspected. Antibiotics usually given if immunosuppression

Criteria for hospital admission

• Dehydration. Decreased frequency of micturation in last 12 hours
• Severe infection e.g. rapidly progressing or temperature > 39oC
• Floor of mouth swelling

Hospital care

• analgesics (paracetamol, ibuprofen)
• If eye shut - chloramphenicol eye drops or ointment to prevent conjunctivitis
• IV fluids
• Warm saline mouthwashes
• Intravenous antibiotics
• swab of pus for MCS culture and sensitivity

Complications

Infections of the canine space can spread via emissary veins, which have no valves to prevent back flow, to the intracranial venous system and potentially causing either a cavernous sinus thrombosis or a brain abscess. The 3rd and 6th crainial nerves lie in the walls of the cavernous sinus, and thrombosis can therefore present with a squint due to disruption of the motor supply to the extraocular muscles.

Spread in fascial planes that surround the airway, with narrowing and stridor

Spread in fascial planes to the mediastinum to cause mediastinitis.

References