C: 1.2 MANAGEMENT OF ODONTOGENIC AND ALL OTHER ORAL INFECTIONS

Question 1

Species of bacteria causing odontogenic infections

Answer 1

Most - Gram -ve rods
Some Gram +ve cocci
60% anaerobic
Almost all odontogenic infections - multiple bacteria

Question 2

Cellulitis

Answer 2

Acute onset
Diffuse large swelling which is poorly circumscribed.
Dull on palpation with no presence of pus.
Aerobic bacteria
Pain - severe and generalised

Question 3

Abscess

Answer 3

Localised pain, swelling - well circumscribed, fluctuant, with pus present.
Mainly Anaerobic bacteria

Question 4

Borders of Submental space

Answer 4

Inferior - hyoid bone
Lateral - Anterior belly of digastric
Superior - mylohyoid

Question 5

Necrotising Fascitis

Answer 5

Can start from minor injury
Intense pain
Usually in pts in poor general health
Smooth, tense, shiny skin with no obvious clear demarcation of area involved.
Pathognomic signs - purplish discolouration of skin, purplish parches, ill-defined borders, blisters, necrosis of fascia and gangrene of overlying skin.
Systemic - sepsis, hypotension, pyrexia, jaundice
Medical emergency - 10-20% mortality