Dentoalveolar and Salivary Gland Infections Flashcards
What is dentoalveolar infection?
Used to describe pyogenic conditions which affect teeth and supporting structures
How is periodontal abscess different from dentoalveolar abscess?
Periodontal abscess is associated with vital pulp
Describe an acute dentoalveolar abscess
Represents onset of a suppurative process at the apex of the root of a tooth with a necrotic pulp
Name 3 ways bacterial can gain access to apical tissue
- Direct spread from pulp chamber
- Through periodontal membrane on root surface
- Local blood vessels
What is the relationship between dentoalveolar infection and bacteria?
- No single causative pathogen has been identified
- Considered a polymicrobial infection
Name 5 dentoalveolar infections of the alveolar cavity
- Periodontal abscess
- Dentoalveolar abscess
- Ludwig’s angina
- Osteomyelitis
- Actinomycosis
What causes a periodontal abscess?
A blockage, occasionally due to impaction of foreign bodies into an established periodontal pocket
`Name 4 gram-negative obligate anaerobe species associated with periodontal abscess
- Porphyromonas spp. (P. gingivalis)
- Prevotella spp. (P. intermedia)
- Fusobacteria spp. (F. nucleatum)
- Spirochaetes (T. denticola)
Name a facultative anaerobe species associated with periodontal abscess
Streptococci spp. (S. mutans)
What 4 processes usually cause dentoalveolar abscess?
- Extension of caries into dentine
- Pulpal exposure via trauma
- Via periodontium
- Via circulation
Name 5 obligate anaerobes associated with dentoalveolar abscess
- Peptostreptococcus spp.
- Porphyromonas gingivalis
- Prevotella intermedia
- Prevotella melaninogenica
- Fusobacterium nucleatum
Name 3 facultative anaerobes associated with dentoalveolar abscess
- Streptococcus milleri
- Streptococcus sanguinis
- Actinomyces spp.
Name 2 ways samples can be collected from dentoalveolar abscesses
- Direct aspiration of pus into sterile syringe
2. Use of paper points
What are 3 methods of laboratory investigations of dentoalveolar abscesses?
- Microscopy
- Culture
- Sensitivity
What can occur if dental abscesses are not adequately treated?
They progress and infection can spread beyond oral cavity
How does Ludwig’s angina arise?
Spread of infection from dental abscess to fascial spaces
Name 4 methods of direct spread of infection of dentoalveolar abscesses
- Spread into superficial soft tissues
- Spread into adjacent fascial spaces
- Spread into alveolar bone
- Spread into maxillary sinus
Name 2 methods of indirect spread of infection of dentoalveolar abscesses
- Lymphatic (via lymphatic system)
2. Haematogenous (via bloodstream)
Where does infection in the anterior mandible spread to?
Sublingual space
Where does infection in the posterior mandible spread to?
Submandibular space
Why must infection of the 3rd molar be treated with particular caution?
It is found at the junction of a number of different fascial spaces and can easily spread along fascial planes and compromise the airway
What is Ludwig’s angina?
Rapidly spreading cellulitis involving the floor of the mouth
What is the major complication with Ludwig’s angina?
Swelling of the anterior soft tissues of the neck has potential for airway obstruction
Name 4 commonly isolate organisms involved in Ludwig’s angina
- Anaerobic Gram negative bacilli
- Alpha haemolytic streptococci
- Staphylococci
- Enterobacteria
