M3 Oral Abscesses Flashcards
Give the 4 main presentations/symptoms of oral abscesses
pain
swelling
erythema
suppuration
Give the 4 main routes of prokaryotic infection in the mouth
caries/trauma
gingival
periodontitis
pericoronitis
Explain what is meant by “caries/trauma” as a route of oral infection
periapical or dentoalveolar abscess
Explain what is meant by “ginigval” as a route of oral infection
gum tissue inflammation
Explain what is meant by “periodontitis” as a route of oral infection
periodontal abscess
Explain what is meant by “pericoronitis” as a route of oral infection
partially erupted tooth
What are the 3 characteristic features of an oral abscess?
Swollen inflamed area, pus, causative agent
What types of bacteria cause oral abscess?
a combination of strict: fusobacterium and prevotella
and
facultative anaerobes: Streptococcus oralis and streptococcus anginosus
List the different types of oral abscesses
Dentoalveolar Periapical Apical Chronic periodical dental infection Dental pyogenic infection Periapical periodontitis
Cause of dentoalveolar abscess
the associated tooth is infected due to caries/trauma
Symptoms of dentoalveolar abscess
tender to pressure, localised
treatment of dentoalveolar abscess
drained, root canal, treatment, extraction, antimicrobials, antibiotics
cause of periodontal abscess
associated tooth has a healthy pulp but there is infection of periodontuim usually due to foreign object in pocket
symptoms of periodontal abscess
sudden onset, swelling, red/tender, may spread and destroy bone/soft tissue
microbiology of periodontal abscess
GNABs, Streptococci, Actinomyces, Fusobacterium nucleatum
treatment of acute periodontal abscess
local drainage, antibiotics, removal of causative agent
treatment of chronic periodontal abscess
drainage, gentle scale, irrigation, antibiotics
presentations of endodontic infections
pulpitis, recurrent infection following RCT
gram negative bacteria causing endodontic infections?
fusobacterium nucealtum, prevotella
gram positive bacteria causing endodontic infections?
S. oralis, S. Mitis, S. anginosus
Enterococcus Faecalis
Lactobacilli, Candida albicans, Staphylococci
What type of bacteria is enterococcus faecalis?
Gram positive, facultative anaerobe
Give 3 key features of enterococcus faecalis
common in intestine, can be eradicated in small numbers, adheres to collagen
What is dry socket?
post extraction localised osteomyelitis
Describe dry socket
following extraction the socket fails to heal then a localised sparse anaerobe infection will result
prophylaxis for dry socket
chlorohexidine irrigation prior to and post extraction
treatment for dry socket
antiseptic dressing and metronidazole
where is actinomyces found in the mouth
supra and sub gingival plaque
what is actinomyces associated with clinically?
root surface caries
what is the 1 main characteristic of actinomycosis?
pus
what type of bacteria are oral spirochetes?
gram negative anaerobes
What is ANUG?
acute necrotising ulcerative gingivitis = acute and painful infection of the gingiva
risk factors of ANUG?
poor OH calculus and overhangs smoking malnutrition systemic illness stress immunosuppression
symptoms of ANUG?
inflammation spontaneous bleeding grey pseudomembrane intense pain tissue destruction
What is the microscopy of ANUG?
fuso-spirochaetal complex
treatment of ANUG?
intensive local oral hygiene
oral hygiene advice and mouth rinses
short course of antibiotics
what antibiotic would be prescribed for ANUG?
metronidazole therapy 200mg 5 days
What is Ludwig’s angina?
Bilateral infection of sublingual and submandibular spaces
symptoms of Ludwig’s angina?
base of mouth and tongue swell
oedema and swelling of neck tissues
airway obstruction
What is the most common cause of Ludwig’s angina?
post extraction infection
treatment for Ludwig’s angina
intravenous penicillin, surgical intervention
