Management Protocol

Question 1

Steps in the management of Maxillo facial and Oral sepsis

Answer 1

1. Determine the severity of Infection
2. Evaluate the state of patients host defense mechanisms
3. Determine whether patient must be managed by dentist/GP or Specialist maxillo facial and Oral Surgeon
4. Treat infection surgically
5. Support patient Medically
6. Choose and prescribe appropriate antibiotics
7. Use right route and right dosage of antibiotic

Question 2

Cardinal signs of inflammation

Answer 2

1. Dolor (pain)
2. Tumor (swelling)
3. Calor (warmth)
4. Rubor (redness)
5. Functio laesa (loss of function)

Question 3

Medical Conditions that compromise host defenses:

Answer 3

• Poorly controlled DM
• Alcoholism
• Malnutrition
• End-stage renal disease
• HIV/AIDS
• Lymphomas and Leukemias
• Other malignancies
• Congenital and acquired immunologic diseases
• Cancer chemotherapy
• Corticosteroids
• Organ transplantation

Question 4

Criteria for referral to a MFOS:

Answer 4

• Rapidly increasing infection
• Dyspnea (difficulty breathing)
• Dysphagia (difficulty swallowing)
• Dehydration
• Moderate to severe trismus
• Swelling extending beyond the alveolar process
• Elevated temperature
• Severe malaise and toxic appearance
• Compromised host defenses
• Need for general anaesthesia
• Failed prior treatment

Question 5

Indications for Therapeutic Use of Antibiotics

Answer 5

• Swelling extending beyond the alveolar process
• Cellulitis
• Trismus
• Lympadenopathy
• Increased temperature
• Severe pericoronitis
• Osteomyelitis

Question 6

Situations in which the use of antibiotics is not necessary

Answer 6

• Patient demand
• Toothache
• Periapical abscess
• Dry socket
• Multiple dental extractions in a non-compromised patient
• Mild pericoronitis (inflammation of the operculum only)
• Drained alveolar abscess

Question 7

Effective Orally administered antibiotics useful for Odontogenic infections:

Answer 7

• Penicillin
• Amoxicillin
• Clindamycin
• Azithromycin
• Metronidazole