Odontogenic Infections

Question 1

Odontogenic infections

Answer 1

Dental infections that spread to surrounding tissues

Question 2

Pulpitis

Answer 2

Caries approaching pulp

The pulp is compromised by inflammation

Question 3

Antibiotics for pulpitis?

Answer 3

Not effective

Question 4

Pulpitis initially

Answer 4

Lowered threshold and prolonged pain response to cold or other stimulus

Question 5

Onset of spontaneous pain sign of

Answer 5

Inevitable pulpal necrosis

Question 6

Pulpitis can be reversed with

Answer 6

Timely treatment of caries

Question 7

Periapical lesions

Answer 7

Pulp necrotic blood supply interrupted immune cells cant reach canal

Question 8

Periapical lesions inflammatory response shifts to

Answer 8

Periapical tissues

Question 9

Periapical lesions bone resorption allows

Answer 9

Space for immune cell barrier

Question 10

Periapical lesions bacteria most numerous in

Answer 10

Root canal

Low levels in periapical tissues

Question 11

Periapical lesions since pulp is necrotic

Answer 11

Often only detected on radiographs

Question 12

Acute dentoalveolar abscess

Answer 12

Acute exacerbation of periapical lesion shift in bacterial species

Question 13

Acute dentoalveolar abscess bacteria and PMNs confide to

Answer 13

Bone at apex

Question 14

Acute dentoalveolar abscess severe

Answer 14

Aching throbbing pain sensitive to pressure

Question 15

Acute dentoalveolar abscess drainage of pus

Answer 15

Brings relief

Question 16

Acute dentoalveolar abscess treatment

Answer 16

Endo or extraction

Question 17

Acute dentoalveolar abscess pus under pressure

Answer 17

Tunnels escape to surface by path of least resistance

Soft tissue abscess must be surgically drained

Question 18

Chronic dentoalveolar (periapical) abscess drainage may occur

Answer 18

Spontaneously through fistula to surface

Drainage brings relief

Question 19

Chronic dentoalveolar (periapical) abscess fistula with parulis

Answer 19

Spontaneous o drains when pressure builds

Gum boil

Not an emergency

Question 20

Chronic dentoalveolar (periapical) abscess drainage into tissues spaces and Oreo facial involvement

Answer 20

Is serious emergency

Question 21

Cellulitis

Answer 21

Bacteria invade soft tissue

Inflammation
Edema
Erythema
Painful
Fever possible

Question 22

Edema

Answer 22

Tissues hard indurate

Question 23

Soft tissue involvement determined by

Answer 23

perforation of the cortical bone in relation to the muscle attachments

Question 24

Odontogenic facial cellulitis

Answer 24

Bacteria from tooth

A-streptococci

Question 25

No odontogenic facial cellulitis

Answer 25

Skin or mucous membrane trauma Sinus bacteria Hemophilia influenzae His vaccine lowered incidence

Question 26

Other causes of acute facial swelling

Answer 26

Mumps

Question 27

Odontogenic usually located

Answer 27

More often lower face Upper face common too

Question 28

Non odontogenic usually in

Answer 28

Usually upper face

Question 29

Cellulitis may progress

Answer 29

To new secondary abscess formation

Question 30

Secondary abscess not

Answer 30

In direct communication with primary Most be drained for resolution

Question 31

Most frequently isolated in odontogenic facial cellulitis

Answer 31

A-hemolytic streptococci

Question 32

Antibiotics not effective against

Answer 32

Infections confined to pulp Apical period Abscesses

Question 33

If tooth ext or RCT does not provide a path of drainage

Answer 33

Surgical incision and drainage required for resolution

Question 34

Antibiotic selection: Penicillin/amoxicillin

Answer 34

Bactericidal Narrow but appropriate spectrum for milder infections Resistance possible Amox has less frequent dosage schedule and better taste

Question 35

Penicillins w/B-lactamases inhibitor

Answer 35

Oral augmentin IV unasyn Resistance unlikely Bactericidal

Question 36

Addition of metronidazole to penicillin

Answer 36

Covers anaerobes so broader spectrum

Question 37

Clindamycin

Answer 37

Oral or IV Less resitance Bacteriostatic

Question 38

Ludwigs Angina

Answer 38

``` Drooling Elevation of the floor of mouth Difficulty swallowing Breathing Limited neck motion Trismus ```

Question 39

Periorbital cellulits

Answer 39

Erythema Induration Tenderness of tissues Rarely progresses to orbital cellulitis

Question 40

Orbital cellulitis

Answer 40

``` More common in children Bulging eye Loss of vision Pain in eye Brain abscess ```

Question 41

Compensated shock

Answer 41

BP mainted by increased cardiac work Rapid pulse Not indefinitely sustainable

Question 42

Uncompensated shock

Answer 42

BP can no longer be maintained Emergency

Question 43

Indications of urgency

Answer 43

``` Rapid Fever Pain level Prior treatment failure Inability to eat ```

Question 44

Criteria for hospital admission

Answer 44

``` Fever malaise Rapid progression Trismus Impending airway Deep space infection Periorbital swelling Compromised host Poor complicate Special healthcare needs ```