Spread of infection Flashcards
Where can upper anterior teeth infection spread to
o Lip
o Nasolabial region
o Lower eyelid
Where can a lateral incisor infection spread to
palate
Why is spread of infection to palate for lateral incisor more likely than other teeth
- less common route specific to the lateral incisor because the apice of its root is more palatally placed so it can spread to the palate but this is still less common than it spreading to the face
Where can lower anterior teeth infection srpead to
- Mental and submental space (can then spread back to the sublingual/mandibular spaces)
Where can upper posterior teeth infection spread to
- Buccally + above insertion of buccinator muscle and spreads into the buccal space & infratemporal region
- Buccally + below insertion of buccinator and drains into mouth
- Palatally
- Upwards into maxillary sinus (very rare)
Why is it unlikely for an upper posterior tooth to spread palatally
- Unlikely due to palatal tissue being more dense
- More likely for this to occur with infection of palatal root or with a lateral incisor as it tends to have a palatally placed root
- Extremely painful as it stretches the palatal tissues
Where can lower posterior teeth infection spread to
- Lingual + perforates above insertion of mylohyoid to go to the sublingual space (sublingual abscess)
- Lingual + perforates below insertion of mylohyoid to go to the submandibular space (submandibular abscess) which is more serious
- Buccally + above insertion of buccinator and drains into mouth
- Buccally + below insertion of buccinator leading to buccal space swelling infection
- Can spread back into the submasseteric space, lateral pharyngeal space, retropharyngeal space
Why is infection more likely to spread lingually in posterior teeth
Generally infection posteriorly will spread lingually as the lingual bone is thinner, but as you go anterior, the labial bone gets thinner meaning it can spread both ways easily
What is the significance of the mylohyoid muscle in spread of infection
mylohyoid line separates the submandibular and sublingual space
mylohyoid muscle has free edge at back which allows infection to spread easily between sublingual and submandibular space
What are the 5 masticatory spaces
- Superficial & deep temporal spaces (in relation to the temporalis muscle)
- Masseteric space (bound by the masseter)
- Infratemporal space (in relation to infratemporal fossa)
- Pterygomandibular space
What is the significance of infection reaching a masticatory space
- When infection reaches one of these spaces, it very easily spreads to the other spaces because they communicate with each other and have very little resistance
What symptom will a patient who has infection in the masticatory spaces experience
- When infection reaches and spreads into these areas, the patient will experience trismus as the muscles go into spasm
Where can infection spread back to once it reaches
- Lateral pharyngeal space → retropharyngeal space → prevertebral space → spread continues
What is significant about the lateral pharyngeal space
- contains has important vessels and nerves running through it so not ideal to have infection + swelling in such an area
How can infection spread from the masticatory spaces to the mediastinum
- The infection can spread via the prevertebral space to the mediastinum and this can put pressure on the heart
