Spread of Infection Flashcards
Where does infection typically spread?
Spreads to the least restrictive area (easiest)
Where can an upper tooth infection spread?
Can spread into the maxillary sinus
Buccally into the buccal space
Can spread palatally but this is rarer (extremely painful as there is less space)- more common in lateral incisors or molars
Where can a lower tooth infection spread to?
Lingually
-mylohyoid muscle
—if the infection perforates the bone above the insertion of the mylohyoid muscle then it spreads into the sublingual space (under the tongue abscess)
— if the infection perforates the bone below the insertion of the mylohyoid muscle it spreads into the submandibular space (more serious, airways)
Buccally
–perforates above the insertion of the buccinator and drains as a sinus in the mouth
–if it perforates below the insertion of the buccinator then it would become buccal swelling
Where do upper anterior teeth infections spread to?
Lip
Nasiolabial region
Lower eyelid (if perforates above the insertion of the buccinator muscle)
labial
Where do upper lateral incisor infections spread to?
Palate
Buccal abscess
Where do upper premolars and molars infection spread to?
Cheek
Infra-temporal region
Maxillary antrum (very rare)
Palate (less common)
Where do lower anterior teeth infections spread to?
Mental and submental (chin) space
Where do lower premolars and molars infection spread to?
Buccal space
Submassateric space
Sublingual space
Submandibular space
Lateral pharyngeal space
What is the surgical management of a spreading infection?
Establishment of drainage
–extra and intra oral
Removal of source of infection
Antibiotics
–if can achieve drainage and remove source of infection then no need for antibiotics
What is Ludwig’s Angina?
Bilateral cellulitis of the sublingual and submandibular spaces
Infection above and below the mylohyoid line
What are the features of Ludwig’s Angina?
Intraorally
–raised tongue
–difficulty breathing
–difficulty swallowing
–drooling
Extraorally
–diffuse redness and swelling bilaterally in submandibular region
Systemic illness (SIRS- systemic inflammatory response syndrome)
–increased heart rate, increased respiratory rate, increased temperature, increased white cell count
What is used in monitoring SIRS?
NEWS- National Early Warning Score
How is level of consciousness measured in the NEWS monitoring?
AVPU
A= alert
V=responds to verbal commands
P= responds to pain
U= completely unresponsive
