Spread Of Infection Flashcards
Where can infection of upper tooth spread
buccal space
Can also spread palatally but looking for area of least resistance
If goes below insertion of buccinator - can drain into mouth
Can spread upwards to maxillary sinus too
Where can infection in lower tooth spread
Lingually - mylohyoid muscle
If above mylohyoid - sublingual abscess
If below - submandibular abscess
Can also go buccally
Where can infection spread posteriorly
(Secondary fascile spaces)
- pterygomandibular space
-masseteric - trismus - superficial/deep temporal/ infratemporal
-lat pharyngeal space
-Retro pharyngeal space
-Pre vertebral space
Compromised airway/hoarsness
What is fascile spaces
Potential spaces for infection
Where would a canine infection likely present
Infraorbital space
What is ludwigs angina
Bilateral submandibular, sublingual and submental involvement cellulitis
high mortality
Who to give AB to for spread of infection
- unable to drain
-systemically unwell
-severely medically compromised
-can’t access dental care
What AB given for odontogenic infection
Pen V
Amoxicillin
Clindamycin
Metranidazole
Red flag symptoms of spreading infection
Difficulty breathing or swallowing
Eye closure due to swelling
Drooling from mouth
Elevated tongue
Hoarseness of voice
Examination for spreading infection
ABC approach
Red flags
- Pyrexia
-hypotension
-tachycardia
-tachyponea
Intra oral red flag signs for spreading infection
- trismus
-raised FOM
-deviation of uvula
-lymphdaenopathy
-periorbital cellulitis
What is sepsis
Life threatening organ dysfunction caused by dysregulated host response to infection
SIRS (systemic inflammatory response syndrome)
Sirs criteria
Temp >38.3 or <36
Tachycardia > 90bpm
Tachyponea >20 breaths/minute
WBC <4000 OR >120000 cells/mm
How to drain (extra and intra orally)
Extra - incise skin
Intra oral - extirpate pulp, remove tooth , incise skin
What can happen if infection reaches retropharyngeal space or pre vertebral space
Can spread to base of skull or mediustinum
-cardiac tamponade
What can happen if infection spreads up to brain
Cavernous sinus thrombosis
Where does infection in lower anterior spread
Mental and submental
Where does infection in lower premolars and molars spread
- buccal space
- submasseteric space
- sublingual space
- submandibular space
- lateral pharyngeal space
Hilton technique
Instrument place into incision then open , stretch tissue to allow pus to come out
Can place drain in for few days
How does ludwigs angina present
- raised tongue
- difficulty breathing
- difficulty swallowing
- drooling
-systemically unwell
-bilaterally swelling and diffuse redness in submandibular region
