WHAT ARE ODONTOGENIC INFECTIONS?

Odontogenic infections are infections that originate from your tooth or the tooth supporting tissues. It can be painful, uncomfortable and disturb your daily activities.  Odontogenic infections can be a life threatening situation when they spread into the deep fascia of the head and neck.

Dental caries  

Demineralization of your tooth structure is the most common cause of odontogenic infection. 

Other causes of odontogenic infection include: pulpitis, peripapical and periodontal infections, periconitis , peri implantitis, infections from the maxillary and mandibular jaw and etc.

WHAT ARE THE SYMPTOMS IF MY CHILD IS HAVING AN ODONTOGENIC INFECTION?

If your child is having an acute odontogenic infection, (cellulitis)

-          He might feel sick or upset.

-          His body temperature will be raised.

-          Your child might be having a red and swollen face.

-        Unable  to eat well.

 

It can be asymptomatic if your child is having a chronic odontogenic infection. (abscess)

Associated symptoms are:

-          His tooth might be mobile and discolored.

-          He might have bad breath/halitosis

-          A sinus opening may be present

MANAGEMENT OF ODONTOGENIC INFECTION

• Determine the severity of infection
• Monitor vital signs (body temperature, pulse rate,breathing rate, blood pressure, etc)
• Identify and remove the source of infection

Your dental practitioner may need to perform an extraction or a root canal treatment on that particular tooth.  Extraction of the particular tooth will bring resolution of infection.

• Local drainage and debridement. The purpose of performing drainage is to remove microorganisms and to decompress the space.
• Provide supportive care (patient should get adequate nutrition, fluid and rest)

WILL MY CHILD BE ADMITTED TO HOSPITAL?

Hospital admission may be required when there is presence of severe infection.

Associated symptoms are:

-          your child is present with a high fever

-          His /her floor of the mouth appears raised and swollen

-          He/she is having difficulty in eating or drinking.

Antibiotics are usually prescribed and they are effective to reduce the spreading of infection before the definitive treatment.  The most common drug prescribed for children with odontogenic infection is amoxicillin.

WHAT ARE THE COMPLICATIONS OF ODONTOGENIC INFECTION?

1)      CAVERNOUS SINUS THROMBOSIS

Spreading of maxillary infections can cause carvenous sinus thrombosis. It is a very life threatening situation  whereby blood blot is formed in the cavernous sinus. (Cavernous sinus is a small cavity at the base of brain that contains arteries, veins, and nerves)

Clinical features of patients with cavernous sinus thrombosis:

-          Bulging eyeballs

-          Drooping eyelids

-          Headache,

-          Unable to see clearly or total loss of vision

 

2)      Ludwig Angina

 

Spreading of mandibular infections can compromise the airway and cause Ludwig angina. Ludwig angina is also a life threatening severe infection of the neck and floor of mouth. The route of infection is usually from the lower molars.

It is  normally diagnosed when there is presence of huge swelling in the floor of mouth (accompanied with symptoms of odontogenic infections) and the tongue is pushed upwards and backwards.

 

Both conditions mentioned above are life threatening and require immediate hospitalization. Treatment usually involves antibiotic medications, surgical incision and drainage. It is also important to make sure the patient has adequate fluid, nutrition and rest.