Acute dental infection usually occurs when bacteria invade the dental pulp (nerve), but it also spreads to the tissues surrounding the tooth. According to important recent studies, the radiological signs of dental infection with involvement of the bone support are extremely common, affecting 0.5-13.9% (average 5.4%) of all teeth.
In addition to localized disease, dental infections can spread to the region, but it can also spread through the bloodstream, leading to the spread of serious infections, especially in medically compromised patients (those with a serious underlying disease or even with immune deficiency).
Can Bad Teeth Cause Swollen Lymph Nodes?
A bad tooth could originate a serious infection that is able to produce swollen lymph nodes. Most dental abscesses are secondary to tooth decay and therefore, can be avoided if basic oral health recommendations are followed. These include a proper oral hygiene with toothpaste that contains fluoride and reduces the intake of sugary foods.
What Are The Warning Symptoms Of The Spread Of Dental Infection?
Although by definition localized dental infection is limited to the mouth, it can spread to other areas of the maxillofacial region and beyond, through tissue planes and the bloodstream. Maxillofacial cellulitis or the spread of odontogenic infection can be fatal. The spread of an odontogenic infection presents with more or less facial swelling, trismus, and pain. The characteristics of localized dental infection may also be present.
Alarm signs suggestive of diffuse dental infection:
- Tachycardia (abnormally rapid heart rate) or tachypnea (abnormally rapid breathing).
- Trismus; it can be relative due to pain, or absolute due to a collection within the muscle. Muscle spasms appear when there is a compromise of the space.
- Enlargement of the tongue and floor of the mouth, drooling.
- Periorbital cellulitis.
- Difficulty speaking, swallowing and breathing.
- Lymphadenopathy (swollen lymph nodes).
Patients with severe signs and symptoms should be reviewed without delay by an oral and maxillofacial surgeon in a hospital. The path of propagation of a dental abscess is determined by the relation of the apex of the root with the insertion of the relevant muscle and the facial planes and may include several anatomical spaces, the neck, the periorbital area, the cavernous sinus or the mediastinum.
The basis of treatment is the prompt administration of intravenous antibiotics such as benzylpenicillin and metronidazole, along with appropriate surgical drainage. Serious trismus and compromise of the airway require a specialized anesthetic review and often also support for its management.
What Is The Dental Infection?
The tooth is composed of a visible crown composed of dentin and enamel and a root, composed of dentine. Its interior is a soft fibrous tissue called dental pulp. Acute dental abscesses occur as a result of a bacterial invasion of the pulp space. Likewise, the condition is precipitated by advanced caries, a failed root canal treatment, an advanced chronic infection of the tooth support structures (periodontitis) or trauma.
The infection may be restricted to the space of the pulp or the periapical area of the affected tooth or may extend to the surrounding dentoalveolar bone, as well as to the soft tissues, causing cellulitis, with the potential to compromise the airway. Dental abscesses can also occur in teeth that have partially erupted (pericoronitis). This most commonly affects third molars, also known as wisdom teeth.
What Is The Cause?
Bacteria commonly isolated in dental infections comprise a mixture of oral streptococci, in particular, the group Streptococcus anginosus (commonly referred to as streptococci of the group “milleri”) and strict anaerobes, such as anaerobic streptococci, and the species of Prevotella and Fusobacterium. In general, these strains are usually sensitive to commonly used antibiotics (amoxicillin or erythromycin). They are rarely used in combination with metronidazole unless there is a strong suspicion of infection by Prevotella lactamase β positive species.
Signs and symptoms of localized dental infection:
- Pain in the mouth and jaw.
- Inflammation inside the mouth.
- Mobile tooth.
- Sensitivity to biting or hitting the affected tooth.
- Pain on the palpation of the gum surrounding the affected tooth.
- Spontaneous drainage of pus.
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