Often, after dental treatment, patients develop odontogenic infections. What it is? After unsuccessful treatment of caries, periodontitis or pulpitis, bacteria can enter other organs and cause an inflammatory process. This is also noted in advanced stages of dental diseases, if the patient does not consult a doctor and does not deal with treatment. Such pathologies are quite dangerous and in severe cases can cause blood poisoning - sepsis.
Classification
There are several types of bacterial diseases, the root cause of which is the ingress of microbes into the tooth cavity:
- The first group includes truly odontogenic infections. What it is? This type of pathology includes inflammation that develops directly in the tooth cavity. These include caries and pulpitis.
- The second group includes diseases that develop in nearby tissues: the oral cavity and periodontium. Such pathologies include gingivitis, stomatitis, periodontitis.
- The third group includes diseases of the throat and sinuses, as well as tissues of the neck, lymph nodes, brain and bones. The inflammatory process is formed in quite distant organs. In these cases, it is very difficult to determine the etiology of odontogenic infections. Bacterial pathways pass through the lymphatic and blood vessels. Together with the flow of blood or lymph, the infection enters other organs and causes inflammation.
Causes
In a diseased tooth, a primary odontogenic focus of infection is formed. Local inflammation occurs. This is the cause of diseases such as caries, pulpitis, periodontitis.
If the patient postpones a visit to the dentist, then the infection spreads to nearby tissues. Bacteria can also enter the distant organs through blood and lymph. The most common cause of chronic and acute odontogenic infections are advanced dental diseases.
Inflammation in various organs can develop with poor-quality dental treatment. An unsuccessful filling or removal of a diseased tooth can provoke an infectious process in other tissues. In this case, it is very difficult for doctors to determine the etiology of the disease. It is necessary to carefully study the patient's history in order to identify all transferred dental procedures.
Risk groups
Acute and chronic odontogenic infections most often develop in patients with reduced immunity. The following categories of patients are at risk:
- children;
- people over 60 years old;
- patients with malignant tumors (especially after chemotherapy);
- patients taking cytostatics and corticosteroids (these drugs reduce immunity);
- people with severe internal diseases (diabetes mellitus, liver, kidney and heart pathologies);
- patients with hepatitis and HIV infection.
All of the above groups of patients need to visit the dentist in a timely manner. Running dental diseases with reduced immunity is very dangerous.
Pathogens
Doctors often encounter high resistance to odontogenic pathogens. What it is? Over time, bacteria develop immunity to many types of antibiotics. This creates great difficulties in the treatment of such diseases. Therefore, it is very important to prescribe the most effective antibacterial drug. Usually, antibiotics are used in therapy that affect a wide range of bacteria.
Most often, the causative agents of pathologies of odontogenic origin are the following bacteria:
- streptococci;
- Staphylococcus aureus;
- pneumococci;
- fusobacteria;
- enterobacteria.
In addition, odontogenic inflammation can be caused by fungal microorganisms (actinomycetes) or protozoa. In this case, severe damage to the lymph nodes occurs.
Most often, the combined origin of odontogenic infections is noted. What it is? The inflammatory process can be caused not by one microorganism, but several at once. After all, as you know, a large number of bacteria live in the oral cavity. Most of them are conditionally pathogenic, they lead to inflammation only with a strong decrease in immunity.
Possible diseases
Odontogenic infections are usually caused by suppuration in the oral cavity. For example, if as a result of untreated caries a patient has a flux (suppuration of the periosteum), then this pathology very often leads to the appearance of secondary foci of inflammation. Patients may be diagnosed with the following diseases:
- phlegmon of the tissues of the face and neck;
- inflammation of the soft tissues of the bottom of the oral cavity (Ludwig's sore throat);
- meningoencephalitis;
- thrombophlebitis of the facial vessels;
- purulent inflammation of the lymph nodes;
- mediastinitis (inflammation of the mediastinum);
- bone osteomyelitis;
- sinusitis.
The most serious complication of dental infections is sepsis. In this disease, bacteria constantly circulate in the bloodstream, affecting various organs. Odontogenic sepsis often causes death.
Symptomatology
Symptoms of odontogenic infections can be varied. Clinical manifestations depend on the variety of pathology. However, we can distinguish common signs of such diseases:
- Fever. With severe purulent inflammation, the temperature can rise up to +40 degrees.
- General intoxication of the body. The patient's health is deteriorating sharply. chills, malaise, aching joints, headache.
- Pain syndrome. There is pain in the affected area, with the accumulation of pus, a sensation of pulsation appears.
- Edema. The affected area swells and turns red.
Signs of an inflammatory reaction in other organs are often accompanied by increased pain in the causative tooth. Redness and swelling of the gums surrounding the tooth tissue is noted.
If inflammation is localized in the throat or oral cavity, then the patient often swells the tongue and larynx. It becomes difficult for a person to speak and breathe. Such a clinical picture is observed, for example, with Ludwig's sore throat.
Diagnostics
As already mentioned, odontogenic diseases can be difficult to diagnose. Therefore, the doctor must pay attention to the condition of the patient’s teeth. You must also carefully study the patient’s medical record. This will help to determine whether the patient has had dental treatment in the recent past.
The patient is prescribed clinical studies of blood and urine. By analysis, you can determine the presence of inflammation. With infections of odontogenic origin in patients, the indicators of leukocytes and ESR increase.
In addition, ultrasound and MRI of the focus of inflammation are performed. These studies are especially useful in the diagnosis of inflammatory processes in the mediastinum. Such a pathology is almost imperceptible during external examination and palpation.
It is very important to conduct tests for bacteriological culture. In this case, it is important not only to identify the pathogen, but also to determine its sensitivity to antibacterial drugs. This will help you choose the most effective antibiotic.
Treatment
Treatment of odontogenic infections begins with the rehabilitation of the oral cavity. It is necessary to treat the primary focus of infection. The causative tooth is removed or filled.
Then carry out sanitation of secondary purulent cavities in other organs. Under anesthesia, an abscess or phlegmon is performed . Currently, such operations are done endoscopically under ultrasound guidance. After incision of the abscess, pus is removed, and the inflamed cavity is washed with aseptic solutions. If necessary, drainages are installed to remove exudate.
After surgery, they begin antibiotic therapy for odontogenic infections. Antibiotics are prescribed after obtaining the results of the study of the biomaterial for bacterial seeding.
- Amoxiclav.
- Ceftriaxone.
- Clarithromycin.
- Lincomycin.
- Ofloxacin.
- Norfloxacin.
These antibiotics can affect various types of microorganisms. If necessary, the treatment regimen includes antiprotozoal drugs: Trichopolum, Tinidazole, Co-trimaxazole. They are effective for inflammation caused by protozoa and fungi.
Prevention
How to prevent the development of odontogenic infections? It is necessary to timely carry out high-quality treatment of dental pathologies. Even with slight pain in the teeth, you should immediately consult a dentist. You also need to undergo preventive examinations of the oral cavity at least 1 time per year.
With a tendency to caries and pulpitis, you need to regularly clean your teeth from the remnants of food. The toothbrush should be replaced at least 1 time per month, otherwise bacteria may accumulate on it.
It is important to remember that sometimes even small caries can lead to such serious complications as blood poisoning and meningoencephalitis. After all, teeth are in close proximity to the brain.