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Management of Odontogenic Infections: 6 Effective Treatments

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Dr. Andreas

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Q.F. Nayibe Cubillos Morales

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Medically Reviewed by

Dr. Gustavo Assatourians D.D.S

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More than 50 billion bacteria inhabit the mouth, with the most common being streptococci, staphylococci, gram-positive, and gram-negative bacilli. These bacteria coexist in a balance formed by themselves and the properties of saliva. Odontogenic infections occur when this balance is disrupted, and bacteria invade the teeth, gums, and other areas of the mouth, causing damage, thus learning management of odontogenic infections is important.

 

What are the Stages of an Odontogenic Infection? 

Odontogenic infections are divided into at least 2 stages; in the initial stages, the infection only affects the gums, with symptoms including pain, swelling, redness in the affected area, the appearance of abscesses in the gum (pus accumulation), bad breath, fever, swollen lymph nodes, among others.

If left untreated, these infections can cause complex health problems such as tooth loss or even spread to other parts of the body, triggering more serious infectious processes and compromising the patient’s life.

In more advanced stages of an odontogenic infection, facial cellulitis may appear. This occurs when the bacteria causing the infection in the mouth migrate to the subcutaneous tissue and fill it with pus, causing widespread and intense pain.

odontogenic infections

Other symptoms of advanced odontogenic infections include:

 General discomfort, fatigue, ear pain, headache, dizziness, and confusion

 Fever, sweating, chills, skin redness, or rashes

 Severe gum swelling, pain, and bleeding

 Diarrhea, vomiting, and abdominal pain

 Increased heart and respiratory rate

 Dehydration

Intense facial swelling, difficulty opening the mouth, swallowing, and breathing properly.

 

When to Seek Professional Help?

It is important to seek specialized attention as soon as possible if you suspect that you may have an odontogenic infection. Depending on the signs and symptoms presented, the recommendation is to visit a dentist, a doctor, or an emergency service.

When to Visit the Dentist?

At the first sign of pain, a visit to the dentist should be scheduled to evaluate if there is an infection present and to control it in time.

When to Visit the Doctor or Attend the Emergency Service?

If you experience symptoms such as difficulty breathing or swallowing, or any of the aforementioned that indicate that the infection has spread deeper into the jaw, throat, or neck, or even to other areas of the body, you should seek medical attention or emergency care as soon as possible to receive immediate care.

 

Diagnosis of an Odontogenic Infection 

During routine check-ups, odontogenic infections can be detected. If the dentist suspects an infection, they can check the tooth and the area around it and give you tips for the management of odontogenic infections. In addition, your dentist is going to perform one or more of the following diagnostic tests:

 Taking a periapical radiograph: Allows observation of the progress of the infection and determines if it has spread to other areas of the body.

 Taking a computed tomography scan: When the infection has spread to other areas apart from the mouth, such as the neck.

 Conducting thermal vitality tests: Involves placing a cotton swab soaked in a cold liquid (-58 ºF) on the surface of the affected tooth. This test helps determine if the tooth’s nerve is alive or dead.

 Conducting percussion tests: Involves tapping the tooth lightly. In the case of an infection in the root, these teeth will be sensitive to touch or pressure.

management of odontogenic infections

 

What Treatments are Available for Odontogenic Infections?

To treat the symptoms of a dental infection, the dentist must eliminate the cause of the infection and one or more of the following treatment options may be required:

1. Root canal treatment or endodontics

The nerve of the tooth is removed and the space is filled with a special material to eliminate the infection, clean the canals, and seal the tooth so that bacteria cannot continue to affect it. Within a few weeks, the infection disappears, and the tooth can be preserved for many years, even for a lifetime, as the success rate of this treatment is high.

2. Apical surgery

When a root canal treatment is performed, but the tooth still has an abscess, apical surgery is the best option. During this procedure, the root of the tooth is uncovered and part of it is cut, while the abscess is surgically removed. Then, the root is sealed, and follow-up appointments are scheduled at least every 3 months.

3. Abscess drainage

A small cut or puncture must be made in the abscess to drain the pus. In some cases, an elastic band is placed to keep the perforation open and continue draining. This treatment can relieve the discomfort of the abscess, but it does not eliminate the infection.

4. Tooth extraction

Sometimes, it is not possible to save the tooth, and it must be extracted. After the tooth extraction, the infected area must be cleaned thoroughly.

5. Prescription of medications

The use of antibiotics can help manage infections and prevent them from worsening and spreading throughout the body. The prescribed medication will depend on the type of bacteria that caused the infection. Some antibiotic options include:

 Penicillins

 Cephalosporins

 Metronidazole

 Clindamycin

 Quinolones

 Macrolides

Remember that the use of medication should only be under the prescription of a healthcare professional, as they can pose serious problems if used freely and without control.

6. Hospitalization

In cases of very severe infections that have caused sepsis, intrahospital management with intravenous antibiotics that can combat the infection is ideal, followed by surgical abscess drainage.

odontogenic infections prevention

 

Home Remedies

There are several recommendations you can follow at home to help alleviate some of the pain and swelling caused by an odontogenic infection:

 Rinse your mouth with saltwater

 Rinse your mouth with baking soda

 Apply clove oil

 Apply peppermint tea bags

 Apply oregano oil

 Apply cold water compresses

 Rinse your mouth with hydrogen peroxide

Remember that these remedies do not solve the problem, they provide temporary relief; it is advisable to consult a dentist to treat the infection safely and effectively.

 

Prevention and Management of Odontogenic Infections

How to avoid a dental infection?

 Maintain proper oral hygiene, use toothpaste with fluoride, brush and floss your teeth at least twice a day.

 Use an antiseptic or fluoride mouthwash.

 Change your toothbrush every 2 to 3 months, or when it looks or feels worn.

 Maintain a balanced diet with plenty of fruits and vegetables, and reduce sugar consumption.

 Avoid habits such as smoking or drinking alcohol.

 Schedule regular visits to the dentist, at least twice a year for professional check-ups and cleanings.

Acquiring these good habits can help maintain oral health, and if there is an infectious process, detect it in time to give treatment before it is too late.

If you want more information about odontogenic infections, what they are, what causes them, the symptoms, and possible complications, you can visit an article on our website that explains it in-depth.

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References

1. Abscessed Tooth: Tooth Infection Symptoms & Treatment. (s. f.). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/10943-abscessed-tooth

2. Ahmadi, H., Ebrahimi, A., & Ahmadi, F. (2021). Antibiotic Therapy in Dentistry. International Journal of Dentistry, 2021, 1-10. https://doi.org/10.1155/2021/6667624

3. Assatourians, G. (December 9, 2022). 13 Main Signs Of Tooth Infection Spreading To The Body. Channel Islands Family Dental Office. https://cidentist.com/tooth-infection-spreading-to-the-body/

4. Jay, K. (August 12, 2022). 10 Home Remedies for a Tooth Abscess. Healthline. https://www.healthline.com/health/home-remedies-for-abscess-tooth

5. Jevon, P., Abdelrahman, A., & Pigadas, N. (2020). Management of odontogenic infections and sepsis: an update. British Dental Journal, 229(6), 363-370. https://doi.org/10.1038/s41415-020-2114-5

6. Tooth abscess – Diagnosis and treatment. Mayo Clinic. (June 29, 2022). https://www.mayoclinic.org/diseases-conditions/tooth-abscess/diagnosis-treatment/drc-20350907

7. Von Arx, T. (2011). Apical surgery: A review of current techniques and outcome. The Saudi Dental Journal, 23(1), 9-15. https://doi.org/10.1016/j.sdentj.2010.10.004

8. Duran, R. (Reviewed November 13, 2021). What Is an Abscessed Tooth? WebMD. https://www.webmd.com/oral-health/guide/abscessed-tooth

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