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DEOH102 > Odontogenic spread > Flashcards

Odontogenic spread Flashcards

1
Q

Name the 4 ways tooth infection can spread

A

Direct -thru tissue
Direct thru fascial spaces
indirect by blood
Indirect by lymphatics

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2
Q

Name the primary fascial spaces for mandibular teeth infection spread and which teeth go there

A

Skin (all )
Vestibular space (all )
Buccal(premolar and molar)
Sublingual (Premolars) +Molars
Submental (incisors)
Submandibular (molars)

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3
Q

Name where the mandibular primary space infections can spread

A
  1. Buccal-<–>Canine space –>Cavernous sinus(brain)
  2. Sublingual <–>Submental.<–> Submandibular–> Lateral pharyngeal –>retropharyngeal –> mediastinum
  3. Sublingual –>Pterygomandibular–> Lateral pharyngeal–>retropharyngeal–>,mediastinum

Ie common pathways
Lateral pharyngeal->retropharyngeal _>mediastinum

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4
Q

Name 6 consequences of mandibular tooth infection
including 2 life threatening

A

Pulpitis
Dentoalveolar abscess
Fistula/Stoma formation
Cellulitis
Osteomyelitis
Ludwigs angina * life threatening
Mediastinitis *

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5
Q

Name the secondary facial spaces for mandibular teeth

A

Pterygomandibular space
Lateral pharyngeal space
retropharyngeal space

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6
Q

Where would a buccal space infection likely be arising from

A

Madbular premolar/molar infection

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7
Q

Name the primary fascial spaces of spread for maxillary teeth and which teeth

A

Skin
vestibular (ALL teeth )
Buccal (Pre molars/molars)
Canine (Canines and 1st premolars )
Palatal (All esp. lateral incisors/palatal roots molars)
Nasal ( anterior teeth)
Maxillary sinus (Molars /premolars )

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8
Q

Name consequences maxillary anterior teeth

A

Pulpitis
Dentoalveolar abscess
Stoma/fistula formation
Cellulitis
Cavernous sinus thrombosis

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9
Q

Name consequences maxillary posterior teeth

A

Pulpitis
Dentoalveolar abscess
Stoma./fistula formation
Cellulitis
Cavernous sinus thrombosis
Maxillary sinusitis
Mediastinitis

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10
Q

Name the communication spaces for the primary fascial spaces to spread ( which ones to where )

A

1.Buccal space<–>Canine –>cavernous sinus

2.Buccal –>Pterygomandibular space –>Lateral pharyngeal space –>Retropharyngeal–>mediastinum

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11
Q

Name 4 factors aggravate odontogenic infection

A

Chemotherapy
Immunodefificent (HIV)
Obesity
Long term diabetes

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12
Q

What are 3 aetiology of odontogenic infection

A
  1. Dental biofilms-eg progressive caries
  2. Erupting teeth eg pericoronitis
  3. Dental surgery - contaminate the dental site /needle tract infection
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13
Q

Name 3 lesions seen with odontogenic infection

A

Abscess
Cellulitis
Osteomyelitis

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14
Q

What is a abscess

A

Well circumscribed collection of trapped pathogens surrounded in pus
Fluctuant and if chronic can lead to a fistula being formed between it and skin ( chronically draining ) - follows path of least resistance to exit on skin or a mucous membrane

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15
Q

How to treat an abscess

A

Remove cause ie extraction
Antibiotics ( not normally work as centre abscess avascular )
Drainage
Moist warm compress/mouth rinses

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16
Q

Name 4 types dental abscess

A

Periapical
Periodontal
Gingival
Pericoronitis ( in emerging teeth )

17
Q

NAme 5 factors affecting dental spread

A

Hosts defence ( eg immunocompromised etc)
Virulence microorganism
Bone thickness
Root apex proximity
Muscle attachments

18
Q

If a tooth infection is to direct spread thru tissues ,name the primary ,secondary and tertiary sites

A

primary: plural chamber/ periodontal structures

secondary: alveolar bone

Tertiary: soft tissues

19
Q

How does maxillary sinusitis arise from teeth and why is it dangerous

A

Maxillary back teeth roots close to maxillary sinus wall–>infection travels thru floor sinus ( or a infected tooth fragment displayed thru the floor in extraction ) then infection travels thru sinus to other sinus to brain !! MUST treat proper;y

20
Q

What is the most common odontogenic infection

A

Vestibular abscess

21
Q

Name 2 complications of blood spread of pathogens

A

Bacteraemia ( bacteria into blood)
Infected thrombus

22
Q

Name the pathway of maxillary tooth infection in blood

A

Maxillary teeth –> superior alveolar vein
–>pterygoid venous plexus –>maxillary vein (joined by superficial temporal vein) –>retromandibular Vein –> internal/external jugular veins __> brachiocephalic –>superior vena cava __> heart

( RISK infection entering heart eg high risk patients with prosthetic valves etc MUST be pre-treated with antibiotics so the bacteraemia not occur )

As no valves on head veins also risk of back flow up into brain if increased pressure and infection into brain

23
Q

Name the pathway of blood spread from mandibular teeth

A

Mandibular teeth –> inferior alveolar vein
–>pterygoid venous plexus –>maxillary vein (joined by superficial temporal vein) –>retromandibular Vein –> internal/external jugular veins __> brachiocephalic –>superior vena cava –> heart

24
Q

what’s risk of bacteraemia from tooth infection

A

( RISK infection entering heart eg high risk patients with prosthetic valves etc MUST be pre-treated with antibiotics so the bacteraemia not occur )

As no valves on head veins also risk of back flow up into brain if increased pressure and infection into brain

25
Q

what’s a cavernous sinus thrombosis and how does it occur from dental infection

A

Thrombus in cavernous sinus ( in sphenoid bone)

Dental infection- thrombus forms and bit breaks off ( embolus ) and as no valves in head veins can enter up into brain

Communicates with pterygoid plexus /superior ophthalmic artery - et spread from all maxillary teeth/mandibular posterior teeth /upper lip/non dental danger triangle face /infratemporal space

26
Q

Signs of cavernous sinus thrombosis

A

Fever ,drowsy, headache ,eyelid swelling /diplopia /visual loss
Emergency - causes death

27
Q

What is Ludwigs angina

A

Life threatening infection- fast progressive cellulitis involving BILATERAL submental/sublingual and submandibular spaces - from any mandibular tooth or tongue piercing etc
Swelling lifts tongue - blocks airway
Spreads rapidly to parapharyngeal and retropharyngeal areas - larynx oedema and complete airway obstruction –> death

28
Q

Signs Ludwigs angina

A

Tongue elevated off floor mouth
High fevers
Swelling ++
Unable talk, swallow, breath properly

29
Q

5 important steps to prevent dental infection spread

A

Provide regular quality dentistry
-1. ID potential infection sources /treat early
2. Id at risk patients —good histories to identify at risk patient and pre treat if required
3. Medical review if concerns
4. Strict hygiene control measures - sterile gloves/environment /equiptment
-antiseptic pre rinses
- no Local thru infected tissue
5.ANtibiotics if required

DEOH102 (27 decks)

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