Odontogenic Infections

Question 1

What is the most common cause of pulpal inflammation and necrosis?

Answer 1

Bacterial infection

Question 2

How does bacteria get to the pulp?

Answer 2

Caries or direct access from fracture

Question 3

T/F: A non-vital tooth is more susceptible to subsequent infection.

Answer 3

True

Question 4

What bacterial species are responsible for the foul odor of necrotic pulps?

Answer 4

Prevotella and porphyromonas

Question 5

What bacterial species have been associated with periapical abscesses?

Answer 5

Prevotella and porphyromonas

Question 6

T/F: Strep is the main cause of pulpal infections.

Answer 6

FALSE

Mixed bacterial infections

Question 7

Where in the pulp do proteolytic bacteria grow best?

Answer 7

Apically

Question 8

T/F: Pulpitis can be reversed if treated early.

Answer 8

True

Question 9

What are the early stage symptoms of pulpitis?

Answer 9

1. Lower pain threshold

2. Prolonged pain response to cold

Question 10

What happens once the pulp becomes necrotic?

Answer 10

No more blood supply so inflammatory response shifts to periapical tissues

Bacteria is still most numerous in the root canal

Question 11

T/F: Periapical lesions are often associated with severe pain.

Answer 11

False

Since pulp is necrotic often asymptomatic

Diagnosis via radiographs

Question 12

What is an acute dentoalveolar abscess?

Answer 12

Bacterial infection including pulp and apical bone

Very painful due to pus causing pressure on tissues

Question 13

T/F: Antibiotics are effective against infections in the pulp and apical periodontitis/abscesses.

Answer 13

FALSE

Question 14

How are persistent apical lesions treated?

Answer 14

Microsurgery or apicoectomy

Question 15

If tooth infections are left untreated, what type of infection can be caused in the surrounding facial tissues?

Answer 15

Cellulitis

Question 16

If tissue is undergoing cellulitis, what would be the clinical signs?

Answer 16

Swollen (edema), hard to palpation, and no pus

Question 17

T/F: Lower facial cellulitis is almost always dental.

Answer 17

True

Question 18

Cellulitis can progress to an _________.

Answer 18

Abscess

Question 19

T/F: Cellulitis and dental abscess is a polymicrobial disease.

Answer 19

True

Question 20

T/F: Anaerobes are more likely to cause cellulitis and dental abscess.

Answer 20

True

Question 21

T/F: Cellulitis can be managed with antibiotics.

Answer 21

True

Still want to remove source of infection

Question 22

What are the first choices of antibiotics for dental abscess and cellulitis?

Answer 22

Clindomycin and penicillin

Question 23

Alveolar osteitis is caused by ___________ formation on bone surface.

Answer 23

Biofilm

Question 24

T/F: Systemic antibiotics are effective against a dry socket.

Answer 24

False

Gentle debridement and medicated dressing

Question 25

T/F: Long term antibiotic treatment is used for osteomyelitis of the jaw.

Answer 25

TRUE

Question 26

How do you avoid MRONJ?

Answer 26

Avoid dental extractions in immunocompromised patients with history of bisphosphonate treatment