orofacial bacterial infections

Question 1

dentoalveolar abscess

Answer 1

pus in structures surrounding teeth

Question 2

periapical abscess

Answer 2

• originates in pulp
• secondary to caries and pulpitis
• bacterial invasion of alveolar bone
• most common in children

Question 3

periodontal abscess

Answer 3

• PDL and alveolar bone

- most common in adults

Question 4

reversible pulpitis

Answer 4

• mild
• caused by caries encroaching on pulp
• pain with hot/cold
• tx: resto

Question 5

irreversible pulpitis

Answer 5

• if not treated
• severe
• pain is spontaneous, persistent, and poorly localized
• tx: root canal or ext

Question 6

what can happen if the cellulitis is associated with upper teeth

Answer 6

risk of cavernous sinus thrombosis

Question 7

periodontitis related abscess originates from

Answer 7

biofilm in PD pocket

Question 8

non periodontitis related abscess

Answer 8

from another local source

• tooth is alive (vital pulp)
• physical blockage of PD pocket

Question 9

what causes PD abscesses

Answer 9

gram NEG ANAEROBIC rods bacteria

Question 10

if inflammed pulp is not treated, it leads to

Answer 10

necrosis => apical periodontitis

Question 11

apical periodontitis

Answer 11

-pain is severe, spontaneous, persistent, and LOCALIZED to affected tooth

Question 12

dry socket

Answer 12

alveolar osteitis

-anaerobic bacteria (halitosis) cause fibrinolysis

Question 13

peri-implantitis

Answer 13

• periodontitis around implant
• causes bone loss
• plaque induced
• AA, p gingivalis, p intermedia, f nucleatum

Question 14

osteomyelitis of the jaws

Answer 14

• polymicrobial
• alpha hemolytic strep
• anaerobic (peptostrep, fusobacterium, prevotella)

Question 15

OM of the jaws following trauma

Answer 15

• staph epidermidis

- difficult to treat (treatment is prolonged)

Question 16

deep fascial space infections usually arise from which teeth

Answer 16

lower 2nd and 3rd molars

Question 17

deep fascial space infections - bacteria

Answer 17

normal oral flora

-anaerobic can be present

Question 18

tx for deep fascial space infections

Answer 18

penicillin

-add clindamycin if anaerobic too

Question 19

cavernous sinus thrombosis mechanism

Answer 19

1. bacteria and clot travel towards the back from upper lip and face via ANTERIOR FACIAL VEIN
2. or.. infection spreads from PTERYGOID SPACE VIA PTERYGOID PLEXUS OF VEINS

Question 20

symptoms of cav sinus thromb

Answer 20

• eyelids swell
• eyeball protrusion
• dilated facial v
• restricted eyeball
• bleeding from retina

Question 21

ludwig’s angina

Answer 21

• swelling of head and neck
• dentoalveolar infection *usually dental source of infection *usually 2nd and 3rd mand molars
• difficult breathing
• bilateral
• submand and subling involved
• begins in floor of mouth

Question 22

non odontogenic bacterial infections of the oral cavity

Answer 22

• pericoronitis
• bacterial sialadenitis
• angular cheilitis
• ulcerative mucositis
• noma

Question 23

ulcerative mucositis

Answer 23

• chemtotherapy associated

- bacteria and yeast

Question 24

noma

Answer 24

• polymicrobial

- opportunistic in immunocompromised

Question 25

pericoronitis

Answer 25

- food trapped behind 3rd molars | - strict anaerobic bacteria: p intermedia, anaerobic strep, fusobacteria, AA, tannerella forsythia

Question 26

what can happen if drainage is interrupted in periocoronitis

Answer 26

infection spreads along fascial planes and go into soft tissue and bone

Question 27

bacterial sialadenitis

Answer 27

- infection of salivary glands - S aureus - parotid: xerostomia - submand: salivary stone blocks duct

Question 28

angular cheilitis

Answer 28

- infection at corners of mouth/lips - s aureus and candida (bacteria + yeast) - use TOPICAL ANTIMICROBIALS

Question 29

acute necrotizing ulcerative gingivitis

Answer 29

- painful infection of gums - trench mouth - immunosuppression - anaerobic bacteria (fusobacteria and spirochetes)

Question 30

actinomyces species

Answer 30

- cause actinomycosis | - filamentous, gram +, avirulent, OPPORTUNISTIC, can cross tissue planes!

Question 31

cervicofacial actinomycosis

Answer 31

- actinomyces species (A israelii) - rock-hard induration - drain spontaneously through the skin