Odontogenic infections are primarily consisting of dental caries and periodontal diseases. Periodontal diseases are mainly encompassing gingivitis (inflammation and infection of the gums) and periodontitis (inflammation and infection of the ligaments and bones that support the teeth). These conditions mainly cause pain and discomfort but they can simply extend beyond the oral cavity and cause adjacent or distant complications and in severe cases, can even lead to death.
Dental caries are globally prevalent. Caries can occur at any surface of the tooth. The earliest findings are the presence of pits and fissure on the affected surface. Demineralization continues gradually and leads to the collapse of the enamel. If the pulp is also involved pain is experienced. Pulp can become infectious and abscesses could be formed. It will ultimately lead to ischemia and necrosis of the pulp. If the process continues, other teeth become involved and pus replaces bone and tissue. The important annoying symptoms is pain which becomes severe as the disease progresses.
The most common periodontal disease in childhood is gingivitis which peaks in adolescence. It causes swelling, discoloration of gingiva to bluish purple and has a tendency to bleed on eating or brushing. No pain is usually experience but a bad breath might be noticed.
A specific form of gingivitis is known as acute necrotizing ulcerative gingivitis, also known as Vincent's angina or trench mouth. It is rarely seen today thanks to the introduction of antibiotics into the practice of medicine and dentistry. These patients develop sudden pain in the gingiva and the eroded tissue appears to be covered by grayish membrane. It can also be accompanied by halitosis, altered taste sensation, fever and enlarged lymph nodes in the neck.
Periodontitis is characterized by gingival inflammation and loss of supportive tissue. The destructive process is slow and is mainly a result of years of dental neglect and chronic gingivitis. At times, pus is present in the periodontal pockets. A periodontal abscess can develop in a focal or diffuse pattern. Gingiva becomes very sensitive to touch and abscesses communicate with periodontal pockets.
Localized infection caused by entrapped food particles or microorganisms under the gums is called pericoronitis. This is the condition that involves the wisdom teeth in adolescents and adults. It can cause pain, discomfort and facial swelling.
These conditions could be seen with each other and, in fact, poor dental hygiene is the number one contributor to all of these conditions. These conditions have local signs and symptoms but if given enough time, can contribute to systemic involvement. A majority of dental procedures are carried out in these conditions and it is not uncommon to see some complications before, during or after the dental procedure.
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