Podcast 844: Dental Infections

Contributor: Meghan Hurley, MD

Educational Pearls:

Educational Pearls:

• Dental infections can be categorized into two main groups
• Infections of the gums
• Pericoronitis
• Tooth eruption leading to inflammation/irritation
• Can progress to an infection
• Requires pain control, no antibiotics
• Gingivitis
• Inflammation of the gums
• Can lead to an infection requiring antibiotics
• Abscess (gums)
• If an infection develops in the gums it can progress to an abscess
• May require drainage
• Acute necrotizing ulcerative gingivitis (ANUG) aka Trench Mouth
• Filmy, grayish discoloration of the gums with "punched out" lesions
• Extremely painful
• Can cause teeth to loosen and fall out
• Treat with IV antibiotics + admission
• Infections of the teeth
• Dental caries
• Causes sensitivity tooth enamel is worn through
• Can lead to infection
• Periapical abscess
• Abscess that extends through the root of the tooth
• Can develop up elsewhere in tooth/gums/mouth
• Causes tooth sensitivity when tapped
• Ludwig angina
• Infection of the soft tissue under the tongue
• Can compromise airway as it expands
• Treat with extensive antibiotics and debridement

• Antibiotic stewardship
• Commonly used antibiotics for dental infections
• Clindamycin
• Augmentin
• Amoxicillin
• Chlorhexidine (Peridex)
• Antiseptic and disinfectant that is helpful for gingival irritation

References

Bridwell R, Gottlieb M, Koyfman A, Long B. Diagnosis and management of Ludwig's angina: An evidence-based review. Am J Emerg Med. Mar 2021;41:1-5. doi:10.1016/j.ajem.2020.12.030

Dufty J, Gkranias N, Donos N. Necrotising Ulcerative Gingivitis: A Literature Review. Oral Health Prev Dent. 2017;15(4):321-327. doi:10.3290/j.ohpd.a38766

Herrera D, Roldán S, Sanz M. The periodontal abscess: a review. J Clin Periodontol. Jun 2000;27(6):377-86. doi:10.1034/j.1600-051x.2000.027006377.x

Kumar S. Evidence-Based Update on Diagnosis and Management of Gingivitis and Periodontitis. Dent Clin North Am. Jan 2019;63(1):69-81. doi:10.1016/j.cden.2018.08.005

Kwon G, Serra M. Pericoronitis. StatPearls. StatPearls Publishing

Copyright © 2022, StatPearls Publishing LLC.; 2022.

Summarized by Mark O'Brien, MS4 | Edited by John Spartz, MD, & Erik Verzemnieks, MD

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