College

CollegeofofMedicine
Medicineand
andHealth
HealthSciences
Sciences

Abscess and dental infections

NSABIMANA Usiel
Assistant Lecturer
School of Dentistry
 College of Medicine and Health Sciences

Introduction
• Dental infections or odontogenic infections
involving the teeth or associated tissues
• Are caused by anaerobic oral pathogens and
usually more than species
• These infections may from dental origins or
nonodontogenic sources
• Infections from dental origins comes from
progressions of dental caries or extensive
periodontal diseases
 College of Medicine and Health Sciences

Cont’
• Pathogens can also be introduced deeper into
the oral tissues by the trauma caused by
dental procedures
• Such as contamination of dental surgical sites
or during needle injections
• Some dental infections of the oral cavity are
secondary infections originated from
infections of skin, ears, tonsils or sinuses
 College of Medicine and Health Sciences

Cont’
• Treatment consists of removal of the sources
of infections ,systemic antibiotic and drainage
• These nonodontogenic infections must
diagnosed early
• Referral to the physician prevent further
spread and potential complications
 College of Medicine and Health Sciences

Types of dental infections

• Dental infections can result in various types of
lesions
• Depending on the location
• Thus type of tissues involved
• Dental infections can result in an
• Abscess, cellulitis or osteomyletitis in the head
and neck
 College of Medicine and Health Sciences

Dental abscess
• A dental abscess is a collection of pus in the
teeth or gums
• This happens when you have an infection in
your mouth.
College of Medicine and Health Sciences

Cont’
 College of Medicine and Health Sciences

Cont’
• An oral abscess occurs when there is localised
entrapment of pathogens from dental
infections in closed tissue space
• The abscess is filled with suppuration
• Periapical abscess formation can occur with
progressions of dental caries
• When pathogens invade the pulp and the
infections spread apically
 College of Medicine and Health Sciences

Cont’
• Pathogens can also became entrapped in deep
pockets in the cases of severe periodontal
diseases and causes periodontal abscess
• An erupting 3rd molar can cause a pericoronal
abscess (Pericoronitis)
• Abscess may not be detectable radio
graphically in the early stage
 College of Medicine and Health Sciences

cont
• In the later stages of infections, abscess may
lead to the formation of passageway (fistula)
in the skin, oral mucosa, or even in bone
 College of Medicine and Health Sciences

Types of dental abscess

College of Medicine and Health Sciences

Cont’
 College of Medicine and Health Sciences

Cont’
• The bacteria infects the pulp and then reaches
the bone that surrounds the tooth.
• This is where the periapical abscess forms.
College of Medicine and Health Sciences

Cont’
 College of Medicine and Health Sciences

Infectious Process
College of Medicine and Health Sciences

Cont’
College of Medicine and Health Sciences

Cont’
 College of Medicine and Health Sciences

Cellulitis
College of Medicine and Health Sciences

Cont’
 College of Medicine and Health Sciences

Ludwig's Angina
• Involvement submandibular spaces bilaterally
and submental space in midline
• Ludwig's Angina is a serious infection under
your tongue.
• Rapid spread to lateral pharyngeal /
retropharyngeal space
• Rapidly obstruct upper airway
College of Medicine and Health Sciences

Cont’
 College of Medicine and Health Sciences

Complications
• Airway compromise

• Spread into the lateral pharyngeal space and

beyond
 College of Medicine and Health Sciences

Causes
• The route of infection in most cases is from
infected lower molars or from pericoronitis,
• which is an infection of the gums surrounding
the partially erupted lower (usually third)
molars.
• Although the widespread involvement seen in
Ludwig's usually develops in
immunocompromised
 College of Medicine and Health Sciences

Cont’
• persons, it can also develop in otherwise
healthy individuals.
• Thus, it is very important to obtain dental
consultation for lower-third molars at the first
sign of any pain, bleeding from the gums,
sensitivity to heat/cold or
• swelling at the angle of the jaw.