MICROBIOLOGY OF ODONTOGENIC INFECTIONS
NATURAL HISTORY OF PROGRESSION OF
PRINCIPLES ‘OF THERAPY OF ODONTOGENIC INFECTIONS
Principle I: Determine Severity of Infection
Physical EXamination .
Principle II: Evaluate State of Patient’s Host Defense
Mechanisms ‘ .
Medical Conditions that Compromise Host
Prindple III: Determine Whether Patient Should Be
Treated by General Dentist or Specialist
Principle IV: Treat Infection Surgically
Principle V: Support Patient Medically
Principle VI: Choose and Prescribe Appropriate
Determine Need for Antibiotic Administration
Use Empiric Therapy Routinely
Use Narrowest-Spectrum Antibiotic
Use Antibiotic with Lowest Incidence of Toxicity
and Side Effects .
Use Bactericidal Antibiotic, if Possible
Be Aware of the Cost of Antibiotics
Principle VII: Administer Antibiotic Properly
Prlnclple VIII: Evaluate Patient Frequently
PRINCIPLES OF PREVENTION OF INFECTION
PRINCIPLES OF PROPHYLAXIS OF WOUND INFECTION
Principle I: Procedure Should Have Significant Risk of
Prlnciplell: Choose Correct Antibiotic
Principle III: Antibiotic Plasma Level Must Be High
Principle IV: TIme Antibiotic Administration Correctly
Principle V: Use Shortest Antibiotic Exposure that Is
PRINCIPLES OF PROPHYLAXIS AGAINST METASTATIC
Prophylaxis Against Infectious Endocarditis
Prophylaxis in Other Cardiovascular Cases
Prophylaxis Against Total Joint Replacement Infection
One of the most difficult problems to manage in dentistry is an odontogenic infection. These . infections may range from low-grade, welllocalized
infections that require only minimal treatment to severe, life-threatening fascial space infections. Although the overwhelming majority of odontogenic infections are easily managed by minor surgieal proceprocedures and supportive medical therapy that includes
antibiotic administration, the practitioner must c~nstantly bear in mind that these infections occasionally become severe in a very short time. .
This chapter. is divided into several sections. The first section discusses the typical microbiology involved in odontogenic infections. Appropriate therapy of odont gernc infections depends on a clear understanding of the
causative bacteria. The second section discusses the natural history of odontogenic infections. -When infections occur, they may erode through bone and into the overlying soft tissue. Knowledge of the usual pathway of infection from the teeth and surrounding tissues through the bone and into the overlying soft tissue planes is essential when planning appropriate therapy The third section ‘of this chapter deals with the principles of.management of odontogenic infections. A series of principles are discussed, with consideration of the microbiology and typical pathway
of infection. The chapter concludes with a section on prophylaxis against infection. The prophylaxis of wound infection and of metastatic infection is discussed.