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Maxillofacial and Dental Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
A periodontal abscess follows periodontitis from poor dental hygiene particularly in smokers and diabetics. Halitosis, increasing pain and swelling occur. There may be systemic malaise and fever, with a risk of spread to deeper fascial spaces.
Bacterial Infections of the Oral Cavity
Published in K. Balamurugan, U. Prithika, Pocket Guide to Bacterial Infections, 2019
P. S. Manoharan, Praveen Rajesh
Bone-loss patterns commonly observed are craters, both horizontal and vertical in nature. Bone sounding with deep probing can be done to perceive the configuration of the defect. Confirmation is done with radiographs. Treatment varies depending on the type of bone defect. Periodontal inflammation can progress to destruction of periodontal cells and accumulation of inflammatory exudate. Periodontal abscess can result in the destruction of the apical area of the tooth or the lateral surface of the tooth. Clear diagnosis can be made if the abscess is in the lateral surface of the tooth and is sensitive to lateral percussion with handle of a mouth mirror.
The Crucial Role of Craniofacial Growth on Airway, Sleep, and the Temporomandibular Joint
Published in Aruna Bakhru, Nutrition and Integrative Medicine, 2018
Periodontitis is generally not a chronically painful disorder. Typically, patients may notice gingival sensitivity and tenderness, or gingival enlargement caused by inflammation and bleeding with brushing or probing examination. There is loss of gingival attachment around the necks of and soft tissue pocketing around the roots of the tooth with loss of bone support, which may result in tooth sensitivity, tenderness, and mobility. Pain secondary to periodontal disease is typically dull, generalized to a larger area, and more constant. In the presence of an acute infection in the periodontal tissues, tenderness to the touch, erythema, and bleeding may be evident. An acute periodontal abscess may cause swelling and purulence. When inflammation or infection occurs in the soft tissue or bone around an erupting or partially erupted tooth (particularly third molars), similar signs and symptoms may be seen with pain as a primary complaint.
The pharmacological management of dental pain
Published in Expert Opinion on Pharmacotherapy, 2020
Joseph V. Pergolizzi, Peter Magnusson, Jo Ann LeQuang, Christopher Gharibo, Giustino Varrassi
A periapical abscess or pulpitis may develop when the tooth’s enamel is damaged by caries, facilitating a bacterial invasion. Pulpitis describes the infection of the pulp of the tooth. Note that if bacterial growth proceeds in such a way that there is a drainage for the infection, the infection may remain asymptomatic or have such mild and diffuse symptoms that they go unnoticed for days or weeks. Severe infections may move apically toward the bone and into soft tissues, becoming a periodontal abscess. In such cases, the abscess must be incised and drained and antimicrobial therapy initiated [66]. Periodontitis describes an abscess that occurs when pathogens invade the periodontal pocket and cannot find escape, spreading to the alveolar bone and/or adjacent tissue. Periodontitis may occur with the eruption of the wisdom teeth, which, in rare cases, may progress to a localized infection [66]. Periodontal disease also includes any of several types of gingival infections, infections of the periodontal ligament, or infection of the alveolar bone which anchors the tooth in the jaw. This condition may proceed without symptoms for a long time. Gingivitis or inflammation of the gingiva causes pain and bleeding of the gums due to infection. Acute infectious gingivitis may involve ulceration and advance to acute necrotizing ulcerative gingivitis (ANUG). Symptoms of ANUG include pain, fever, malaise, and the gingiva will be necrotic [66].
Complete Eye Ophthalmoplegia: the unusual initial presentation of Leptomeningeal Carcinomatosis
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Lakshpaul Chauhan, Ateeq Mubarik, Abdulmagid Eddib, Mohammad Eid, Ali Vaziri, Salman Muddassir
We present a 60-year-old male with no significant medical history who presented to the emergency room with a rapidly growing lump in the right axilla for three weeks. Associated symptoms included jaw pain and swelling, bifrontal headache, weight-loss, and double vision for a one-week duration. Of note, he recently underwent dental surgery two weeks before presentation for a periodontal abscess associated with cervical lymphadenopathy and was now concerned about the possibility of disease progression.
Prevotella species as oral residents and infectious agents with potential impact on systemic conditions
Published in Journal of Oral Microbiology, 2022
Eija Könönen, Dareen Fteita, Ulvi K. Gursoy, Mervi Gursoy
Odontogenic infections are typically of endodontic or periodontal origin. In acute apical abscesses, the most prevalent Prevotella taxa include P. multisaccharivorax, P. intermedia, P. baroniae, and A. tannerae, as well as occasional recoveries of P. oralis and P. nigrescens [152–156]. Significant variations in the microbiome can be, at least in part, explained by geographic/ethnic differences; for example, P. nigrescens, A. tannerae, and F. nucleatum were more prevalent in endodontic abscess samples from the USA than in those from Brazil [153]. Of the 138 clinical strains isolated from periodontal abscesses, the majority represented Prevotella taxa [157]. Of those, 1/3 were identified as P. intermedia, and around 1/10 as P. nigrescens, P. melaninogenica, P. dentalis, P. denticola, and P. buccae . Occasional recoveries included P. fusca, P. histicola, P. multiformis, P. oris, P. oulorum, P. pallens, P. salivae, P. veroralis, and A. rava. Recently, the microbiome compositions between abscess pus and the corresponding periodontal pocket (coronally from the abscess) and periodontally healthy gingival crevice samples were compared [158]. Based on the beta-diversity analyses, periodontal abscess pus and the periodontal pocket shared similar compositions. In comparison to the healthy gingival crevice, P. intermedia and P. heparinolytica, together with P. gingivalis, were the predominant findings and significantly more abundant in periodontal abscesses [158]. In 50 German patients hospitalized for severe odontogenic abscesses, the frequency of Prevotella was 17.7% in saliva (collected prior to the abscess incision) and 27.2% in the pus samples, being the most abundant genus in odontogenic abscesses [159]. In spreading odontogenic infections, members of the genus Prevotella are common, especially P. buccae and P. oris [160–162].