Spread Of Dental Infections

Front 1

Dental infections are also known as _____________, and are infections that involve the teeth or associated structures/tissues

Back 1

odontogenic infections

Front 2

Dental infections are caused by Oral pathogens that are predominantely _________ and are usually of multiple species and are found on dentition, gingival crevice, etc.

Back 2

anaerobic

Front 3

Treatment of dental infections consist of

Back 3

removal of the source of infection, systemic antibiotics, and area drainage

Front 4

Dental Infections can result in various types of lesions such as:

Back 4

Abscess, Cellulitis, and Osteomyelitis

Front 5

An _________ is a localized entrapment of pathogens from dental infection in closed tissue space

Back 5

Abscess

Front 6

the abscess is filled with __________, which is pus that contains pathogenic bacteria, WBC’s, tissue fluid, debris

Back 6

suppuration

Front 7

_____________ formation can occur with progressive caries when the pathogens invade the usually sterile pulp and the infection spreads apically

Back 7

Periapical abscess

Front 8

___________ is inflammation around the crown

Back 8

Pericoronitis

Front 9

True or False
An abscess should be detecable on a radiograph even during early stages

Back 9

False - During early stages it may not be detectable on radiograph

Front 10

in later stages of infection the abscess formation can lead to the formation of a _________________ in the skin, oral mucosa, or even bone that allows drainage of the infection and creates suppuration on a surface

Back 10

passageway or fistula (drainage)

Front 11

The opening of the fistula is called a

Back 11

Stoma

Front 12

The soft tissue over a fistula in the alveolar bone may also have an extraoral or intraoral __________, which is a small, elevated, circumscribed lesion of either the skin or oral mucosa that contains suppuration

Back 12

Pustule

Front 13

The location of the pustule is based on

Back 13

muscle attachments

Front 14

____________ of Face and neck can also occur with dental infections and is characterized by diffuse inflammation of soft tissue spaces

Back 14

Cellulitis

Front 15

the clinical signs and symptoms of Cellulitis are:

Back 15

- Pain, tenderness, redness, diffuse edema of involved soft tissue space, causing massive and firm swelling
- Dysphagia (difficulty swallowing), ptosis (restricted eye opening)

Front 16

Cellulitis Can lead to

Back 16

Ludwig’s angina

Front 17

Treatment of Cellulitis involves

Back 17

removal of infection cause and antibiotics

Front 18

______________ is another type of lesion related to dental infection that is an inflammation of bone marrow

Back 18

Osteomyelitis

Front 19

Osteomyelitis inflammation develops from the invasion of the tissue of a long bone by pathogens, usually from a

Back 19

skin or pharyngeal infection

Front 20

In osteomyelitis involving the Jawbone, the pathogens are most likely derived from

Back 20

- abscess
- from extension of cellulitis
- or contamination of a surgical site

Front 21

Osteomyelitis most commonly occurs in

Back 21

Mandible

Front 22

Osteomyelits occurs rarely in __________ because the ___________ is less vascularized, and has thicker bone

Back 22

- Maxilla
- mandible

Front 23

Untreated osteomyelitis leads to:

Back 23

- Resorption of bone and formation of Sequestrae

Front 24

___________ are pieces of dead bone separated from the sound bone within the area

Back 24

Sequestrae

Front 25

___________ or pins and needle sensation may develop in mandible due to proximity of IAN(inferior alveolar nerve)

Back 25

Paresthesia

Front 26

Treatment of osteomyelitis consists of

Back 26

- drainage
- surgical removal of any sequestra
- and antibiotic regimen

Front 27

Normal flora do not create infections, however if body’s natural defenses are compromised then they can create

Back 27

opportunistic infections

Front 28

Medically compromised patients include those with

Back 28

AIDS, diabetes, cancer, etc.

Front 29

Patients that have a higher risk of complications include those at risk for

Back 29

- Infective endocarditis
- or infection with their implanted prosthetic joints

Front 30

More than 50% (half) of gram (-) anaerobic bacteria are capable of producing the ________________, which is responsible for the initial etiology of head and neck infections as well as many treatment failures in dental infections.

Back 30

beta-lactamase enzyme

Front 31

The beta-lactamase survives _________ therapy

Back 31

penicillin

Front 32

Many odontogenic infections start in the

Back 32

dentition and associated oral tissues

Front 33

Normally a localized abscess establishes a fistula in the

Back 33

skin, oral mucosa, or associated bone, and etc)

Front 34

Maxillary sinuses can become infected as a sequelae of

Back 34

odontogenic infection

Front 35

Secondary sinusitis occurs mainly near the maxillary sinuses because the

Back 35

maxillary posterior teeth (PMs/Ms) and associated tissues are close in proximity to these sinuses

Front 36

_____________ can be caused by spread of infection from a periapical abscess perforation or post-extraction infection due to residual fragments

Back 36

maxillary sinusitis

Front 37

However most common infections of maxillary sinuses are not of dental origin but are caused by an _____________ that has spread to the sinuses and can be fatal due to communication to other sinuses

Back 37

Upper respiratory infection

Front 38

Maxillary sinusitis symptoms include

Back 38

headache, foul-smelling nasal or pharyngeal discharged, fever, weakness

Front 39

The skin over sinus can be _____________ and difficulty breathing (Dyspnea) occurs

Back 39

tender, hot, red due to the inflammation in the area

Front 40

Radiographically – early evidence of sinusitis is the thickening of sinus walls, with subsequent radiographic evaluation showing

Back 40

increased radioopacity, and possible perforation – may need MRI

Front 41

_____________ usually responds to aggressive antibiotic regimen and drainage (decongestant)

Back 41

Acute sinusitis

Front 42

_____________ may require surgical intervention to increase drainage (canine fossa)

Back 42

Chronic sinusitis

Front 43

the Vascular System of head and neck can allow the spread of infection from the teeth and associated oral tissues because pathogens can travel in the _________ and drain the infected oral site into other tissues or organs

Back 43

veins

Front 44

The spread of dental infection by way of the vascular system can occur because of

Back 44

bacteremia or an infected thrombus

Front 45

__________ is caused by bacteria traveling in the vascular system

Back 45

Bacteremia

Front 46

Bacteremia can occur during a dental treatment and can have an effect on

Back 46

- infective endocarditis (antibiotic premedication)
- newly-placed joint prosthetics
- medically compromised patients

Front 47

and infected intravascular clot (thrombus) can dislodge from the inner blood vessel wall and traveal as an

Back 47

embolus

Front 48

___________ is the most likely to be involved in the possible fatal spread of dental infection

Back 48

Cavernous sinus

Front 49

An infection in the cavernous sinus is called a

Back 49

cavernous sinus thrombus

Front 50

Cavernous sinus is located on

Back 50

side of the body of sphenoid

Front 51

The left cavernous sinus and the right side cavernous sinus communicate with each other and also communicate with the ___________ and with the _____________

Back 51

- pterygoid plexus
- ophthalmic vein

Front 52

The Pterygoid plexus and ophthalmic vein anastomose with the

Back 52

facial vein

Front 53

Bacteremia potential is due to

Back 53

lack of valves in veins of head to prevent flow of blood back into the cavernous sinus

Front 54

Needle track contamination to ____________ if PSA block administered incorrectly

Back 54

pterygoid plexus

Front 55

Nonodontogenic infections of the area considered to be the “dangerous triangles of the face” are the

Back 55

orbital, nasal, paranasal sinuses

Front 56

Signs and Symptoms of cavernous sinus thrombus include:

Back 56

Fever, drowsiness, rapid pulse

Front 57

in a cavernous sinus thrombus there is also a loss of function of CN VI (abducens nerve paralysis) resulting in

Back 57

impaired eye movement, diplopia, eyelid edema, lacrimation, exophthalmus

Front 58

Other CN damage involved in cavernous sinus thrombus may invlove the following CN:

Back 58

CN III, CN IV, CN V

Front 59

Lymphatics can allow the spread of infection from the teeth and associated oral tissues, because pathogens can travel in the ________ through the lymphatic vessels that connect the series of nodes from the oral cavity to other tissues or organs

Back 59

lymph

Front 60

These pathogens travel in the lymph from the __________ near infected site to a ___________ at a distant site

Back 60

- primary node
- secondary node

Front 61

Mandibular incisors drain into submental node which drain into the

Back 61

submandibular node or into deep cervical node

Front 62

Maxillary third molars drain into

Back 62

superior deep cervical nodes

Front 63

All other dentition (except mandibular incisors, maxillary M3s) drain into ____________ which drain into _____________

Back 63

- submandibular nodes
- superior deep cervical node

Front 64

True or False
The Fascial Spaces of the head and neck can allow spread of infection from the teeth and associated oral tissues because the pathogens can travel within the fascial planes, from one space near the infected site to another, more distant space by means of the spread of the related inflammatory exudates. when involved infections, the space can undergo cellulitis.

Back 64

True

Front 65

If Maxillary dentition and associated teeth are infected, the infection can spread into

Back 65

Maxillary vestibule, buccal space, canine space

Front 66

If Mandibular dentition and associated teeth are infected, the infection can spread into the

Back 66

Mandibular vestibule, buccal space, submental space, sublingual space, masticator spaces, space of body of mandible

Front 67

Infection in relationship to mylohyoid muscle dictates

Back 67

which mandibular subspace will be effected

Front 68

Apex of mandibular M1 (and all other mandibular dentition anterior to this point) is located above the mylohyoid muscle so involvement of this tooth or teeth anterior to this will involve the

Back 68

sublingual space

Front 69

Apex of M2 and M3 located below mylohyoid muscle and infection here will first spread to the

Back 69

submylohyoid space

Front 70

_____________ is on of the most serious lesions of the jaw region

Back 70

Ludwig's Angina

Front 71

Ludwig's Angina is cellulitis of the

Back 71

submandibular space

Front 72

Ludwig's angina involves spread of infection from any of the mandibular teeth to one space initially (submental, sublingual, submandibular space) and will later involve bilateral _________________ and then spread to the _________________ and then to the ___________________ of neck and cause swelling.

Back 72

- submandibular spaces
- spread to parapharyngeal space
- retropharyngeal space

Front 73

Ludwig's angina leads to

Back 73

difficulty swallowing, difficulty breathing, fever, excessive drooling

Front 74

Ludwig's angina can also lead to respiratory obstruction of retropharyngeal space and will then ultimately lead to

Back 74

Asphyxiation and death

Front 75

an emergency __________ may be required to open airway in patient with Ludwig's angina

Back 75

cricothyrotomy