Fast Five Quiz: Hygiene-Related Diseases

Richard H. Sinert, DO

Disclosures

May 04, 2021

Dental caries are commonly caused by poor oral hygiene. Dental infection is most often not a life-threatening disease; however, if an odontogenic infection spreads through fascial planes, patients are at risk for sepsis, airway compromise (eg, Ludwig angina, retropharyngeal abscess), and odontogenic infection.

Masticator space infection almost always presents with trismus and is due to infection of the third molar of the mandible. Large abscesses may track toward the posterior parapharyngeal spaces. Patients may require fiberoptic nasoendotracheal intubation while awake.

Pericoronal infection occurs in an erupting or a partially impacted tooth when tissue covering the tooth's crown becomes inflamed and infected. An abscess may form and require incision and drainage. The tooth itself is not usually involved.

Retropharyngeal space infection is identified by stiff neck, sore throat, dysphagia, hot potato voice, and stridor, with possible spread to the mediastinum. These infections are due to infection of the molars. With spread to the deeper areas of the neck, signs and symptoms of vagal injury, Horner syndrome, and lower cranial nerve injury may be seen. Infection in this space is more common in children younger than 4 years.

Ludwig angina (so called because of sensations of choking and suffocation) is characterized by brawny boardlike swelling from a rapidly spreading cellulitis of the sublingual, submental, and submandibular spaces, with elevation and edema of the tongue, drooling, and airway obstruction. The condition is odontogenic in the vast majority of cases and typically arises from the second and third mandibular molars. If infection spreads through the buccopharyngeal gap (space created by the styloglossus muscle between the middle and superior constrictor muscle of the pharynx), adjacent retropharyngeal and mediastinal infection is possible.

Dental caries can be prevented by brushing and flossing daily as well as using antibacterial mouthwash in order to reduce the amount of bacteria in the mouth.

Read more about dental infections.

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