Odontogenic Infections: Causes, Types, and Treatment
Odontogenic Infections
Odontogenic infections are primarily caused by bacterial plaque. The oral cavity contains different layers of organisms, such as streptococci and lactobacilli. Food particles, initially loose on the teeth and mucous membranes, can be removed by rinsing. However, these particles can become trapped between teeth and impact their surfaces. At this stage, they can only be eliminated by mechanical methods, such as brushing and flossing.
There are two types of bacterial plaque:
- Supragingival plaque: Formed with few layers of bacteria, it is located above the gingival margin and is not usually visible.
- Infragingival plaque: This type is thicker because it has many layers of bacteria. It penetrates below the gingival margin, between the gum and tooth root, clogging the space. Anaerobic bacteria can thrive here, potentially causing gingivitis and periodontitis.
Gingivitis
Gingivitis is the inflammation of the gums, characterized by redness or a bluish discoloration. It is caused by the accumulation of infragingival plaque. The best treatment for gingivitis is prevention through proper and thorough brushing, performed frequently.
Caries
Tooth decay, or caries, is a progressive disease affecting the hard structures of the tooth. It is characterized by:
- Decalcification of enamel
- Destruction and proteolysis of proteins
- Microbial invasion
Caries is a multifactorial disease, meaning that its occurrence requires the interaction of three different factors:
- The host
- Bacterial flora
- Food debris
Most parts of the tooth predisposed to developing caries are: occlusal, mesial, distal, buccal, and lingual or palatal surfaces.
Pulpitis
Pulpitis refers to the inflammation of the dental pulp. The pulp consists of loose connective tissue with channels for circulating neurovascular bundles that branch and anastomose.
Factors that favor its appearance include:
- Microorganisms reaching the pulp chamber through the action of caries
- Iatrogenic factors caused by medical actions that can infect or irritate the pulp
- Systemic diseases that favor its onset
Periodontitis
All cases of periodontitis are preceded by gingivitis. Gingivitis always precedes the passage of bacteria from the supragingival to the infragingival area, allowing germs to access the periodontium. The specific cause is the accumulation of bacteria in the periodontal tissue, almost always accompanied by a decreased ability of the patient’s immune response to infection. There are several types of periodontitis, depending on the type of germs involved and the age at which it appears.
Symptoms include:
- Yellowish-gray coloration of the tooth
- Redness and swelling of the gums
- Painful percussion of the tooth
- Tooth mobility
Effective treatment involves the elimination of periodontal pockets, as well as plaque both below and above the gum line. This is often done using a tool called a curette.
Tooth Abscess
A tooth abscess, or osteoflemón, is a collection of pus. In most cases, it is caused by suppurative periodontitis. It is usually located in the periapical area. The symptoms are similar to those of periodontitis but more pronounced.