Contributor: Meghan Hurley, MD
Educational Pearls:
Educational Pearls:
- Dental infections can be categorized into two main groups
- Infections of the gums
- Pericoronitis
- Tooth eruption leading to inflammation/irritation
- Can progress to an infection
- Requires pain control, no antibiotics
- Gingivitis
- Inflammation of the gums
- Can lead to an infection requiring antibiotics
- Abscess (gums)
- If an infection develops in the gums it can progress to an abscess
- May require drainage
- Acute necrotizing ulcerative gingivitis (ANUG) aka Trench Mouth
- Filmy, grayish discoloration of the gums with "punched out" lesions
- Extremely painful
- Can cause teeth to loosen and fall out
- Treat with IV antibiotics + admission
- Infections of the teeth
- Dental caries
- Causes sensitivity tooth enamel is worn through
- Can lead to infection
- Periapical abscess
- Abscess that extends through the root of the tooth
- Can develop up elsewhere in tooth/gums/mouth
- Causes tooth sensitivity when tapped
- Ludwig angina
- Infection of the soft tissue under the tongue
- Can compromise airway as it expands
- Treat with extensive antibiotics and debridement
- Antibiotic stewardship
- Commonly used antibiotics for dental infections
- Clindamycin
- Augmentin
- Amoxicillin
- Chlorhexidine (Peridex)
- Antiseptic and disinfectant that is helpful for gingival irritation
References
Bridwell R, Gottlieb M, Koyfman A, Long B. Diagnosis and management of Ludwig's angina: An evidence-based review. Am J Emerg Med. Mar 2021;41:1-5. doi:10.1016/j.ajem.2020.12.030
Dufty J, Gkranias N, Donos N. Necrotising Ulcerative Gingivitis: A Literature Review. Oral Health Prev Dent. 2017;15(4):321-327. doi:10.3290/j.ohpd.a38766
Herrera D, Roldán S, Sanz M. The periodontal abscess: a review. J Clin Periodontol. Jun 2000;27(6):377-86. doi:10.1034/j.1600-051x.2000.027006377.x
Kumar S. Evidence-Based Update on Diagnosis and Management of Gingivitis and Periodontitis. Dent Clin North Am. Jan 2019;63(1):69-81. doi:10.1016/j.cden.2018.08.005
Kwon G, Serra M. Pericoronitis. StatPearls. StatPearls Publishing
Copyright © 2022, StatPearls Publishing LLC.; 2022.
Summarized by Mark O'Brien, MS4 | Edited by John Spartz, MD, & Erik Verzemnieks, MD
The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account.
