Skip to main content
SpringerLink
Log in

Odontogenic Infections

  • Chapter
  • First Online:
Peterson’s Principles of Oral and Maxillofacial Surgery

  • 3929 Accesses

Abstract

Severe odontogenic infections present to the oral and maxillofacial surgeon emergently. Therefore, the surgeon must constantly refresh his or her knowledge of the anatomy of the deep fascial spaces and the ever-changing microbiology and antibiotic therapy of head and neck infections. Fortunately, Dr. Larry Peterson first outlined eight principles, or steps, in the management of these infections that guide the surgeon through effective management of odontogenic infections. This chapter also presents 10 principles of modern antibiotic therapy for head and neck infections. The first of these principles is that surgery is primary treatment; antibiotics are secondary.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Williams AC. Ludwig’s angina. Surg Gynecol Obstet. 1940;70:140.

    Google Scholar 

  2. Williams AC, Guralnick WC. The diagnosis and treatment of Ludwig’s angina: a report of twenty cases. N Engl J Med. 1943;228:443.

    Article  Google Scholar 

  3. Hought RT, Fitzgerald BE, Latta JE, Zallen RD. Ludwig’s angina: report of two cases and review of the literature from 1945 to January 1979. J Oral Surg. 1980;38:849–55.

    CAS  PubMed  Google Scholar 

  4. Flynn TR, Shanti RM. Principles of antibiotic therapy for head, neck, and orofacial infections. In: Hupp JR, Ferneini E, editors. Head, neck, and orofacial infections: a multidisciplinary approach. St Louis: Elsevier; 2016. p. 141–63.

    Chapter  Google Scholar 

  5. Flynn TR. Evidence-based principles of modern antibiotic therapy. In: Ferneini EM, Goupil M, editors. Evidence-based oral surgery: a clinical guide for the general dental practitioner. New York: Springer Nature; 2019. p. 283–316.

    Google Scholar 

  6. Flynn TR. Anatomy and surgery of deep fascial space infections. In: Kelly JJ, editor. Oral and maxillofacial surgery knowledge update. Rosemont: American Association of Oral and Maxillofacial Surgeons; 1994. p. 79–107.

    Google Scholar 

  7. Flynn TR. Anatomy of oral and maxillofacial infections. In: Topazian RG, Goldberg MH, Hupp JR, editors. Oral and maxillofacial infections. 4th ed. Philadelphia: WB Saunders Company; 2002. p. 188–213.

    Google Scholar 

  8. Flynn TR, Shanti RM, Levy M, Adamo AK, Kraut RA, Trieger N. Severe odontogenic infections, part one: prospective report. J Oral Maxillofac Surg. 2006;64:1093–103.

    Article  PubMed  Google Scholar 

  9. Umeda M, Minamikawa T, Komatsubara H, et al. Necrotizing fasciitis caused by dental infection: a retrospective analysis of 9 cases and a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95:283–90.

    Article  PubMed  Google Scholar 

  10. Balcerak RJ, Sisto JM, Bosack RC. Cervicofacial necrotizing fasciitis: report of three cases and literature review. J Oral Maxillofac Surg. 1988;46:450–9.

    Article  CAS  PubMed  Google Scholar 

  11. Langford FPJ, Moon RE, Stolp BW, et al. Treatment of cervical necrotizing fasciitis with hyperbaric oxygen therapy. Otolaryngol Head Neck Surg. 1995;112:274–8.

    Article  CAS  PubMed  Google Scholar 

  12. Terao Y, Mori Y, Yamaguchi M, Shimizu Y, et al. Group a streptococcal cysteine protease degrades C3 (C3b) and contributes to evasion of innate immunity. J Biol Chem. 2008;283:6253–60.

    Article  CAS  PubMed  Google Scholar 

  13. Mallampati SR, Gatt SP, Gugino SP, et al. A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J. 1985;32:429–34.

    Article  CAS  PubMed  Google Scholar 

  14. Frerk CM. Predicting difficult intubation. Anaesthesia. 1991;46:1005–8.

    Article  CAS  PubMed  Google Scholar 

  15. Flynn TR. Anesthetic and airway considerations in oral and maxillofacial infections. In: Topazian RG, Goldberg MH, editors. Oral and maxillofacial infections. 3rd ed. Philadelphia: WB Saunders Company; 1993. p. 496–517.

    Google Scholar 

  16. Miller WD, Furst IM, Sandor GKB, et al. A prospective blinded comparison of clinical examination and computed tomography in deep neck infections. Laryngoscope. 1999;109:1873–9.

    Article  CAS  PubMed  Google Scholar 

  17. Zheng L, Yang C, Zhang W, Cai X, et al. Is there association between severe multispace infections of the oral maxillofacial region and diabetes mellitus? J Oral Maxillofac Surg. 2012;70:1565–72.

    Article  PubMed  Google Scholar 

  18. Miller EJ Jr, Dodson TB. The risk of serious odontogenic infections in HIV-positive patients: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;86:406–9.

    Article  PubMed  Google Scholar 

  19. Flynn TR. Odontogenic infections. Oral Maxillofac Surg Clin North Am. 1991;3:311–29.

    Article  Google Scholar 

  20. Flynn TR, Shanti RM, Hayes C. Severe odontogenic infections, part two: prospective outcomes study. J Oral Maxillofac Surg. 2006;64:1104–13.

    Article  PubMed  Google Scholar 

  21. Lee JK, Kim HD, Lim SC. Predisposing factors of complicated deep neck infection: an analysis of 158 cases. Yonsei Med J. 2007;48:55–62.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Wang LF, Kuo WR, Tsai SM, Huang KJ. Characterizations of life-threatening deep cervical space infections: a review of one hundred ninety-six cases. Am J Otol. 2003;24:111–7.

    Article  CAS  Google Scholar 

  23. Steinkeler AR, Granquist E. Odontogenic infections: early incision and drainage decreases length of hospitalization. J Oral Maxillofac Surg. 2014;72:e83–4.

    Article  Google Scholar 

  24. Igoumenakis D, Giannakopoulos NN, Parara E, et al. Effect of causative tooth extraction on clinical and biological parameters of odontogenic infection: a prospective clinical trial. J Oral Maxillofac Surg. 2015;73:1254–8.

    Article  PubMed  Google Scholar 

  25. Ahmad N, Abubaker AO, Laskin DM, Steffen D. The financial burden of hospitalization associated with odontogenic infections. J Oral Maxillofac Surg. 2013;71:656–8.

    Article  PubMed  Google Scholar 

  26. Seppänen L, Lemberg KK, Lauhio A, Lindqvist C, et al. Is dental treatment of an infected tooth a risk factor for locally invasive spread of infection? J Oral Maxillofac Surg. 2011;69:986–93.

    Article  PubMed  Google Scholar 

  27. Christensen BJ, Park EP, Suau S, Beran D, et al. Evidence-based clinical criteria for computed tomography imaging in odontogenic infections. J Oral Maxillofac Surg. 2019;77:299–306.

    Article  PubMed  Google Scholar 

  28. Weyh A, Busby E, Smotherman C, Gautam S, et al. Overutilization of computed tomography for odontogenic infections. J Oral Maxillofac Surg. 2019;77:528–35.

    Article  PubMed  Google Scholar 

  29. Bouloux GF, Wallace J, Xue W. Irrigating drains for severe odontogenic infections do not improve outcome. J Oral Maxillofac Surg. 2013;71:42–6.

    Article  PubMed  Google Scholar 

  30. Gidley PW, Ghorayeb BY, Stiernberg CM, et al. Contemporary management of deep neck pace infections. Otolaryngol Head Neck Surg. 1997;116:16–22.

    CAS  PubMed  Google Scholar 

  31. Marra S, Hotaling AJ. Deep neck infections. Am J Otol. 1996;17:287–98.

    Article  CAS  Google Scholar 

  32. Shumrick KA. Deep neck infections. In: Paparella MM, editor. Otolaryngology, vol. 3. 3rd ed. Philadelphia: WB Saunders Company; 1991. p. 2556–63.

    Google Scholar 

  33. Flynn TR, Paster BJ, Stokes L, Susarla SM, et al. Molecular methods for diagnosis of odontogenic infections. J Oral Maxillofac Surg. 2012;70:1854–9.

    Article  PubMed  Google Scholar 

  34. Mansfield JM, Campbell JH, Bhandari AR, Jesionowski AM, et al. Molecular analysis of 16S rRNA genes identifies potentially periodontal pathogenic bacteria and archaea in the plaque of partially erupted third molars. J Oral Maxillofac Surg. 2012;70:1507–14.

    Article  CAS  PubMed  Google Scholar 

  35. Cunningham LL Jr, Madsen MJ, Van Sickels JE. Using prealbumin as an inflammatory marker for patients with deep space infections of odontogenic origin. J Oral Maxillofac Surg. 2016;64:375–8.

    Article  Google Scholar 

  36. Biederman GR, Dodson TB. Epidemiologic review of facial infections in hospitalized pediatric patients. J Oral Maxillofac Surg. 1994;52:1042–5.

    Article  CAS  PubMed  Google Scholar 

  37. Telford G. Postoperative fever. In: Condon RE, Nyhus LM, editors. Manual of surgical therapeutics. 6th ed. Boston: Little, Brown; 1985. p. 179.

    Google Scholar 

  38. Matijević S, Lazić Z, Kuljić-Kapulica N, Nonković Z. Empirical antimicrobial therapy of acute dentoalveolar abscess. Vojnosanit Pregl. 2009;66:544–50.

    Article  PubMed  Google Scholar 

  39. Brook I, Frazier EH, Gher ME. Aerobic and anaerobic microbiology of periapical abscess. Oral Microbiol Immunol. 1991;6:123–5.

    Article  CAS  PubMed  Google Scholar 

  40. Kim MK, Chuang SK, August M. Antibiotic resistance in severe orofacial infections. J Oral Maxillofac Surg. 2017;75:962–8.

    Article  PubMed  Google Scholar 

  41. Rega AJ, Aziz SR, Ziccardi VB. Microbiology and antibiotic sensitivities of head and neck space infections of odontogenic origin. J Oral Maxillofac Surg. 2006;64:1377–80.

    Article  PubMed  Google Scholar 

  42. Flynn TR. What are the antibiotics of choice for odontogenic infections, and how long should the treatment course last? Oral Maxillofac Surg Clin North Am. 2011;23:519–36.

    Article  PubMed  Google Scholar 

  43. Martins JR, Chagas OL Jr, Velasques BD, Bobrowski AN, et al. The use of antibiotics in odontogenic infections: what is the best choice? A systematic review. J Oral Maxillofac Surg. 2017;75:2606.e1–2606.e11.

    Article  Google Scholar 

  44. Islam S, Loewenthal MR, Hoffman GR. Use of peripherally inserted central catheters in the management of recalcitrant maxillofacial infection. J Oral Maxillofac Surg. 2008;66:330–5.

    Article  PubMed  Google Scholar 

  45. Baddour LM, Wilson WR, Bayer AS, et al. Infective endocarditis:diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association. Circulation. 2005;111(23):e394–434.

    PubMed  Google Scholar 

  46. Bliziotis IA, Samonis G, Vardakas KZ, Chrysanthopoulou S, Falagas ME. Effect of aminoglycoside and beta-lactam combination therapy versus beta-lactam monotherapy on the emergence of antimicrobial resistance: a meta-analysis of randomized, controlled trials. Clin Infect Dis. 2005;41(2):149–58.

    Article  CAS  PubMed  Google Scholar 

  47. Sarna T, Sengupta T, Miloro M, Kolokythas A. Cervical necrotizing fasciitis with descending mediastinitis: literature review and case report. J Oral Maxillofac Surg. 2012;70:1342–50.

    Article  PubMed  Google Scholar 

  48. Roccia F, Pecorari GC, Oliaro A, Passet E, et al. Ten years of descending necrotizing mediastinitis: management of 23 cases. J Oral Maxillofac Surg. 2007;65:1716–24.

    Article  PubMed  Google Scholar 

  49. von Konow L, Nord CE. Ornidazole compared to phenoxymethylpenicillin in the treatment of orofacial infections. J Antimicrob Chemother. 1983;11:207–15.

    Article  Google Scholar 

  50. Andersson DI, Hughes D. Antibiotic resistance and its cost: is it possible to reverse resistance? Nat Rev Microbiol. 2010;8:260–71.

    Article  CAS  PubMed  Google Scholar 

  51. Lewis MA, McGowan DA, MacFarlane TW. Short-course high-dosage amoxycillin in the treatment of acute dento-alveolar abscess. Br Dent J. 1986;161:299–302.

    Article  CAS  PubMed  Google Scholar 

  52. Chardin H, Yasukawa K, Nouacer N, et al. A reduced susceptibility to amoxicillin of oral streptococci following amoxicillin exposure. J Med Microbiol. 2005;58:1092–7.

    Article  Google Scholar 

  53. Flynn TR, Halpern LR. Antibiotic selection in head and neck infections. Oral Maxillofac Surg Clin North Am. 2003;15:17–38.

    Article  PubMed  Google Scholar 

  54. Flynn TR, Piecuch JF, Topazian RG. Infections of the oral cavity. In: Feigin RD, Cherry JD, editors. Textbook of pediatric infectious diseases, vol. 1. 4th ed. Philadelphia: WB Saunders Co.; 1998. p. 134–48.

    Google Scholar 

  55. Flynn TR, Topazian RG. Infections of the oral cavity. In: Waite D, editor. Textbook of practical oral and maxillofacial surgery. 3rd ed. Philadelphia: Lea & Febiger; 1987. p. 273–310.

    Google Scholar 

  56. Flynn TR. Principles and surgical management of head and neck infections. In: Bagheri SC, Bell RB, Khan HA, editors. Current therapy in oral & maxillofacial surgery. St. Louis: Elsevier; 2011. p. 1080–91.

    Google Scholar 

  57. Flynn TR. Surgical management of orofacial infections. Atlas Oral Maxillofac Surg Clin North Am. 2000;8:77–100.

    Article  CAS  PubMed  Google Scholar 

  58. Bennett JD, Flynn TR. Anesthetic considerations in orofacial infections. In: Topazian RG, Goldberg MH, Hupp JR, editors. Oral and maxillofacial infections. 4th ed. Philadelphia: WB Saunders Company; 2002. p. 439–55.

    Google Scholar 

  59. Sakamoto H, Kato H, Sato T, Sasaki J. Semiquantitative bacteriology of closed odontogenic abscesses. Bull Tokyo Dent Coll. 1998;39:103–7.

    CAS  PubMed  Google Scholar 

  60. Flynn TR. Principles of management and prevention of odontogenic infections. In: Ellis E, Hupp JR, Tucker MR, editors. Contemporary oral and maxillofacial surgery. 5th ed. St. Louis: Mosby; 2008. p. 291–315.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Oral and Maxillofacial Surgery, University of Pennsylvania, Philadelphia, PA, USA

    Rabie M. Shanti

  2. Private Practice (Retired), Reno, NV, USA

    Thomas R. Flynn

Authors
  1. Rabie M. Shanti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas R. Flynn
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. College of Dentistry, University of Illinois, Chicago, IL, USA

    Michael Miloro

  2. Department of Oral & Maxillofacial Surgery, Louisiana State University Health Science, Shreveport, LA, USA

    G. E. Ghali

  3. Oral and Maxillofacial Surgery, The Ohio State University, Columbus, OH, USA

    Peter E. Larsen

  4. Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham School of Dentistry and Medicine, Birmingham, AL, USA

    Peter Waite

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Shanti, R.M., Flynn, T.R. (2022). Odontogenic Infections. In: Miloro, M., Ghali, G.E., Larsen, P.E., Waite, P. (eds) Peterson’s Principles of Oral and Maxillofacial Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-91920-7_40

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-91920-7_40

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-91919-1

  • Online ISBN: 978-3-030-91920-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation