Abstract
Oral infections can be odontogenic or nonodontogenic in origin. Odontogenic infections are most prevalent and include dental caries, periodontal disease, and suppurative deep space infections. Nonodontogenic infections include sialadenitis and parotitis, vesiculobullous gingivostomatitis, aphthous ulcers, oropharyngeal candidiasis, and severe oral mucositis in the immunocompromised host. Clinical presentations can be variable. An understanding of the underlying anatomic structures, the oral microflora, and associated medical conditions of the host is critical to guide appropriate diagnosis and management. In this paper, preventative strategies to reduce dental plaque formation and promote oral health are emphasized.
Similar content being viewed by others
References and Recommended Reading
Chow AW: Head and neck infections. In Therapy of Infectious Diseases. Edited by Baddour L, Gorbach SL. Philadelphia: Saunders; 2003:25–39.
Schuster GS: Oral flora and pathogenic organisms. Infect Dis Clin North Am 1999, 13:757–774.
Munson MA, Banerjee A, Watson TF, et al.: Molecular analysis of the microflora associated with dental caries. J Clin Microbiol 2004, 42:3023–3029.
Lucas VS, Beighton D, Roberts GJ: Composition of the oral streptococcal flora in healthy children. J Dent 2000, 28:45–50.
Jousimies-Somer H, Summanen P: Recent tanomic changes and terminology update of clinically significant anaerobic gram-negative bacteria (excluding spirochetes). Clin Infect Dis 2002, 35(Suppl 1):S17-S21. This is an update on anaerobic gram-negative taxonomy, highlighting changes to Bacteroides, Prevotella, and Porphyromonas groups.
Nederfors T: Xerostomia and hyposalivation. Adv Dent Res 2000, 14:48–56.
Hicks J, Garcia-Godoy F, Flaitz C: Biological factors in dental caries: role of saliva and dental plaque in the dynamic process of demineralization and remineralization (part 1). J Clin Pediatr Dent 2003, 28:47–52. This is an overview of new findings in the role of salivary composition and proteins in oral health.
Amerongen AV, Veerman EC: Saliva--the defender of the oral cavity. Oral Dis 2002, 8:12–22.
Ettinger RL: Epidemiology of dental caries. A broad review. Dent Clin North Am 1999, 43:679–694.
Winn DM, Brunelle JA, Selwitz RH, et al.: Coronal and root caries in the dentition of adults in the United States, 1988–1991. J Dent Res 1996, 75:642–651.
Shay K: Infectious complications of dental and periodontal diseases in the elderly population. Clin Infect Dis 2002, 34:1215–1223.
Shay K, Ship JA: The importance of oral health in the older patient. J Am Geriatr Med 1995, 43:1414–1422.
Loesche WJ, Grossman NS: Periodontal disease as a specific, albeit chronic, infection: diagnosis and treatment. Clin Microbiol Rev 2001, 14:727–752.
Marsh PD: Microbiologic aspects of dental plaque and dental caries. Dent Clin North Am 1999, 43:599–614.
Moore WEC, Moore LVH: The bacteria of periodontal diseases. Periodontol 2000 1994, 5:66–77.
Caufield PW, Griffen AL: Dental caries. An infectious and transmissible disease. Pediatr Clin North Am 2000, 47:1001–1019.
Wood SR, Kirkham J, Marsh PD, et al.: Architecture of intact natural human plaque biofilms studied by confocal laser scanning microscopy. J Dent Res 2000, 79:21–27.
Brook I: Microbiology and management of endodontic infections in children. J Clin Pediatr Dent 2003, 28:1–17.
Hicks J, Garcia-Godoy F, Flaitz C: Biological factors in dental caries: role of remineralization and fluoride in the dynamic process of demineralization and remineralization (part 3). J Clin Pediatr Dent 2004, 28:203–214. This is an overview of new findings in the role of salivary composition and proteins in oral health.
Bader JD, Shugars DA, Bonito AJ: A systematic review of selected caries prevention and management methods. Community Dent Oral Epidemiol 2001, 29:399–411. This is a systematic literature review grading the evidence for caries treatment and prevention strategies.
National Institutes of Health Consensus Development Panel: National Institutes of Health Consensus Development Conference statement. Diagnosis and management of dental caries throughout life, March 26–28, 2001. J Am Dent Assoc 2001, 132:1153–1161.
Brown LJ, Brunelle JA, Kingman A: Periodontal status in the United States, 1988–91: prevalence, extent, and demographic variation. J Dent Res 1996, 75:672–683.
Van Dyke TE, Serhan CN: Resolution of inflammation: a new paradigm for the pathogenesis of periodontal diseases. J Dent Res 2003, 82:82–90.
Armitage GC: Development of a classification system for periodontal diseases and conditions. Ann Periodontol 1999, 4:1–6.
Robinson PG, Adegboye A, Rowland RW, et al.: Periodontal diseases and HIV infection. Oral Dis 2002, 8(Suppl 2): 144–150.
Patton LL, Phelan JA, Ramos-Gomez FJ, et al.: Prevalence and classification of HIV-associated oral lesions. Oral Dis 2002, 8(Suppl 2):98–109. This is an excellent review of HIV-associated oral diseases.
Lockhart PB, Brennan MT, Fox PC, et al.: Decision-making on the use of antimicrobial prophylaxis for dental procedures: a survey of infectious disease consultants and review. Clin Infect Dis 2002, 34:1621–1626.
Mylonakis E, Calderwood SB: Infective endocarditis in adults. N Engl J Med 2001, 345:1318–1330.
Drangsholt MT: A new causal model of dental diseases associated with endocarditis. Ann Periodontol 1998, 3:184–196.
Carmona IT, Diz DP, Scully C: An update on the controversies in bacterial endocarditis of oral origin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002, 93:660–670.
Dajani AS, Taubert KA, Wilson W, et al.: Prevention of bacterial endocarditis: recommendations by the American Heart Association. JAMA 1997, 277:1794–1801.
Horstkotte D, Follath F, Gutschik E, et al.: Guidelines on prevention, diagnosis and treatment of infective endocarditis executive summary; the task force on infective endocarditis of the European Society of Cardiology. Eur Heart J 2004, 25:267–276.
Advisory state: antibiotic prophylaxis for dental patients with total joint replacements. American Dental Association; American Academy of Orthopaedic Surgeons. J Am Dent Assoc 1997, 128:1004–1008.
Holmstrup P, Poulsen AH, Andersen L, et al.: Oral infectionsand systemic diseases. Dent Clin North Am 2003, 47:575–598. This is a good summation of the current epidemiologic evidence for the role of dental caries in systemic health.
Li X, Kolltveit KM, Tronstad L, et al.: Systemic diseases caused by oral infection. Clin Microbiol Rev 2000, 13:547–558. This is an excellent review that compliments the study by Holmstrup et al. [34••], highlighting the proposed mechanisms and inflammatory pathways linking oral and systemic health.
Dahlen G: Microbiology and treatment of dental abscesses and periodontal-endodontic lesions. Periodontol 2000 2002, 28:206–239. This is a well-written article regarding periodontal health, collating published studies of microbiologic etiologies of the periodontal conditions.
Ylijoki S, Suuronen R, Jousimies-Somer H, et al.: Differences between patients with or without the need for intensive care due to severe odontogenic infections. J Oral Maxillofac Surg 2001, 59:867–872.
Ariji Y, Gotoh M, Kimura Y, et al.: Odontogenic infection pathway to the submandibular space: imaging assessment. Int J Oral Maxillofac Surg 2002, 31:165–169.
Matthews DC, Sutherland S, Basrani B: Emergency management of acute apical abscesses in the permanent dentition: a systematic review of the literature. J Can Dent Assoc 2003, 69:660.
Brook I: Antibiotic resistance of oral anaerobic bacteria and their effect on the management of upper respiratory tract and head and neck infections. Semin Respir Infect 2002, 17:195–203.
Brook I: Acute bacterial suppurative parotitis: microbiology and management. J Craniofac Surg 2003, 14:37–40.
Carrozzo M, Gandolfo S: Oral diseases possibly associated with hepatitis C virus. Crit Rev Oral Biol Med 2003, 14:115–127.
Amir J: Clinical aspects and antiviral therapy in primary herpetic gingivostomatitis. Paediatr Drugs 2001, 3:593–597.
Scully C, Gorsky M, Lozada-Nur F: The diagnosis and management of recurrent aphthous stomatitis: a consensus approach. J Am Dent Assoc 2003, 134:200–207.
Pappas PG, Rex JH, Sobel JD, et al.: IDSA guidelines for treatment of candidiasis. Clin Infect Dis 2004, 38:161–189.
Reichart PA: Oral manifestations in HIV infection: fungal and bacterial infections, Kaposi’s sarcoma. Med Microbiol Immunol (Berl) 2003, 192:165–169.
Donnelly JP, Belim LA, Epstein JB, et al.: Antimicrobial therapy to prevent or treat oral mucositis. Lancet Infect Dis 2003, 3:405–412.
Chow AW: Orofacial and odontogenic infections. In Infectious Diseases in Aging—A Clinical Handbook. Edited by Yoshikawa TT, Norman DC. Totowa, NY: Humana Press Inc.; 2000:147–162.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hull, M.W., Chow, A.W. An approach to oral infections and their management. Curr Infect Dis Rep 7, 17–27 (2005). https://doi.org/10.1007/s11908-005-0019-8
Issue Date:
DOI: https://doi.org/10.1007/s11908-005-0019-8