Oral infections - Salivary gland infection, Periodontitis, Gingivitis, Mandibular abscess

Introduction to Oral infections

Oral infection in humans can manifest as:

1. Gingivitis

2. Anaerobic infection - Periodontitis

3. Salivary gland infection

4. Mandibular abscess

Clinical manifestations of oral infection

The clinical manifestations of oral infections include:

Gingivitis

Gingivitis is a common and mild form of periodontal disease characterized by inflammation of the gums. The gum becomes swollen, dark red, and tender. Bidding occurs during brushing. The most common cause of gingivitis is the accumulation of plaque in teeth.

Major risk factors

1. Poor oral hygiene

2. Smoking and chewing tobacco

3. Hormonal changes,

4. Malnourishment (caused by Streptococcus mutans, Actinobacillus)

Anaerobic infection

Periodontitis

Periodontitis results as a complication of gingivitis. During periodontitis collagen attachment of the gum to the teeth is lost. This forms a pocket in which plaque gets deposited. The plaque hardens to form tartar (calculus) in which bacteria gets deposited. Severe inflammation occurs characterized by bleeding gums, pus formation between gums and teeth, bad breath, and painful chewing.

Etiological agents

The commonly associated bacteria causing periodontitis are:

• Prophyromonas gingivalis

• Pervotella intermedia

• Actinobacillus actinomycetocomitans

• Fusobacterium nucleatum

• Pervotella melanogenica

• Pervotella oralis

* The tissues in, around, and supporting the tooth get infected and damaged.

Other etiological agents infecting periodontitis include:

• Staphylococci

• Eikenella corrodens

• Streptococcus anginosus

• Bacteroides fragilis

• Peptostreptococcus

• Veillonella

• Fusobacterium

• Actinomyces israelii

Salivary gland infection

Acute suppurative parotitis (inflammation of the salivary glands located under the cheek of the front and below the external ear) is seen in very ill patients, especially those who are dehydrated, malnourished, elderly, or recovering from surgery.

It is associated with painful, tender swelling of the parotid gland. Purulent drainage may be evident at the opening of the duct of the gland in the mouth.

Etiological agent

• Staphylococcus aureus (major pathogen)

• Enterobacteriaceae

• oral anaerobes

• Mycobacterium tuberculosis (frequent) - is involved in infection with the parotid gland in conjugation with pulmonary tuberculosis

Mandibular abscess

Mandibular abscess results in a complication of periodontitis. During an abscess, there is a localized collection of pus and usually, the origin of the abscess is bacterial in nature. The pus is generally accumulated in the soft, open, dead pulp of the teeth. It might also be associated with local tissue damage and necrosis. The mandibular abscess is treated with antibiotics and draining of pus.

The symptoms of mandibular abscess are:

• Growing sharp throbbing pain

• localized face swelling

• lymphadenitis

• headache