DISEASES OF THE TEETH AND ALVEOLAR PROCESS : ORAL SEPSIS (ODONTOGENIC INTOXICATION) (SEPSIS, INTOXICATIO ORALIS) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
The etiology is most often infectious foci of dental origin.
The pathogenesis. The relationship of infectious dental foci with various organs and systems of the body is possible through preferential flow in the blood or microbe (bacterienne communication), or toxins - products of abnormal metabolism in inflammation (toksogennaâ communication). Bacterienne communication often occurs in acute septic osteomyelitis jaw and causes acute effects of sepsis. Those forms of the disease, which are called oral sepsis, accompanied by a chronic course and pathogenetically should be considered in most cases as gravitaxis. From this point of view, the pathogenetic role of dental foci of infection can be reflected in three groups:
Symptoms. Among the local symptoms include the effects caused by the active form of chronic productive periodontitis. The clinical picture of active chronic periodontitis is defined according to the percussion sensitivity of the periodontium, edema of the mucosa in the apical region with symptoms of persistent vasomotor reaction of the gums to the pressure, and x-ray diffraction data, diffuse resorbed Ostia and cementite. The presence of active foci of odontogenic infection is also characterized by the voltage lymph barriers first and second order - submaxillary and cervical glands. Common symptoms include weakness, irregular low-grade fever, left shift of leukogram, increased volatile ROHE, sensitivity to adrenaline, a rise in the index during congratula sample of the reticulo-endothelial system, especially accompanied by monocytosis.
Course and complications. For oral intoxication is characterized by a sluggish course of the disease, accompanied by the defeat of individual systems (kidneys, joints, eyes, etc.) or without it. Pulpless teeth at times give a small flash of inflammation; periodontitis often occurs latently.
Detection is difficult, because none of the local or General symptoms is not independent, and the more specific oral intoxication; only the combination of a number of symptoms and exclusion of other foci of intoxication enables the recognition of odontogenic intoxication.
Recognized cases of oral intoxication give a relatively favorable prognosis, as there is a possibility of radical intervention by the removal of the lesions, which after some time (months) partial or complete improvement of the General condition of the patient.
The removal of all teeth, which are the foci of active infection. To remove teeth should not be immediately and systematically in a certain sequence depending on clinical assessment of activity of the process. The sulfonamides. Penicillin. General treatment of sepsis.