Infections to the tooth

Introduction

Dental infection is an invasion of pathogens (generally bacteria) which, through the dentin or the root foramen, penetrate the tooth and multiply there causing damage to the surrounding dental structures.

Although it is well established that "tooth infection is one of the most feared complications after a" dental extraction, it must be emphasized that a dental element can also become infected independently of avulsion interventions. Just think, for example, that even a simple tooth decay is part of the long list of tooth infections: in such circumstances, the bacteria, devious and greedy for sugars, bypass the natural dental defenses starting from the enamel (the hard tissue of the tooth) and, penetrating into the dentin up to the dental pulp, they gradually destroy it.
Infections of the oral cavity are very numerous and can differ in severity, origin and, clearly, type of lesion. In these chapters we will review all the main dental infections, trying to highlight the causes, symptoms and possible therapies to reverse the infection, ward off the bacterium and prevent any recurrence. Let us briefly recall that the vast majority of dental infections - from caries more simple to more complex dental abscess - it requires immediate dental intervention to avoid the most extreme and worrying solution of all: tooth extraction.

Pathogens involved

In most cases, tooth infections are bacterial in nature. In this sense, the most involved bacterial agents belong to the species Streptococcus mutans, especially the strains cricetus, rattus, ferus, sobrinus. Even the bacterium Lactobacillus acidophilus, although not the main triggering agent of dental infections, it can favor or support the infectious processes affecting the teeth (due to its strong ability to acidify the environment in which it is found). Lactobacillus acidophilus produces lactic acid starting from the fermentation of glucose; therefore, a high charge of this bacillus reduces the oral pH and, by weakening the enamel, encourages infections.

Dental infections: symptoms

It is not always so immediate to notice a "dental infection in progress, especially if no dental interventions have been performed in the short term.
In general, it is possible to roughly distinguish the typical symptoms of "common" dental infections from those characteristic of more severe and deeper infectious processes.
Superficial tooth infections can cause toothache, localized pain, edema (swelling) and dentinal hypersensitivity to temperature and chewing.
Patients with deeper dental infections, such as abscesses, granulomas or cysts, may instead experience more serious and dangerous symptoms, such as high fever, difficulty swallowing, pain opening the mouth and, in some severe cases, even breathing difficulties. . In cases of extreme severity, dental infections can spread to various parts of the body to the point of causing sepsis, dangerously endangering the patient's life.

Asymptomatic dental infections

Not all dental infections begin with precise and specific symptoms.
Granuloma - as we will see in the second part of the article - deserves an in-depth study in its own right: it is a typical complication of caries, dental chipping or trauma to the teeth, essentially caused by an infection coming from the root canal. Granuloma is an equivocal infection that, generally, does not begin with any particular symptom. The danger of this type of dental infection consists precisely in its asymptomaticity: by not treating the disorder from the very first stages, the granuloma can remain silent for a very long time time, unexpectedly evolving into fistulas or dental cysts much more dangerous than the initial infection.
We have reported this example to make it clear that, although it is asymptomatic, an "infection must not" be neglected nor ignored.

General classification

The general classification of dental infections provides a first distinction based on the origin of the disorder:

Periodontal origin: the infection takes place from a periodontal disease (eg pyorrhea), that is, involving the gums, the elastic connecting fibers and the supporting bone cavity.
Pericoronal origin: the infection comes from damage to the crown of the tooth (eg caries). The infectious process starts from the tooth enamel, and then eventually spreads into the dentin and dental pulp.
Traumatic-surgical origin: infection (eg.alveolitis) is closely linked to a failure of an invasive dental intervention, or to the failure to comply with the precautionary rules after the extraction of a tooth or another dental operation.