Pathophysiology of Dental Infection
Acute dental abscess usually occurs secondary to dental caries or following a dental procedure or trauma. The most common cause, dental caries, is caused by erosion of enamel by acids produced as a by-product of fermentation of dietary carbohydrates by normal bacterial flora. This introduces bacteria into the tooth, which spreads firstly into the pulp then to the root and local tissues. Infection then may spread superficially into the tissues producing gingivitis or a dental abscess. Very occasionally infection spreads to the deep facial planes forming a retropharyngeal abscess or Ludwig’s angina.
Dental abscess is usually polymicrobial with numerous pathogen combinations being recognised. Common pathogens include Streptococcus sp. Along with Staphylococcus sp, Staph.aureus has been isolated in up to 15% of abscess cultures (MSSA in 90% of these cases, MRSA in 10%) with the most common anaerobic species being Prevotella sp of dentoalveolar abscesses 4.
Learning bite
Dental infection most commonly arises from the process of dental caries and is usually polymicrobial with both aerobic and anaerobic bacteria being responsible.