Antibiotic Therapy and Bacterial Odontogenic Infections

What is it about?

Odontogenic infections (OIs) are common in the oral and maxillofacial regions and can affect both genders at any age. Infection of the dental pulp resulting from caries and their major pathogens, the streptococci, is the most important cause of OIs. In fact, following bacterial attack, the dental pulp becomes necrotic and the bacteria of the normal flora undergo a change from main aerobes to anaerobes leading to an abscess formation at the apex of the root. In some cases, the infection may spread to the surrounding spaces resulting in additional complications. Hence, their early diagnosis and adequate therapy are requisite. Successfully treating OIs depends from one side on eliminating the causal factor and from the other side selecting the appropriate anti-infectious agent. This selection should be considered according to each and every clinical case based on clinical and bacteriological factors, with the use of broadspectrum antibiotics for short periods of time. This article aims to set out the most common odontogenic infectious diseases as well as the involved germs and to help dentists choosing the right antibiotic.

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Why is it important?

Although antibiotic therapy (AT) is essential in odontogenic infections, it is often used improperly. In fact, the literature reports lack of knowledge among dentists regarding the choice of adequate antibiotic and/or the clinical situations indicated for AT. When required, the prescription of an antibiotic should be the result of a comprehensive evaluation that takes into consideration the patient’s general and oral health, the causative bacterial agent, and the properties of the drug (range of activities, capacity of diffusion, etc.).