Effective Ways To Prevent Infections After Dental Surgery

Surgical infections

A disease caused by microorganisms especially those that release toxins or invade body tissue during or after surgical procedures.

Classification of Surgical Infections

According to depth ofwound infection:

“Causes Of Infections After Dental Surgery”

According to etiology:

According to the time:

“Can Poor Oral Hygiene Cause Infections After Dental Surgery”

Surgical Principles in dental Surgery

Follow the shortest and most direct route to the accumulation of exudates or pus, but always preserve integrity of anatomical structures.
Performing incisions with esthetic criteria in areas of minimal impact as on the face.
Place the incisions in areas of healthy mucosa or skin,avoiding areas with flctuation and atrophic alterations.
Perform strictly cutaneous or mucosal incisions (with a No. 11 blade)
The incision is penetrated using hemostat or sinus forceps in closed position, advanced into the pus locules, by blunt dissection in open position of the sinus forceps.
The hemostat is withdrawn in the same position in open state to avoid damage to anatomical structures such as nerves, vessels.
Choice of appropriate drainage material is according to the site of infection. Avoid using gauze as drainage material,since secretions would be retained and coagulate, thereby creating a tamponade that would cause the infection to persist.

“Symptoms Of Infection After Dental Surgery”

Treatment Of Infection In Dental Surgery

Excision of sinus:

In most of the cases, the abscess escapes the tissue spaces spontaneously, through a sinus if left without any treatment for sufficient period of time.
Pus discharge through the skin in a location unfavorable for drainage follows and the resulting scar is always puckered, thickened, and depressed.
Further, the sinus will become chronic unless the original source of infection is removed, and it is subjected to exacerbations and remissions with attempts at healing during the quiescent phase.
To treat this sinus, an elliptical incision is made around its external orifie so that on closure the scar lies in Langer’s line without puckering.
This is done with scissors, using which the sinus tract is followed to its source which is usually found on the bony surface of the jaws.
Then a deep soluble suture is inserted to eliminate the dead space and the skin wounds are closed with careful eversion of the edges.

“Can Antibiotics Prevent Dental Surgery Infections”

Antibiotic therapy:

Since dental infections are caused by aerobic and anaerobic bacteria following antibiotics are given:

Amoxycillin with clavulanic acid 2 g one hour prior to surgery followed by 2 g every 12 hours for 5 to 7 days.
As an alternative regime clindamycin 300 mg every 6 hourly for 5–7 days can be given.
When the patient fails to respond to empirical antibiotic therapy and after treatment of the causes within 48 hours.
When the infection is disseminated to other fascial spaces despite initial treatment.
In an immunosuppressed patient, or ifhe/she has prior history of bacterial endocarditis and does not respond to the initial antibiotic.

“The Role Of Antibiotics In Preventing Dental Surgery Infections”

Supportive therapy:

Apart from antibiotic therapy, patients with dental infection may require complementary measures, particularly in severe cases with considerable systemic involvement or in life-threatening situations.
Analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs) and nutritional support are mandatory.
Patients with infection and fever present considerable loss of body fluids—250 mL for every degree (centigrade) temperature rise.
Ambulatory patients must drink 8–10 glasses of water or any other liquid.
Intravenous flids can be given to those patients who are hospitalized to improve hydration.
The daily calorie requirement also increases by 13% for each degree (centigrade) above normal body temperature.
Thermal agents should be used to aid the body defenses.
Heat produces vasodilatation and increased circulation, more rapid removal of tissue breakdown products, and greater influx of defensive cells and antibodies.
A crucial aspect to be considered in these patients is the potential risk onset of respiratory impairment,requiring airway monitoring, perhaps even on an emergency basis, by means of endotracheal intubation, cricothyrotomy or tracheotomy.

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