Infection Management

The most common cause of infection in the lower half of the face is a tooth abscess {odontogenic infection}. The unique combination of a background in Dentistry as well as extensive training in the surgical arts and medicine qualifies our Oral and Maxillofacial surgeon to properly diagnose and treat often extensive life-threatening infections of the head and neck area. Because of the close working relationship with all medical specialties required for management of complex patients, our doctor can manage patients with severe infections requiring hospitalization, extensive surgical management and coordinated care.

Our doctor is often called upon to assist other dentists and physicians in the management of difficult infections which do not initially respond to treatment. This situation may require an office procedure to establish drainage of an abscess, removal of cysts and other pathology causing an infection, coordination of antibiotic therapy to best treat the infection, and perhaps removal of the tooth if deemed not able to be repaired. It is usually not necessary or advisable to wait until all infection disappears before teeth can be removed or treated. Severe infections may not resolve until the cause is removed.

APICOECTOMY

During the process of a root canal, strongly irritating agents must be used inside the tooth to sterilize the nerve cavity before filling. Often these substances and debris leak out the opening at the end of the tooth into the adjacent bone. This can result in inflamation and occasional abscess formation which is difficult to resolve. Because of inflamation, cysts can form around the root of the tooth which will continue to expand, eventually becoming infected. A procedure called Apicoectomy is often recommended in such situations. During this surgery, which can usually be accomplished under local anesthesia and nitrous oxide analgesia, surgical access is made through the gum over the end of the root of the tooth and the contents of the abscess cavity or cyst are thoroughly removed. Often a portion of the apex or end of the tooth must be removed to completely remove all the soft tissues. The end of the tooth and root canal filling are then heat sealed using a warmed instrument. In situations where there is inadequate filling material to seal the end of the root canal, a retro-fill of the canal may be necessary. This involves placement of a filling material in the end of the root canal from the surgical access.