Treatment of orofacial infections of odontogenic origin

Acute purulent orofacial infections are often of odontogenic origin. The microorganisms and the anatomical site involved, largely determine the clinical manifestations. The infections are usually self-limiting but serious complications may ensue. Direct invasion of different anatomical spaces may cause mediastinitis, airway obstruction and also intracranial spread. Anaerobic bacteria belonging to the normal oropharyngeal flora (anaerobic cocci, bacteroides and fusobacteria) are usually isolated from orofacial abscesses. Surgical treatment including incision and drainage is essential. The drug of choice for antimicrobial therapy is penicillin. Penicillin resistant anaerobic bacteria may however make penicillin ineffective and antimicrobial agents such as metronidazole or clindamycin are then recommended to be used.