Brain abscess and dentistry: a review of the literature

Brain abscess is a rare, extremely aggressive, life-threatening infection. A mortality rate of between 36% and 90% has been reported as recently as 1990. It is resistant to antibiotics and is one of the few bacterial infections whose morbidity and mortality statistics remain unaffected by the development of antimicrobial medications. Successful treatment appears to be dependent on early diagnosis, surgical intervention, and direct antibiotic irrigation of the surgical wound site, as well as intravenous administration of high doses of antibiotics throughout the crisis. It has been suggested that there is a relationship between dental infection or treatment and brain abscess. Dental infection and treatment have been found culpable in numerous cases reported in the literature. However, careful review of the articles reveals that dental infection or treatment has often been named as a causative factor (1) solely because an infection or treatment occurred within several months of brain abscess; (2) when nondental bacteria were cultured from the brain abscess; and (3) without culturing both the dental infection and the brain abscess to ascertain flora match.