Manifestations depend on the nature of the course of the disease. Each form has its own characteristics.
Acute odontogenic jaw osteomyelitis appears suddenly. The patient complains of a toothache that may radiate to the ear, temple and eye area. The gingival mucosa swells, nearby teeth near the infected become mobile.
Other symptoms of jaw osteomyelitis:
- weakness and malaise;
- an increase in body temperature to febrile values;
- sleep disturbance;
- loss of appetite.
As the infection process develops, purulent contents are separated from the affected area, and a bad smell comes from the mouth. Puffiness and hyperemia of soft tissues are expressed.
When the inflammatory process spreads to the soft tissues, more severe osteomyelitic manifestations occur in the form of limited mouth opening, problems with chewing and swallowing food, and also in the form of shortness of breath.
If therapeutic measures are absent, then the disease passes into the subacute stage. It is characterized by the formation of fistulas and areas of necrosis. When opening abscesses, the patient’s condition improves, but inflammation only intensifies. Further, chronic odontogenic osteomyelitis develops. This is the most dangerous form of the disease.
Chronic osteomyelitis of the lower jaw is manifested by a violation of the sensitivity of the lower lip and chin skin. Symptoms of intoxication and lymphadenitis appear.
Chronic odontogenic osteomyelitis is accompanied by the formation of fistulas, small and large multiple sequestrations.
The most dangerous disease for babies, so self-medication is unacceptable.
Osteomyelitis in children can appear against the background of acute respiratory viral infections. The symptomatology of the disease is pronounced, the signs quickly increase. Body temperature can rise up to 40 ° C.
Which doctor treats jaw osteomyelitis?
For treatment, you need to consult a dentist.
To make the correct diagnosis, differential diagnosis is needed. Acute osteomyelitis is differentiated with purulent periostitis, acute periodontitis and jaw cysts. Also, the disease should be differentiated with specific pathologies, namely with tuberculosis, syphilis, actinomycosis and tumors.
The diagnosis is made after examination of the patient and a comprehensive examination. The patient must undergo a general blood test, sometimes it is necessary to sow the contents of the discharge from the lesion focus.
Diagnosis is carried out by a dentist or traumatologist based on patient complaints. Jaw MRI or radiography.
The treatment of jaw osteomyelitis is complex. It includes:
- drug therapy;
- surgical intervention.
If inflammation is limited and the disease lasts less than 3 months, surgical procedures can be dispensed with. The acute stage is treated in a hospital.
Initially, all the foci of the purulent-infectious process are processed: the infected tooth is removed, abscesses are opened, sequestra and fistulas are removed, the cavity is sanitized, wounds are treated.
Moving teeth are fixed with braces. If there is a risk of jaw fracture, a splint is applied.
With a fracture of the jaw, bone fragments and teeth are necessarily removed.
After surgery, drug therapy is prescribed:
- antibacterial drugs – Ceftriaxone, Amikacin, Ofloxacin;
- detoxifying agents – physiological saline, glucose, hemodesis;
- anti-inflammatory drugs – Ketorol, Ibuprofen;
- painkillers – Drotaverin, No-Shpa.
Antifungal drugs, such as nystatin, may be prescribed.
To purify the blood, hemosorption or plasmapheresis is used. Physiotherapeutic procedures are effective – magnetotherapy and ultrasound.
Antioxidants and immunostimulants are prescribed to strengthen immunity.
Complications can occur in acute and chronic osteomyelitis. The most severe of them:
- phlegmon, abscesses, adenophlegmon;
- sinusitis or purulent sinusitis;
- phlegmon of the eye socket;
- thrombophlebitis or thrombosis of large vessels of the face;
- brain abscess;
Even the liver and spleen may suffer.
A common consequence of chronic odontogenic osteomyelitis is a fracture of the jaw.
The best preventive measure is the timely treatment of foci of infection, it does not matter caries, tonsillitis or even pyelonephritis. All damaged areas must be treated with an antiseptic.
It is also important to observe the rules of personal hygiene – brush your teeth in the morning and in the evening, wash your hands, treat the umbilical wound in a newborn. It is necessary to strengthen the immune system, temper and lead a healthy lifestyle. With an increase in the body’s defenses, the risk of infectious and viral diseases is reduced.
With timely diagnosis, the disease is well treatable. Otherwise, the infection enters the bloodstream, causing the appearance of purulent foci in the internal organs.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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