Dentoalveolar Infections

Healthy teeth should not hurt. If your child has been complaining of tooth pain or sensitivity, he or she may have a cavity or a dentoalveolar (relating to the teeth) infection. A dentoalveolar infection is an infection in or around your child’s tooth/teeth.

Here is some basic information about dentoalveolar infections:

• A dentoalveolar infection starts when bacteria enter a tooth through a cavity or fracture in the tooth.
• An infection can also be caused by an impacted tooth, which is a tooth that does not fully emerge through the gums.
• If your child has a toothache, tooth sensitivity to hot or cold, or mouth swelling, you should take him or her to the dentist.
• A dentoalveolar infection is typically easy to treat if diagnosed early. However, if left untreated, the infection can spread to other areas of the body and may result in a life-threatening situation.
• A dentoalveolar infection is typically treated with antibiotics. In more severe cases or repeat infections, the affected tooth may need to be removed.

No. If your child has a dentoalveolar infection, he or she will need treatment. For most dentoalveolar infections, treatment involves an attempt to save your child’s tooth by the dentist. If that is not possible, the tooth may need to be removed. Antibiotics may need to be prescribed at the same time to treat the infection.

If caught early, most dentoalveolar infections can be treated by antibiotics or by tooth extraction. If left untreated, however, the infection can spread to other parts of your child’s mouth and even get into the blood, causing a serious condition called “sepsis.”

If your child has any of the following symptoms, you should take him or her to the dentist or pediatrician: 

• Toothache
• Fever
• Cheek swelling
• Tooth sensitivity to hot, cold, or pressure
• Swollen lymph nodes
• Redness or swelling of the gums next to a tooth

If your child has an abscess that ruptures, bad-tasting fluid (pus) may rush into his or her mouth. Even after the abscess ruptures and the pain goes away, the source of the infection still needs to be treated.

It starts when bacteria enter a tooth through an untreated cavity or a chip in the enamel. It can also be caused when food is trapped in the soft tissue surrounding a tooth.

We believe that the first step in treating your child’s dentoalveolar infection is forming an accurate and complete diagnosis.

When you bring your child in for an evaluation, we will perform a thorough examination of the affected tooth and the surrounding area to look for swelling and signs of infection.

• X-rays help identify the abscess or impacted tooth.
• A blood test may be needed to look for signs of infection.

How your child is treated depends on cause of infection and how quickly it progresses.

Infection caused by an cavity or fracture in the tooth

• The first step in treating a dentoalveolar infection is to drain the infection. This can sometimes be done through a root canal — a procedure that removes infected nerve from inside the tooth.
• A root canal can sometimes save the affected tooth; other times it will need to be taken out.
• After the tooth has been drained or taken out, we will most likely prescribe a course of antibiotics to ensure that the bacteria that caused the infection have not spread to other areas in your child's mouth.
• If your child's infection is severe, he or she may need to stay in the hospital for a few days to receive Intravenous antibiotics.

Infection caused by an impacted tooth

Impacted teeth can be partly covered by gum tissue. Once food and bacteria enter the space between the tooth and gum tissue, an infection forms.

Antibiotics will take care of the infection, but the tooth ultimately has to be removed. The surgeon will make an incision of the gum covering the tooth, remove a small portion of the bone, and remove the tooth. Sutures (stitches) will hold the gum together once the tooth has been removed.

The best way to prevent a dentoalveolar infection is to take care of your child's teeth and encourage good dental hygiene. If you know your child has an impacted tooth, an evaluation by an orthodontist may be necessary.

Preventing tooth decay and cavities involves five simple steps:

• Brush your child's teeth and tongue twice a day with a fluoridated toothpaste, or supervise them brushing their teeth.
• Floss your child's teeth daily after the age of 2.
• Make sure your child eats a well-balanced diet and limit sugary snacks.
• Consult your child's physician or dentist about the supplemental use of fluoride and/or dental sealants.
• Schedule routine dental cleanings and examinations for your child ‘s teeth every six months.

The American Academy of Pediatric Dentistry recommends the following to ensure your child eats correctly to maintain a healthy body and teeth:

• Ask your child's pediatric dentist to help you assess your child's diet.
• Shop smart. Don't routinely stock your pantry with sugary or starchy snacks.
• Buy fun foods just for special times.
• Limit the number of snacks and choose nutritious snacks.
• Provide a balanced diet, and save foods with sugar or starch for mealtimes.
• Do not put your young child to bed with a bottle of milk, formula, or juice.
• If your child chews gum or sips soda, choose those without sugar.

Most dentoalveolar infections are treated with antibiotics and cleaning out or removal of the affected tooth or teeth. However, if the infection spreads, it can be much more difficult to treat and could even require surgery and hospitalization. Be sure to bring your child to the dentist or pediatrician at the first sign of an infection.

Your child’s specific treatment depends upon his or her symptoms and condition. Treatment can include everything from a simple prescription for antibiotics to extraction of a tooth.

The surgeons in our Department of Oral and Maxillofacial Surgery have performed countless tooth extractions, including removal of impacted wisdom teeth. They will assess your child's unique situation and develop a treatment plan.

• Patient education: From the very first visit, our nurses will be on hand to walk you through your child's treatment and help answer any questions you may have.

The following websites provide additional information about oral health care and hygiene. The sites also include information and educational activities for kids.

• American Academy of Pediatric Dentistry
• American Dental Association
• Massachusetts Dental Society