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Jaw Infection - Causes, Symptoms and Treatment

Published on Apr 18, 2022 and last reviewed on Sep 27, 2022   -  6 min read

Abstract

Jaw infections involve infection and inflammation of the upper and lower jaws (maxilla and mandible) resulting from untreated dental and periodontal conditions.

Contents

Overview:

It is surprising how tiny microorganisms cause the destruction of mighty structures in the body. Moreover, infections frequently occur despite immense efforts from the body’s immune system. For example, invading structures like muscles and bones is a cakewalk for the microbes when they can destroy the tooth’s enamel (the strongest tissue in the body that forms the tooth's outer covering). Likewise, the jawbones (maxilla and mandible) are prone to microbial invasion as they have an intimate relationship with the oral microflora.

What Are Jaw Infections?

Infections of the jawbones occur indirectly through the spread of infections from teeth, gums, and other oral structures. Untreated dental caries and gum disease (gingivitis and periodontitis) progress to infect the surrounding oral structures. The prevalence of jaw infections is slightly high in developing countries with low socioeconomic status, owing to poor healthcare and inadequate oral hygiene. When the infection reaches the jawbones, immediate medical attention and a multidisciplinary treatment approach are required. Conditions that are likely to cause jaw infections are discussed below.

What Causes Jaw Infections?

Causes of Jaw Infections

A. Gum Disease:

Periodontitis manifests as a result of chronic inflammation of the gums (gingivitis). This often results in the destruction and loss of the jawbones. In addition, periodontitis is associated with multiple factors such as the type of microbes, the body’s immune mechanisms, environmental factors, personal habits, oral hygiene, etc.

Progression of Gum Disease -

1. Plaque build-up around the tooth and gums.

2. Inflammation of the gums due to the toxins produced by microbes.

3. Spread of infection and inflammation and damage to surrounding structures.

4. Continued infection destroys bone and loosens teeth.

5. Advanced periodontitis leads to abscess formation and jaw infection.

Microorganisms Associated With Periodontitis -

Periodontitis is caused by:

B. Endodontic and Periapical Diseases:

Dental caries is one of the most common oral diseases that are globally prevalent. Microorganisms reach the pulp (mass of tissue present in the innermost part of the tooth) through a fracture, caries, and exposed tooth surface (endodontic infection). Through the pulp, the microbes reach tissues around the tip of the tooth root (periapical infection). If left untreated, these infections progress to cause abscess and bone destruction.

Progression of Endodontic Diseases -

1. Irritants enter the tooth through caries, fractures, or exposed surfaces.

2. Destruction of enamel and dentin (yellow-colored tissue that forms the bulk of the teeth).

3. Inflammation of the pulp.

4. Spread of infection to periapical tissues.

5. Abscess in the dentoalveolar (related to teeth, gums, and jawbone) region.

6. Jaw infection.

Microorganisms Associated With Endodontic and Periapical Infection -

C. Dental Implant Infection:

Implants have gained popularity in the last decade because of their high success rate and esthetics. However, implants can fail due to poor oral hygiene and smoking habits. This pathology is called peri-implantitis, where the tissues around the dental implant get inflamed. Ideally, the implant surface should integrate with the surrounding jaw bone (osseointegration). When this fails, microorganisms have a higher chance of causing infection.

Progression of Peri-Implantitis -

1. Failure of osseointegration due to poor oral hygiene, systemic conditions, habits, etc.

2. Microbes infect the tissues surrounding the implant.

3. Inflammation of the tissues around the dental implant (peri-implant mucositis).

4. Spread of infection leading to bone loss and jaw infection.

Microorganisms Associated With Peri-Implantitis -

D. Osteomyelitis:

Osteomyelitis is the infection of jawbones that can be acute or chronic. These infections are common in developing countries with poor socioeconomic status. Osteomyelitis can affect a single site or spread to the bone marrow and surrounding soft tissues. Additionally, people with immunocompromised conditions such as diabetes and HIV (human immunodeficiency virus) are prone to the infection. Most osteomyelitis infection develops as a sequel to dental and periodontal diseases.

Occurrence of Jaw Osteomyelitis -

1. Spread of infection from dental or periodontal infection.

2. Direct inoculation of microbes into the bone (rare case).

3. Infection post-surgery or post-trauma.

Microbes Associated With Osteomyelitis of the Jaw Bone -

What Are the Signs and Symptoms of Jaw Infections?

A. Periodontal Disease:

B. Endodontic and Periapical Disease:

C. Peri-Implantitis:

D. Osteomyelitis:

What Is the Treatment for Jaw Infections?

A. Periodontal Disease:

B. Endodontic and Periapical Disease:

C. Peri-Implantitis:

D. Osteomyelitis:

Conclusion:

Jaw infections involve infection and inflammation of the upper and lower jaws (maxilla and mandible) resulting from untreated dental and periodontal conditions. Many factors contribute to jaw infections, including oral hygiene, systemic factors, oral environmental factors, etc. Dental infections like periodontitis and peri-implantitis progress to infect the jawbones. Antibiotic therapy and debridement of the infected tissues are the primary treatment modalities. Jaw infections can be prevented by maintaining good oral health and visiting the dentist frequently.

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Frequently Asked Questions


1.

What Is the Best Way to Relieve Jaw Pain Caused by a Sinus Infection?

Jaw pain can be reduced in the following ways:
- Applying heat or cold packs - Applying heat or cold to the affected area reduces pain and inflammation. For example, a moist hot towel or ice pack can be wrapped and applied for 5 to 10 minutes.
- Diet - Eating a soft diet and avoiding hard, spicy, and sticky food can help relieve jaw pain.
- Medications - Over-the-counter medications such as Ibuprofen (painkillers) and antibiotics can help reduce pain and inflammation.
- Hydration - Drinking water relieves sinus congestion by thinning down mucus and reducing the pressure inside the sinus.
Steam - Hot and moist air open the nasal passages and relieves sinus congestion. Hot drinks and soups can also help.
- Sinus flush and nasal sprays - Saline rinse and nasal sprays moisturize the sinuses and clear the allergens.

2.

How Can Jaw Swellings Due to Tooth Infection Be Reduced?

Jaw swelling can occur due to injections, injuries, etc. Inflammation of tissue causes accumulation of fluid within the tissue planes resulting in swelling and pain. Identification of the cause of infection is necessary before initiating the treatment. Jaw swelling due to tooth infection can be reduced by:
- Taking a course on the appropriate antibiotics which helps in treating the infection.
- Using ice packs on the swollen area for 20 minutes can reduce the inflammation.
- Eating a soft diet and staying hydrated can be helpful.
- Removing infection from the affected tooth with a root canal treatment (RCT) or tooth extraction.
Draining the abscess (collection of pus) by making a small incision followed by saline irrigation is helpful.

3.

What Is the Treatment for Jaw Infections?

Treatment of jaw infection depends on the underlying cause. After identifying the underlying pathology, appropriate treatment can be started. The causes and their treatment include:
1. Gum disease - Surgical draining of the abscess, gum surgery, scaling, root planing, antibiotics, using Chlorhexidine or Betadine mouth rinse.
2. Tooth infection - Removing the infected pulp (root canal treatment), draining the pus, extracting or removing the infected tooth, and antibiotic course.
3. Implant infection - Debridement of the implant surface, decontaminating the implant surface with citric acid or saline, antibiotics therapy, surgical correction.
4. Jaw bone infection - Surgical debridement, surgical resection of the affected jaw, antibiotics and painkillers, and hyperbaric oxygen chamber (providing extra oxygen for tissues infected with anaerobic bacteria).

4.

Why Does Sinus Infection Cause Jaw Pain?

The infection in the sinus (sinusitis) can cause jaw pain as the sinus cavities are present in the upper jaws (maxilla). When sinuses become inflamed, they are likely to cause pain around the posterior teeth of the upper jaw. This is mainly due to the pressure built up in the sinus cavity because of the accumulation of inflammatory fluid. Once this infection starts to spread, pain can be felt in other areas of the jaw (even teeth in the lower jaw).

5.

Which Group of Antibiotics Can Treat Jaw Infections?

Jaw infections can occur due to several conditions of the oral cavity. These conditions are, in turn, caused by different microorganisms. The antibiotics that target the specific microbes associated with oral cavity conditions are:
1. Gum infections or periodontal abscess - Penicillin (might cause severe allergic reactions), Metronidazole, Tetracyclines, Ciprofloxacin, Clindamycin, etc.
2. Tooth infection or dental abscess - Amoxicillin, Penicillin, Cephalexin, Clindamycin, Azithromycin, etc.
3. Jaw bone infection or osteomyelitis - Penicillin, Vancomycin, Ciprofloxacin, Clindamycin, Ampicillin, etc.

6.

How Long Does a Jaw Infection Take to Heal?

The symptoms of jaw infection do not go away immediately after taking the necessary treatment. The healing depends on several factors such as the type of infection, the environment of the affected area, the patient’s systemic conditions, habit history, age, etc. In a healthy individual, improvement in the symptoms can be seen after two to three days. However, it might take seven to 10 days for complete recovery and sometimes even weeks.

7.

What Is the Treatment for Jaw Pain Due to a Bacterial Infection?

The first step in treating jaw pain due to a bacterial infection involves identifying the type of infection. Gingivitis, periodontitis, tooth abscess, implant infection, and jaw bone infection (osteomyelitis) are some of the manifestations. The treatment involves:
1. Gum disease (periodontitis or periodontal abscess) - Draining the abscess surgically, gum surgery, scaling, root planing, antibiotics, Chlorhexidine, or Betadine mouth rinse.
2. Tooth infection - Removing the infected pulp (root canal treatment), draining the pus, extracting or removing the infected tooth, and antibiotic course.
3. Implant infection - Debridement of the implant surface, decontaminating the implant surface with citric acid or saline, antibiotics therapy, surgical correction.
4. Jaw bone infection - Surgical debridement, surgical resection of the affected jaw, antibiotics and painkillers, and hyperbaric oxygen chamber (providing extra oxygen for tissues infected with anaerobic bacteria).

8.

What Happens if a Tooth Infection Spreads to the Jaw?

When the infection from the tooth spreads to the jaws, the patient might experience the following symptoms:
- Severe pain of the affected tooth. The pain can be sharp or dull and throbbing.
- Pain from the tooth radiated to other regions.
- Tooth sensitivity to hot or cold food and drinks.
- Swelling of the affected area.
- Fever and swollen lymph nodes.
- Difficulty in swallowing food or breathing.
- Foul-smelling or foul taste in the mouth.

9.

Can a Jaw Infection Heal on Its Own?

No, jaw infections do not heal on their own. Therefore, it is important to visit your dentist or physician for medical advice. Untreated jaw infections can lead to cellulitis (spread of bacterial infection to the skin), Ludwig's angina (spread of bacterial infection to the floor of the mouth), the spread of infection to other parts of the head, and neck, etc. The condition can become life-threatening if ignored. Your dentist may prescribe the necessary medications (anti-inflammatory and antibiotics) and a proper treatment protocol to control the infection.

10.

What Are the Signs of an Infection Spreading to the Jaws?

The general indications of spreading infection include:
- Severe pain of the affected tooth. The pain can be sharp or dull and throbbing.
- Pain from the tooth radiated to other regions.
- Tooth sensitivity to hot or cold food and drinks.
- Swelling of the affected area.
- Fever and swollen lymph nodes.
- Pus discharge.
- Inability to chew or open and close the mouth.

11.

Is Amoxicillin Effective for Treating a Jaw Infection?

Yes, Amoxicillin is an effective drug for the treatment of jaw infections. It belongs to the Penicillin group of antibiotics and is the most common first-line treatment for jaw infections. If the patient is allergic to Amoxicillin, alternate medications such as Cephalexin and Clindamycin can be used. Amoxicillin also prevents the spread of infection to other parts of the head and neck.

12.

What Are the Symptoms of Osteomyelitis of the Jaw?

The symptoms of osteomyelitis of the jaw include:
- Fever, weakness, malaise, and headache.
- Swelling of the affected site and face.
- Inability to open and close the mouth.
- Pus discharge.
- Severe throbbing and radiating pain.
- Inability to chew food.
- Numbness or prickling sensation around the affected site.

13.

Is the Surgery for an Infected Jaw a Major Procedure?

A surgical procedure associated with jaw infection is not a major procedure per se. It mainly depends on the extent of the involved area and the severity of the infection. The treatment involves hospitalization and surgical debridement of the affected jaw bone under anesthesia. Following the surgery, antibiotics are prescribed to prevent reinfection. Minor endodontic and gum infections can be treated with root canal therapy and gum surgeries. Extensive involvement of the jaw bone requires decortications, resection, and reconstruction of the bone.

14.

What Are the Options for Treating an Infected Jaw After Surgery?

If an infection develops after jaw surgery, the following measures must be taken:
- Apply icepacks over the swelling.
- Eat a soft and healthy diet. Avoid consuming hot and spicy foods.
- Over-the-counter painkillers can help in pain management.
- Visit your doctor for further evaluation of the infected site.
- Your doctor might inspect the area and advise antibiotic treatment.

Last reviewed at:
27 Sep 2022  -  6 min read

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