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Dangers of a tooth abscess Part 4: Cavernous Sinus Thrombosis

Chicago tooth extractionDental abscesses can lead to a host of complications, ranging from simple inflammation of the oral cavity to fatal systemic infections. If an abscess progresses far enough, Chicago patients may need much more that just a tooth extraction to prevent the bacteria from traveling throughout the body.

These bigger problems can arise when the bacteria found in the abscess of the dental pulp or root have the opportunity to escape the confines of the tooth and jaw bone and spread elsewhere.

Therefore, patients should be aware of the early signs and symptoms of dental abscesses, such as severe tooth pain and bad breath, so that they can visit an oral surgeon in Downtown Chicago for a timely intervention.

In addition to the common localized pain and swelling that accompanies a dental abscess, a more rare complication of a tooth abscess can occur called a cavernous sinus thrombosis (CST).   This is just one example of another serious issue that can arise from a dental abscess.

The cavernous sinuses are cavities located at the base of the skull. A cavernous sinus thrombosis is usually a complication of an infection of the central face, paranasal sinuses, bacteremia, trauma, and infections of the ear or maxillary (upper) teeth. A CST is generally a sudden and severe process with high rates of morbidity and mortality.  Yes, once again, as with Ludwig’s angina and mediastinitis, you can die from a tooth abscess that leads to a CST!

The cavernous sinuses receive blood from a web of veins that contain no valves, therefore blood can flow in any direction depending on the prevailing pressure gradients. Since the cavernous sinuses receive blood via this distribution, infections of the upper teeth and face can spread easily via the facial vein into this complex of veins.  The infection causes an inflammatory thrombotic reaction in the vasculature and cavernous sinus cavities leading to a host of severe symptoms.

Symptoms of the condition include bulging eyes, drooping eyelids, headache, and immobility of the eye, among related problems. Patients with cavernous sinus thrombosis are also likely to develop acute headaches early on.  Signs of sepsis are an indication of severe progression.

Typically, death is due to sepsis or central nervous system infection. With aggressive management, the mortality rate is now less than 30%.  Morbidity, however, remains high, and complete recovery is rare, even with early intervention. Roughly one sixth of patients are left with some degree of visual impairment, and one half have cranial nerve deficits.

Patients who develop cavernous sinus thrombosis face hospital admission and a prolonged regimen of strong IV antibiotics to eradicate the infection. That course of medication may be delivered for several weeks.

In many cases of dental abscesses, a tooth extraction can help patients prevent negative outcomes like a cavernous sinus thrombosis. If a dental abscess is treated early, before the bacteria have a chance to spread to nearby structures, the bacteria can be contained and removed from the mouth.

It’s important to recognize the signals that may indicate a tooth abscess. If you feel that you may have a dental abscess, consult with our oral surgeon serving Chicago IL and the surrounding Chicago-land suburbs to get a confirmed diagnosis and to begin planning for treatment.

 

 

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