Odontogenic Sinusitis

A patient presented to us today with sinus symptoms following dental treatment.
The scan clearly showed a foreign body in the right maxillary sinus.

Odontogenic sinusitis is a well-recognized condition and accounts for approximately 10% to 12% of cases of maxillary sinusitis. An odontogenic source should be considered in individuals with symptoms of maxillary sinusitis with a history of odontogenic infection, dentoalveolar surgery, periodontal surgery, or in those resistant to conventional sinusitis therapy.

 Diagnosis usually requires a thorough dental and clinical evaluation including appropriate radiographs. The most common causes of odontogenic sinusitis include dental abscesses and periodontal disease that had perforated the Schneidarian membrane, irritation and secondary infection caused by intra-antral foreign bodies, and sinus perforations during tooth extraction.

 An odontogenic infection is a polymicrobial aerobic-anaerobic infection, with anaerobes outnumbering the aerobes. The most common isolates include anaerobic streptococci and gram-negative bacilli, and Enterobacteriaceae. 

Surgical and dental treatment of the odontogenic pathological conditions combined with medical therapy is indicated

Dental disease in Northland

Dental infection and secondary neck abscesses are regrettably very common emergency admission for our department. Northland experiences some of the highest dental disease rates in New Zealand. For the last year the hospital dental services are available 24hrs. a day for managing acute abscesses and we are available for extensive neck involvement.

This picture is a case I was involved with. The sad thing is that this is largely a preventable disease. It interested me that this man had never brushed his teeth for as long as he could remember.
When we see patients with other problems we will always discuss and educate them about smoking, but how often do we comment on their teeth and the importance of prevention of dental disease. I appreciate the big factor is cost, but I would encourage all of us to spend time in our consultation to look and advise on the patients teeth. For more reading go to Oral health for all Northlanders