[Dental Knowledge] Oral floor cellulitis: Small wounds can cause big problems!
Toothache isn't a disease, but it can be excruciating! Many people consider toothache a minor ailment that they can simply endure. However, if it becomes infected and isn't treated promptly, it can be life-threatening. Today, let's learn about one of the most dangerous "hidden killers" in the oral cavity: oral cellulitis.
What is oral cellulitis?
Oral and maxillofacial infections are most commonly odontogenic, among which oral floor cellulitis is a serious oral infection that primarily occurs in the tissues of the floor of the mouth. It generally refers to simultaneous bacterial infection of the bilateral submandibular, sublingual, and submental spaces, which rapidly spreads to surrounding tissues. Oral floor cellulitis primarily caused by Staphylococcus aureus is called suppurative oral floor cellulitis; while infection primarily caused by anaerobic bacteria is called putrefactive and necrotic oral floor cellulitis. If the infection is not controlled in time, it can spread downwards along the interstitial spaces and neck, potentially leading to multi-space infections of the neck or even mediastinal abscesses.
Causes of oral floor cellulitis
Oral floor cellulitis is mainly caused by infections of the oral cavity and face. Common sources of infection include cavities in the mandibular teeth, periodontal disease, pericoronitis of wisdom teeth, and other infectious lesions. Submandibular gland inflammation, lymphadenitis, and acute tonsillitis can all induce oral floor cellulitis.
Symptoms of oral floor cellulitis
- Purulent oral cellulitis
In the early stages of the disease, swelling and pain are often present in the submandibular or sublingual space on one side, manifesting as swelling and pain in the submandibular region and floor of the mouth on one side. If the inflammation continues to develop, it will spread to the entire floor of the mouth, resulting in diffuse swelling in the submandibular region, floor of the mouth, and neck on both sides.
- Necrotizing oral floor cellulitis
It often manifests as widespread, recurrent edema of the floor of the mouth, with spontaneous, severe pain and a burning sensation throughout the entire floor of the mouth and jaw. The skin in the swollen area also becomes rough, red, and hard, turning purplish-red, and exhibits obvious pitting edema. If pressing a finger on the swollen skin causes an indentation that doesn't immediately disappear after releasing the finger, this is a sign of pitting edema, and should be taken very seriously.
How to prevent oral cellulitis?
Oral floor cellulitis of 80% or higher is initially caused by dental disease, and the best way to prevent it is to treat dental disease as early as possible.
(1) Remove wisdom teeth as early as possible and maintain oral hygiene: preventive wisdom tooth extraction, regular dental cleanings, timely treatment of cavities, and effective daily dental cleaning.
(2) Actively control systemic diseases: A considerable number of patients with oral floor cellulitis have a history of diabetes. Studies have shown that diabetic patients have relatively weak resistance and immunity, and the inflammation lasts for a long time.
(3) Seek medical attention promptly if symptoms appear: If swelling occurs in the submandibular region on one side or infection of the masseter muscle space in the early stage of the disease, it is the right choice to seek medical attention promptly.
How to treat oral floor cellulitis?
Patients typically experience persistent toothache, followed by swelling in the face or jaw area, requiring immediate consultation with a dentist for a thorough diagnosis and advice. Here are some common treatment options:
(1) Use of antibiotics: Doctors will prescribe appropriate doses and courses of oral antibiotics or steroid anti-inflammatory drugs to control the infection. Diabetic patients and elderly patients with chronic diseases are especially advised to be observed and treated in the hospital.
(2) Treatment of dental problems: If the abscess of oral cellulitis is related to the teeth, the doctor will recommend different treatment options depending on the severity of the infection, such as extraction of the related teeth, surgical drainage or aspiration, etc.
Most cases of odontogenic cellulitis are caused by neglecting oral hygiene or by self-medicating due to busy work schedules or financial constraints, leading to a worsening of the infection. Therefore, it's essential to pay attention to your dental health. As the saying goes, "prevention is better than cure," and regular dental cleanings and checkups are undoubtedly the best way to prevent odontogenic infections.
Author: Dr. Eric Chan
