The role of odontogenic infection in the onset and evolution of focal disease

Abstract

Introduction. The focal disease is a pathological condition characterized by a wide variety of functional disorders and organic tissue alterations, due to chronic foci of infection, from which various microbes, microbial toxins, and toxic products of septic tissue disintegration originate. According to the percentage distribution, 90% of the foci of the body are located in the cephalic region, and 10% in the rest of the body [17]. Research has shown that on the list of foci of infection, those in the oral cavity are in first place, with 93% of active foci being caused by teeth and their pathologies. Important clinical criteria that mark this fundamental difference of the odonto-periodontal focal infection include the profile of local inflammation, the level of the tissue hypersensitivity process, the level of the microbial load in the focus and, no less importantly, the reactivity of the body. Material and methods. The present study is a retrospective clinical observational study and included 87 patients with foci of odontogenic infection, classified according to the frequency of pathologies encountered and the virulence of microbial pathogens as follows: with periodontal disease - 35 patients (gingivitis - 11 patients and 24 patients with different stages of periodontitis); with endodontic pathologies - 27 patients (pulpitis - 5 patients and periapical lesions - periodontitis (Pt) - 22 patients); with dental caries of varying severity - 19 patients, and 6 patients with oral mucosa pathologies. Results. Through clinical observations, it was found that with the removal of the foci of infection, the “vegetative alarm symptoms” begin to disappear, some of them even very quickly, such as causeless fatigue. At the same time, symptoms that have been present for a longer period, such as long-term depressive states and memory disorders in patients with periodontal disease–particularly severe periodontitis with a major microbial load–and lesions of the oral mucosa, decreased more slowly, over a period of 1-3 months. The 100% disappearance of symptoms in the case of carious lesions and oral mucosa lesions demonstrates the direct relationship between the foci of infection and the patient’s general health. In relation to periodontal disease and periapical lesions (over 90% of symptoms have subsided), the remaining clinical signs are related to the increased bacterial load and the virulence of the pathogens. Conclusions. The identification, evaluation, and elimination of foci of odontogenic infection play an important role in aggravating already existing systemic conditions, thus triggering focal disease. The role of the dentist in the prophylaxis of focal disease is primary in the detection and elimination of foci of odontogenic infection. In the prophylaxis of focal disease, doctor-patient cooperation is very important, and no less important is collaboration with general medicine specialists.