Bacterial infection of oral

cavity
Rare
Usually due to commensal pathogen

impaired defense mechanism

pathogenic
Number and type of bacteria are
influenced by amount of periodontal
disease and level of oral hygiene

80% facultative and anaerobic streptococci and

diphtheroids

Streptococcus, Corynebacterium, Veillonella,

Staphylococcus aureus and other staphylococci,
Costobacillus, Leptothrix, Actinomyces,
Bacteroides, Fusobacterium, spirochetes,
Neisseria, Candida, and protozoa

Bacterial infection of oral

cavity
Disease:
Vincent stomatitis, or Vincent angina

(acute necrotizing ulcerative gingivitis,

Trench mouth)
Streptococcal infection
Diphtheria
Syphillis

Syphilis
Etiology: Treponema pallidum
Primary syphilis of the oral mucosa appears as

an erosive ulceration with erythema and raised

margins which is non-tender and indurated.
There is a non-tender, rubbery cervical
lymphadenopathy.
This characteristic lesion has been referred to
as a chancre.
In the oral cavity, the lips are the site of
predilection with the commissures also
exhibiting ulcerations, When appearing on the
outer surfaces of the lips, ulcerations become
crested in contrast to those found within the
oral cavity which remain moist.

Syphilis

Vincents angina
Vincents angina (Plaut-vincent
angina, Vincents stomatitis,
trench mouth, necrotizing
ulcerative gingivitis)
Etiology: Fusiform bacillus, or spirochete

infection
Predisposing factor:

Stress
Poor oral hygiene
Insufficient rest
Nutritional deficiency
Smoking

Vincents angina
Signs and symptoms:
Sudden onset: painful, superficial bleeding, gum

ulcers (rarely, on buccal mucosa), covered with a

gray white membrane
Crater-like ulcers between the teeth
Gums appear reddened and swollen
Grayish film on the gums
Painful gums
Profuse gum bleeding in response to any pressure
or irritation
Ulcers become punched out lesions after slight
pressure or irritation

Malaise, mild fever, excessive salivation, bad

breath, pain on swallowing or talking, enlarged

submaxillary lymph nodes

Vincents angina

Vincents angina
Management:
Removal of devitalized tissue
Antibiotics (penicillin or or erythromycin)
Analgesics as needed
Hourly mouth rinses
Soft, non irritating diet; rest; no smoking
With treatment, improvement within 24

hours

Streptococcal Infection
SCARLET FEVER
Etiology: Streptococcus
Rash is the most striking sign of scarlet fever.

It usually begins looking like a bad sunburn with tiny bumps

and it may itch. The rash usually appears first on the neck and
face, often leaving a clear unaffected area around the mouth.
It spreads to the chest and back, then to the rest of the body.
In body creases, especially around the underarms and elbows,
the rash forms classic red streaks. Areas of rash usually turn
white when you press on them. By the sixth day of the
infection the rash usually fades, but the affected skin may
begin to peel.

Reddened sore throat, tonsils and back of the throat

may be covered with a whitish coating, or appear red,

swollen, and dotted with whitish or yellowish specks of
pus(Strep throat).
Fever > 101 Fahrenheit (38.3 C)

Streptococcal Infection
Swollen glands in the neck.
Early in the infection, the tongue may have a

whitish or yellowish coating.

Also may have chills, body aches, nausea,
vomiting, and loss of appetite.
Fever typically stops within 3 to 5 days, and the
sore throat passes soon afterward. Rash usually
fades on the sixth day after sore throat symptoms
began, but skin that was covered by rash may
begin to peel. This peeling may last 10 days.
With antibiotic treatment, the infection itself is
usually cured with a 10-day course of antibiotics,
but it may take a few weeks for tonsils and
swollen glands to return to normal.

Streptococcal Infection

Streptococcal Infection

Streptococcal Infection

Clinical Manifestation

Clinical Manifestation

Conclusions
Recognizing the presence of infection and the

cardinal signs of inflammation alerts the general

dental practitioner to perform the necessary
laboratory procedure to identify the disease process.
Dentists should obtain a thorough medical history in
order to ascertain the patients medical status.
Secondly, a thorough head and neck physical
examination should be performed and all abnormal
findings investigated.
In dentistry bacterial infections can present as
localized inflammatory processes as an abscess, or as
spreading infections such as cellulitis. The latter can
certainly become life threatening wherein septic
embolization can occur during the spread of infection
through varied fascial and cervical tissues spaces.

Conclusions
With the advent of Acquired Immune Deficiency

Syndrome, the oral mucosa has become the site in

the early detection of this disease.
Patients on immunosuppressive drug therapy also
present with various microbial infections of the oral
mucosa.
The dental practitioner should be aware of all signs
and symptoms relating to the presence of infectious
diseases. They must become aware of the
therapeutic modalities employed to treat these
diseases. They should know the ppropriate
laboratory tests required to identify these diseases.
Finally, referral and consultations with our medical
colleagues is essential in many instances specially
when sophisticated modalities of therapy are
required.