Osteomyelitis
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Osteomyelitis is the inflammation of the Bone Marrow of the jaws caused by an infecting organism.
Causes
- Infection
- Trauma
- Radiation injury
- Poor oral hygiene etc.
Signs and symptoms
- Throbbing, deep-seated pain
- Swelling due to inflammation
- Purulent discharge
- Irritability
- Trimus(difficulty opening the mouth)
- Pathological fracture
Differential diagnosis
- Fibrous dysplasia
- Peripheral Osteoma
Complications
- Cellulitis
- Septicaemia
Investigations
- Blood test
- Biopsy
- X-ray
- MRI and CT Scan
Treatment objectives
- Relieve pain
- Treat infection and other underlying causes
- Restore the facial profile
Non-pharmacological treatment
- Lifestyle changes e.g smoking cessation to improve blood circulation.
- Replace infected prosthetic part, if needed.
Pharmacological treatment
Amoxicillin oral:
Adult:
500mg every 8 hours for 7 days
Child:
6-12 years: 250mg every 8 hours for 7 days
1-5 years 125mg every 8 hours for 7 days,
<1 year: 62.5mg every 8 hours for 7days
AND
Metronidazole oral
Adult:
400mg every 8 hours for 7 days
Child:
100-200mg every 8 hours for 7days
Alleviate pain
Paracetamol oral
Adult:
500mg-1g every 6-8hours
Child:
6-12 years: 250-500mg every 6-8 hours
1-5 years: 120-250mg every 6-8 hours,
3months-1 year: 60-120mg every 6-8 hours when required
OR
Ibuprofen oral
Adult:
200-400mg every 8 hours
Child:
100-200mg every 8 hours
- Treat any underlying conditions
Referral
- Refer to dental surgeon for;
- Excision and Draining of pus or fluid that has built up in response to the infection around the infected bone.
- Debridement: removal of as much diseased bone as possible, including any surrounding tissue with signs of infection may also need removing.
Prevention
- Regular dental assessment and care.