Orofacial infections of odontogenic origin.

Purulent infections of the orofacial region are often of odontogenic origin. The clinical manifestations are largely dependent on the complex microbiota and the anatomical routes of spread. Serious complications may ensue, especially if hematogenous spread occurs. Direct invasion of different anatomical spaces may cause mediastinitis, airway obstruction and intracranial spread. Proper surgical treatment is mandatory to evacuate pus as soon as abscess formation is recognized. Anaerobic bacteria belonging to the normal oropharyngeal flora are usually isolated from these abscesses. The drug of choice for antimicrobial therapy is penicillin. However, antimicrobial treatment may have to be altered due to emergence of antimicrobial-resistant anaerobic bacteria.