Abstract

IDENTIFICATION OF BACTERIAL AETIOLOGIES AND ASSESSMENT OF FACTORS ASSOCIATED WITH DENTO ALVEOLAR ABSCESSES OF INCREASED SEVERITY: A STUDY DONE IN PATIENTS ATTENDING SELECTED DENTAL UNITS, SRI LANKA

Melanie Naamal Jayawardena, Jananie Kottahachchi*, Pintherumahawaduge Dilan Chaminda Fernando, Thushari Dissanayaka, Dushyanthie Athukorala, Anthoni Baduge Madura Jagath Nalaka, Panthiarachilage Chethani Udeshika Samaraweera, Chandima Pathirana Weerasinghe, Mahesh Priyadarshana Kumbukage, Neluka Fernando

Abstract

Introduction - Acute dentoalveolar abscesses cause significant morbidity, financial impact and loss of income. Knowledge of the aetiology, susceptibility patterns and associated factors would help in effectively managing patients. Objectives - To identify the bacterial aetiologies and the antibiotic sensitivity patterns of the aerobic bacteria at selected dental units in Sri Lanka, and to assess the risk factors for dentoalveolar abscesses of increased severity and determine the relationship between pathogen and the clinical severity of illness. Materials and Methods - A descriptive cross sectional study was undertaken among thirty patients presenting to selected dental units, with acute dentoalveolar abscesses. An interviewer administered questionnaire was used to assess the associated factors. An aspirated sample was processed to isolate the aerobic and anaerobic bacteria.Antimicrobial susceptibility was performed for the aerobes. Results – Viridans streptococci were the most isolated facultative anaerobe, while Porphyromonas species was the commonest strict anaerobe isolated. These organisms were sensitive to amoxicillin and clindamycin. Multiple risk factors associated with acute dentoalveolar abscesses of increased severity include male sex, educational level, frequency of changing the toothbrush, time spent brushing teeth, technique of cleaning teeth, frequency of performing mouth rinsing, use of tobacco and consuming snacks high in refined sugars. No statistically significant relationship could be demonstrated between pathogen and clinical severity of illness. Conclusions - Polymicrobial etiology was demonstrated, with the majority being anaerobes. The aerobes were mostly sensitive to the commonly used antibiotic. Multiple modifiable and non-modifiable factors were associated with dentoalveolar abscesses of increased severity.

Keywords: dentoalveolar abscess, anaerobic bacteria, antimicrobial agents.