Podcast 844: Dental Infections - The Emergency Medical Minute

Podcast 844: Dental Infections

Contributor: Meghan Hurley, MD

Educational Pearls:

Educational Pearls:

  • Dental infections can be categorized into two main groups
    • Infections of the gums
      • Pericoronitis
        • Tooth eruption leading to inflammation/irritation
        • Can progress to an infection
        • Requires pain control, no antibiotics
      • Gingivitis
        • Inflammation of the gums
        • Can lead to an infection requiring antibiotics
      • Abscess (gums)
        • If an infection develops in the gums it can progress to an abscess
        • May require drainage
      • Acute necrotizing ulcerative gingivitis (ANUG) aka Trench Mouth
        • Filmy, grayish discoloration of the gums with “punched out” lesions
        • Extremely painful
        • Can cause teeth to loosen and fall out
        • Treat with IV antibiotics + admission
    • Infections of the teeth
      • Dental caries
        • Causes sensitivity tooth enamel is worn through
        • Can lead to infection
      • Periapical abscess
        • Abscess that extends through the root of the tooth
        • Can develop up elsewhere in tooth/gums/mouth
        • Causes tooth sensitivity when tapped
      • Ludwig angina
        • Infection of the soft tissue under the tongue
        • Can compromise airway as it expands
        • Treat with extensive antibiotics and debridement
  • Antibiotic stewardship
    • Commonly used antibiotics for dental infections
      • Clindamycin
      • Augmentin
      • Amoxicillin
    • Chlorhexidine (Peridex)
      • Antiseptic and disinfectant that is helpful for gingival irritation



Bridwell R, Gottlieb M, Koyfman A, Long B. Diagnosis and management of Ludwig’s angina: An evidence-based review. Am J Emerg Med. Mar 2021;41:1-5. doi:10.1016/j.ajem.2020.12.030 

Dufty J, Gkranias N, Donos N. Necrotising Ulcerative Gingivitis: A Literature Review. Oral Health Prev Dent. 2017;15(4):321-327. doi:10.3290/j.ohpd.a38766

Herrera D, Roldán S, Sanz M. The periodontal abscess: a review. J Clin Periodontol. Jun 2000;27(6):377-86. doi:10.1034/j.1600-051x.2000.027006377.x

Kumar S. Evidence-Based Update on Diagnosis and Management of Gingivitis and Periodontitis. Dent Clin North Am. Jan 2019;63(1):69-81. doi:10.1016/j.cden.2018.08.005

Kwon G, Serra M. Pericoronitis. StatPearls. StatPearls Publishing

Copyright © 2022, StatPearls Publishing LLC.; 2022.


Summarized by Mark O’Brien, MS4 | Edited by John Spartz, MD, & Erik Verzemnieks, MD


The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account. 


Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.


Stay up to date by
joining our mailing list!