HISTORY
History of studying the influence of chronic dental infection on general health has more than 100 years. In 1911 the English physician William Hunter reported a recovery of patients with systemic diseases after removal of pulpless teeth. He accused such doctors, who preserved such teeth, of contributing to the development of rheumatism. The report of William Hunter laid grounds for extraction of pulpless teeth, because at that time there were no methods of eliminating infection from root canals and airtight three-dimensional obturation.
Essence. The problem of impact of dental infection on the health status focuses on the role of bacteremia resulting from oral pathogens migrating into the bloodstream and causing a systemic disease. Continuous migration of microorganisms to the blood is called bacteremia. Bacteremia is dangerous for those patients who have joint prostheses, transplanted organs, coronary bypass and prosthetic heart valves. Bacteremia can cause such diseases as infective endocarditis, uveitis, iridocyclitis, rheumatoid arthritis, endocarditis. Bacte-remia may significantly worsen the prognosis of surgical intervention on other organs and tissues.
The main sources of bacteremia in dentistry are as follows
1. Teeth with periapical lesions (with untreated root canals or poor end-odontic treatment) draining through a fistula.
2. Inflamed periodontal tissues draining through periodontal pockets.
3. Teeth with endodontal-periodontal lesions in which the lesion is drained through the periodontal pocket and/or through the fistula.
CLINICAL MANIFESTATIONS
Generally, the patient presents no specific complaints, but there may be complaints of fatigue, weakness. In general, a complete blood count may show a slight increase in erythrocyte sedimentation rate and leukocytosis. No complaints related to dental status are presented, because the chronic inflammatory process in the periodontal or periapical area drains through the fistulas or periodontal pocket. A so-called dynamic equilibrium in which the immune defense cannot completely suppress the source of dental infection is achieved, and an exacerbation of the process develops. No self-treatment of foci of infection in the oral cavity is possible. Pathogens of the oral cavity, constantly spreading in the blood and lymph vessels, can cause the following systemic changes in the body.