Oral inflammations have a wide variety of forms and intensities; in worst case they can be life threatening. In the second part of his presentation about inflammations in dentistry, Dr. Markus Tröltzsch introduces diagnostics and treatment methods for the therapy of inflammations. First, a thorough anamnesis needs to be taken.
It is the cornerstone of any successful treatment and gives information about the patient’s medical history, his general state of health as well as about local symptoms. Usually, inflammations undergo two stages requiring different therapeutic approaches. In the primary phase a serous infiltrate of interstitial fluid and inflammatory mediators is produced. The serous phase is different from the second, the cellular phase, which is mainly characterized by the formation of pus. Generally, the serous phase of an inflammation can be successfully treated through the sole use of antibiotics.
If pus has developed, a surgical intervention, which includes the incision, drainage and rinsing of the abscess, is indicated. In such a case, a marginal incision, but also a direct incision at the point of maximum swelling can be performed. The former is often less painful, causes less bleeding and results in a superior wound healing with better readaptation.
The direct incision on the other hand allows for a better physical irrigation of the abscess cavity; however it shows healing by second intention and may result in unsightly scars. Usually, adjuvant medication like systemic antibiotics and analgesics as well as cooling and rest may be prescribed and provide a significantly faster pain relief.