Infection in the oral maxillofacial region is a rather common occurrence. In fact, most people will have an oral infection at least once in their life if not more.

A very common infection in the oral and maxillofacial region is an infection related to the wisdom tooth. Many a times the wisdom tooth is impacted or not able to erupt properly into space and is “stuck” in an abnormal position. The primary reason for this is lack of space and as the last tooth to erupt, it is very prone to being crowded out. An impacted wisdom tooth or any other tooth for that matter predisposes to a possible food trap and difficulty in cleaning.

This in turn leads to bacteria accumulation and the “twin terror” of most dental problems. They are caries and gum inflammation leading to gum disease. When food debris gets trapped around an impacted tooth and bacteria thrives, the gums in the region gets inflamed and swollen. This leads to pain and possible infection of the gums with accumulation of pus in severe cases.

In extreme cases, the swelling can extend to the face and neck region which can be life threatening. Trismus or inability to open wide beyond one and a half to two fingers is another common sequelae due to involvement of the muscles of mastication.

In cases of infection, the removal of the source of the infection is the primary mode of treatment and in infection involving wisdom teeth, the removal of the offending tooth is necessary. The surrounding infection needs to be cleared too and this procedure is termed “incision and drainage”. In this procedure, the abscess is explored and pockets of infection relieved with copious irrigation using saline and/or chlorhexidine. Some surgeons also use hydrogen peroxide to irrigate the area. The idea of drainage is to reduce the bacteria load to a count of ten to the power of four and below so that the antibiotics given thereafter and the body immune system can overcome the offending bacteria.

Antibiotics are given for a period of five to seven days to eliminate the infection. The above mentioned procedures can be done under local or general anaesthesia depending on the severity of the infection and the surgeon’s clinical acumen.