Hello Hermina Friends, In August last year, social media X and Tiktok were shocked by a viral post about a patient who died due to a tooth infection after undergoing intensive treatment in the ICU for 28 days. According to the @TrinityTraveler account, initially the uploader's friend (patient) complained of pain in a cavity, then swelling appeared on the cheek which extended to the neck and chest. The patient was then diagnosed with Descending Necrotizing Medistinitis (DNM). What is the medical explanation for this disease? the following is the discussion.
Dental infection or commonly referred to as odontogenic infection is an infection caused by bacteria which causes the formation of pus pockets (abscesses) around the teeth. Odontogenic infections most often occur due to cavities, periodontal disease (disease of the gums and bone supporting teeth), and teeth that grow crookedly (impacted). In cavities, bacteria can enter under the root of the tooth and colonize, causing the formation of an abscess. Abscesses that are initially small can slowly enlarge and cause swelling of the cheek and neck. Apart from that, abscesses can also spread down into the chest cavity and cause Descending Necrotizing Mediastinitis (DNM).
DNM is a very aggressive and life-threatening infection. In DNM, there is massive inflammation and tissue decay in the chest cavity (mediastinum), where this area is close to various vital organs of the body such as the heart, lungs, large blood vessels and nerves. The death rate due to DNM can be said to be quite high, namely around 40 percent of all cases. Apart from dental infections, DNM can also occur due to infections in the throat area, sinusitis and infections of the cervical spine. Some of the symptoms of DNM include sore throat, difficulty swallowing, shortness of breath, hoarseness, fever and swelling and redness of the cheeks, neck and chest. DNM treatment is usually carried out through surgery by cleaning the pus that has collected from the oral cavity, neck and chest cavity. Apart from that, tooth extraction is usually carried out to remove the source of infection. Patients with DNM are also usually treated in the ICU because the surgical procedures performed are very massive and require intensive monitoring.
Because DNM is a serious disease and can result in death, it is important for us to be more aware of this disease. One way to prevent DNM caused by odontogenic infections is to regularly maintain oral hygiene. The following are tips for maintaining oral hygiene to avoid DNM:
1. Brush your teeth regularly, at least twice a day, morning and evening
2. Regularly check your teeth and mouth at the nearest dentist, at least once every 6 months
3. If you have cavities, grow crookedly or loosely, immediately consult a dentist for filling, scaling or tooth extraction.
4. If there are signs of odontogenic infection such as swelling of the cheeks, especially causing shortness of breath, difficulty swallowing and fever, immediately consult a dentist who specializes in oral and maxillofacial surgery at the nearest hospital.
That is a brief explanation of dental infections that can cause DNM. Dental infections, which are often underestimated, can actually cause serious complications and even death. So, from now on, let's check the condition of our teeth and mouth regularly at the Dentist, so that our teeth and mouth are healthy and avoid complications from more serious diseases.
Drg. Arbi Wijaya, Sp.BMM
Oral and Maxillofacial Surgeon Specialist at Hermina Mekarsari Hospital
Teaching Staff at the Department of Oral and Maxillofacial Surgery, FKG UI