Case study: infected upper molars in a diabetic patient

71 year old male patient reported with severe pain in upper left back tooth region and swelling in the middle 3rd of left side of the face with mild fever since two days.

Examination

• On examination Diabetic for past 10 yrs (under control).
• Root stumps 27 28 and fractured 26 (nonmobile and tender on percussion).
• Left submandibular lymph node enlarged, tender,mobile,firm and palpable.
• Extraoral swelling evident in left middle 3rd of face obliterating the nasolabial fold with warmth and tenderness and intraoral swelling obliterating the vestibular depth confirmed the space infection probably the left buccal space
• RVg confirmed the presence of lesion.

Treatment

• Antibiotics and an anti-inflammatory painkiller were prescribed before the extraction to control the infection.
• After monitoring the blood pressure and RBS level on the day of surgery
• Extraction of 26 27 28 done under Local anesthesia, and the socket is degranulated well and irrigated. Post-op antibiotic coverage and NSAID and instructions given to the patient.