Orbital cellulitis and its link to dental health

BELIEVE it or not, infections that start in your mouth or sinuses can spread to other parts of your body.

One example of this type of complication is orbital cellulitis, a dangerous infection that, if not treated promptly, can lead to blindness or other serious, long-term consequences.

Here’s what you need to know about this condition and how to prevent it.


Orbital vs preseptal cellulitis

Cellulitis is a type of skin infection and there are different subcategories which describe the part of the body that’s affected.

Cellulitis classified as “orbital” is an infection that begins deep in the orbital septum, which is the thin membrane between the eyelids and the bony eye socket. Preseptal cellulitis is an infection of the eyelid and surrounding skin. While preseptal is more common, orbital may be more serious — and both are more frequently seen in children.


Causes and dental origin

It’s reported that more than 90 per cent of orbital cellulitis cases in young adults and children are due to an underlying bacterial sinus disease, especially involving the ethmoid sinuses. These infections can also be caused by trauma that has damaged the orbital septum area or by infected adjacent areas.

This eye infection can also have a dental origin. Dental infections, including severely decayed teeth or an abscessed tooth, can sometimes spread to the orbital area. Recent dental treatment may also contribute to the development of this condition.


Symptoms and complications

Both orbital and preseptal cellulitis may cause fever and discolouration of the eyelid. Swelling can also occur, which may make opening the eyelid difficult. Serious cases of orbital cellulitis usually involve pain whenever moving, along with decreased ability to move the eye and, sometimes, vision problems.

If the infection originated from the sinuses, the patient may have nasal discharge. If the infection has a dental origin, the patient may have gum pain or gum swelling. However, in the earlier infection stages, these symptoms may be more subtle or absent.

Because orbital cellulitis can result in serious complications, such as meningitis and vision loss, anyone with symptoms of cellulitis should seek medical attention immediately.


Diagnosis and treatment

If your doctor suspects cellulitis in your orbital septum they may refer you to an ophthalmologist, who specialises in diseases of the eye. This infection can progress rapidly, so the common procedure is to admit patients to the hospital for frequent monitoring.

Doctors will typically perform blood tests and, if a child is very sick, possibly a spinal tap. X-rays of the sinus areas are helpful for diagnosis, as are computerised tomography (CT) scans and magnetic resonance imaging of the sinuses and eye area.

Using a sterile cotton swab, a medical professional may also gather a sample of cells and fluids from the eyes, nasal passage and the throat for examination. This can help to pinpoint the source of the primary infection and guide your doctor in prescribing the appropriate antibiotics.

Doctors usually treat hospitalised patients with antibiotics administered through a vein. In some cases, surgery may be needed to drain an abscess or relieve pressure in the eye area.


Importance of oral care

Preventing oral infections, such as gum disease and severe tooth decay, may help lessen your chances of having to deal with orbital cellulitis. Keep up with the following oral hygiene tips to ensure your mouth stays as healthy as possible:

• Brush twice a day with a fluoride toothpaste.

• Floss daily.

• Replace your toothbrush regularly.

• Schedule regular dental cleanings and check-ups.

• Call your dentist if you have tooth pain, bleeding gums or any other symptoms of an oral infection.

The good news is you can recover fully from orbital cellulitis with prompt treatment. Be sure to maintain a good oral care routine, and see your doctor if you have a sinus infection that’s not getting better. In addition, if you do experience any of the symptoms of orbital or preseptal cellulitis, visit a medical professional as soon as possible.


Dr Sharon Robinson, DDS has offices at Dental Place Cosmetix Spa, located at shop #5, Winchester Business Centre, 15 Hope Road, Kingston 10. Dr Robinson is an adjunct lecturer at the University of Technology, Jamaica, School of Oral Health Sciences. She may be contacted at 876-630-4710. Like their Facebook page, Dental Place Cosmetix Spa.

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