Osteomyelitis simply put is an infection of the bone that can become so severe that it often leads to necrosis of the bone. Infections leading to osteomyelitis can be transmitted through the patient’s blood stream or from a nearby tissue.
Clinically, a patient that is suffering from Osteomyelitis will exhibit signs associated with severe infection. Patients will usually have a fever and the accompanying chills. Pain will be felt in the area where the infection occurred and the four textbook signs of rubor, calor, dolor, and tumor.
Osteomyelitis is typically associated with Staphylococcus bacteria and other types of bacteria found on the skin of every human. What makes osteomyelitis particularly detrimental is the effect that it can have on individuals that are medically compromised. In an individual with a healthy immune system, the body can usually fight off an infection associated with the bacteria that cause osteomyelitis. Conditions that can lead to a greater susceptibility of osteomyelitis include recent surgeries or injuries and circulation disorders like diabetes mellitus. Patients receiving chemotherapy treatment are also more susceptible to developing osteomyelitis.
As practicing dentists, it is important that we are aware of the danger that osteomyelitis poses to certain patients that we are likely to see throughout the duration of our careers. If the proper care is not taken, routine dental procedures can cause serious complications in patients that are often times suffering from other illnesses.
Complications from osteomyelitis can lead to death (osteoradionecrosis) of the infected bone. If this occurs, then the section of bone that was affected can be surgically removed. If the infection pervades through enough of the bone however, the limb may have to be amputated to prevent the further spread of the infection. In addition to osteoradionecrosis, another complication could occur if the infection spreads to a neighboring joint in what is known as septic arthritis.
A common area where osteomyelitis can be seen is in the jawbone and in extraction sites of medically compromised patients. The best way manage osteomyelitis infections is through prevention. If the doctor and patient have a good means of communication, the proper precautions can be made to minimize the patient’s risk to potentially harmful bacteria.
Medications associated with increased instances of osteomyelitis are chemotherapeutic agents, steroids and bisphosphonates. Should a patient present to the clinic taking any of these medications, the dentists should take extra precaution when performing any dental procedure.