title: Odontogenic signs and symptoms as predictors of odontogenic infection: a clinical trial.
abstract: BACKGROUND
  The authors conducted a study to determine if odontogenic signs and symptoms in the emergency department predicted the development of overt odontogenic infection at a follow-up dental visit.
  
  
  METHODS
  One hundred ninety-five patients with odontalgia, but without overt signs of infection, were enrolled in a prospective, double-blind, randomized clinical trial. Data included dental diagnosis, pain characteristics, presence of caries and restorations, presence and size of periapical radiolucencies and other diagnostic test results.
  
  
  RESULTS
  Thirteen of 134 subjects for whom data were available had signs of infection at the follow-up visit. Subjects in the follow-up infected (FU-I) group had larger baseline radiolucencies than did subjects in the follow-up noninfected (FU-NI) group, and restorations were more prevalent for involved teeth in the FU-I group than in the FU-NI group.
  
  
  CONCLUSIONS
  A relationship exists between radiolucency size and the presence of amalgam restorations in patients who develop clinical signs of infection. Penicillin did not appear to influence this progression.
  
  
  CONCLUSIONS
  Antibiotics are not effective in preventing the development of odontogenic infection when definitive dental therapy cannot be provided for acute pain in the absence of clinical signs of infection. Although the overall risk of developing infection is low, early treatment is indicated for teeth with larger periapical radiolucencies, amalgam restorations or both.
authors.affiliation: Oral Medicine Residency, Carolinas Medical Center, Department of Oral Medicine, 1000 Blythe Blvd., MEB-409, Charlotte, NC 28232, USA. mike.brennan@carolinas.org
authors.forename: Michael T
authors.initials: MT
authors.lastname: Brennan
authors.forename: Michael S
authors.initials: MS
authors.lastname: Runyon
authors.forename: Jayne J
authors.initials: JJ
authors.lastname: Batts
authors.forename: Philip C
authors.initials: PC
authors.lastname: Fox
authors.forename: M Louise
authors.initials: ML
authors.lastname: Kent
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Cox
authors.forename: H James
authors.initials: HJ
authors.lastname: Norton
authors.forename: Peter B
authors.initials: PB
authors.lastname: Lockhart
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis*; D003731:Dental Caries / Q000145:classification; D003793:Dental Restoration, Permanent; D004311:Double-Blind Method; D004487:Edema / Q000175:diagnosis; D005260:Female; D005334:Fever / Q000175:diagnosis; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010404:Penicillin V / Q000627:therapeutic use; D010483:Periapical Diseases / Q000000981:diagnostic imaging; D010919:Placebos; D011446:Prospective Studies; D011671:Pulpitis / Q000145:classification; D011859:Radiography; D013492:Suppuration; D014076:Tooth Diseases / Q000382:microbiology*; D014098:Toothache / Q000175:diagnosis*
chemical_list: D000900:Anti-Bacterial Agents; D010919:Placebos; D010404:Penicillin V