The term focus (region of a localized infection or disease) at the orofacial area stands for a local deviation that causes pathological changes of remote organs. It is presumed that caries products of dental foci sensitize and allergize the whole organism. Focal infections may cause a variety of diseases, such as endocarditis, myocarditis, phlebitis, nephritis, pyelonephritis, migraines, subfebrile states, eczemas and rheumatic diseases. As the foci of a dental infection, all teeth with an X-ray detectable periapical finding, devitalized and gangrenous teeth, chronic pulpitis, sinusitis, radices, retained teeth, dental cysts, dentitio difficilis, periodontal pockets and abscesses may be designated.
Detection of a dental focus is based on an anamnesis (the relationship between a basic disease and a pathological state of mouth) and on the clinical and X-ray examinations. Provocation tests are not used in these cases due to their unreliability. Dental focus therapy relies on a focus removal by conservative or surgical means. The treatment is performed under an antibiotic screen which should decrease the possibility of complications to minimum.
The scheme of antibiotic prophylaxis (Pávek 1989)
A. Patients tolerant to penicillin:
1 hour before surgery 3 grams of amoxycillin administered perorally (Amoclen 6 tablets)
B. Patients allergic to penicillin:
1 hour before surgery 1.5 grams of erythromycin administered perorally (Erythromycin 6 tablets)
plus 0.5 gram (2 tablets) of erythromycin 6 hours after surgery
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