MANAGEMENT OF SILENT ORAL INFECTIONS IN A HOSPITAL SETTING

Abstract

Silent oral infectious foci, characterized by chronic inflammatory processes of odontogenic origin and often asymptomatic, represent a critical risk, especially in hospitalized patients undergoing immunosuppressive therapies such as hematopoietic stem cell transplantation (HSCT) and solid organ transplantation (SOT). Such foci, including chronic apical periodontitis and deep periodontal pockets, are reservoirs of pathogens with the potential for systemic dissemination and development of sepsis. Preventive management, or foci sanitation, is crucial to mitigate post-procedure complications of high complexity. This study is a narrative literature review aiming to synthesize the scientific evidence on the management of these foci. The literature reinforces the association between multiple chronic pre-transplant oral foci and increased morbidity, prolonged hospital stay, and risk of systemic infectious and inflammatory complications, such as brain abscesses and worsening of Graves' orbitopathy. The predominant clinical approach is tooth extraction for rapid risk elimination. It is concluded that the integration of dentistry into hospital care is essential, as the elimination of these foci prevents local and systemic complications, potentially reducing transplant rejection and avoiding fatal outcomes in critically ill patients.