Health status in patients hospitalised for severe odontogenic infections

Abstract

Objective: Previous findings refer to certain predisposing medical conditions that compound the risk of developing severe and potentially lethal acute odontogenic infections (OI). The objective of this study was to clarify this rationale and infection severity in general. Material and methods: Records of patients aged !18 years requiring hospital care for deep OI were retrospectively investigated. The main outcome variable was need for intensive care unit (ICU) treatment. Additional outcome variable was occurrence of infection complications and/or distant infections. Several parameters describing patients' prior health and recent dental treatment were set as independent variables. Results: Of the 303 acute OI patients included, 71 patients (23%) required treatment in the ICU, with no significant difference between previously healthy and patients with disease history. OIs originating from teeth in the mandible compared with maxilla had 7.8-fold risk (p ¼ .007) for ICU treatment in binary logistic regression analyses. Elevated levels of infection parameters at hospital admission predicted further ICU stay. Infection complications and/or distant infections occurred in 7.6% of patients, of which septicaemia and pneumonia were the most common. The mortality rate was 0.3%. Infection complications and/or distant infections occurred significantly more often in smokers (p ¼ .001) and in patients with excessive consumption of alcohol or drugs (p ¼ .025), however smoking showed 3.5folded independent risk for infection complications and/or distant infections (p ¼ .008) in logistic regression. Conclusions: Severe OIs often occur in previously healthy patients. Smokers in particular are prone to the most serious OIs.

Emergency Treatment of Severe Odontogenic Infection Extending to the Four Maxillofacial Spaces: Case Report

“…Severe symptoms of odontogenic infection can lead to complications and death, so urgent care in the hospital and close observation are needed. [2,7,8] Treatment can be started by maintaining the airway, administering antibiotics, analgesics, and pus drainage incisions. [5,8,17] Empirical broad-spectrum antibiotics for aerobic and anaerobic bacteria should be administered immediately while waiting for culture and bacterial resistance results.…”

“…[2,7,8] Treatment can be started by maintaining the airway, administering antibiotics, analgesics, and pus drainage incisions. [5,8,17] Empirical broad-spectrum antibiotics for aerobic and anaerobic bacteria should be administered immediately while waiting for culture and bacterial resistance results. Empiric antibiotics should cover both aerobic and anaerobic, Gram-positive and Gram-negative bacteria.…”

“…[5,11] Surgical drainage incisions can shorten hospital stay. [8] In this case, a drainage incision was immediately performed under general anesthesia because there were signs of airway obstruction, trismus, difficulty swallowing, decreased blood pressure, and leukocytosis. The drainage incision, in this case, was performed extra orally in the submandibular area that penetrated the neck.…”

“…Odontogenic infections can extend to the maxillofacial area around 50%-89%. [6,7,8,9] Odontogenic infections often originate from periapical infections of the teeth (60.3%), followed by pericoronitis (27.4%), mandibles (95.9%), and teeth Molars (97.3%). [6] The mandibular molars, especially the third molars, were the most common cause of odontogenic infections (36.5%).…”

Effect of COVID-19 pandemic on orofacial and respiratory infections in ear, nose, and throat and oral and maxillofacial surgery emergency departments: a retrospective study of 7900 patients

“…The most severe infections in the facial area require admission to ward and these infections often require surgical treatment in combination with antibiotic medication [12,13]. Deep neck infections originate most often from an odontogenic cause [12,14].…”