Odontogenic cervico-fascial infections: a continuing threat

Précis

Dental abscesses can evolve to cervico-fascial infections with potentially life-threatening complications. General dental practitioners (GDPs) have a crucial role, as they are often the first point of contact for patients. Close monitoring and re-evaluation of the patient is essential. This paper highlights such severe complications and offers an optimal patient care pathway that can be used in primary care.

Abstract

Statement of the problem: Dental abscesses are common and can occasionally progress to life-threatening cervico-fascial infections. Despite medical advances, odontogenic cervico-fascial infections (OCFIs) continue to be a threat. The potential seriousness of odontogenic infections (OIs), or dental abscesses, is frequently underestimated. General dental practitioners (GDPs) in primary care face the challenging decision of whether to refer patients to secondary care or to manage them in the community.

Purpose of the review: This paper reviews the relevant aspects of OIs that might be helpful to primary care dental practitioners in providing a better understanding of the anatomy and pathology, and aims to assist in clinical decision.

Method: An up-to-date review of literature on OCFIs, highlighting their potential risks with clinical examples.

Results and conclusion: Dental abscesses are common and continue to be a major cause for emergency hospital admission to oral and maxillofacial surgery departments. They occasionally spread to fascial spaces of the neck, potentially posing significant morbidity and mortality. GDPs are usually the first point of contact and face the challenge of recognising those at risk of developing OCFIs, which are potentially life threatening and require urgent referral for hospital treatment. We propose a patient care pathway to be used in primary care.

Journal of the Irish Dental Association 2013/2014; 59 (6): 301-307

Hannah Cottom
BDS(Hons) MJDF
Senior House Officer, Department of Oral & Maxillofacial Surgery, Northampton General Hospital, Northampton NN1 5BD, UK

James R Gallagher
BDS FDSRCS FFDRCSI MB BS MRCS(Eng) FRCS(OMFS)
Consultant Oral & Maxillofacial Surgeon, Department of Oral & Maxillofacial Surgery, Northampton General Hospital, Northampton NN1 5BD, UK

Daljit K Dhariwal
BDS FDSRCS MB BCh FRCS FRCS(OMFS)
Consultant Oral & Maxillofacial Surgeon, Department of Oral & Maxillofacial Surgery, John Radcliffe Hospital, Oxford OX3 9DU, UK

M Abu-Serriah
BDS(Hons) MBChB FDSRCPS (Glasg) MRCS (Glasg) MSc (MedSci) (Hons), PhD
Specialist Registrar, Department of Oral & Maxillofacial Surgery, John Radcliffe Hospital, Oxford OX3 9DU, UK

Corresponding author: M Abu-Serriah
Department of Oral & Maxillofacial Surgery, John Radcliffe Hospital, Oxford OX3 9DU, UK
E: m.abuserriah@gmail.com