Advertisement

European Archives of Paediatric Dentistry

, Volume 15, Issue 4, pp 259–268 | Cite as

Presentation and management of facial swellings of odontogenic origin in children

  • J. A. MichaelEmail author
  • S. A. Hibbert
Original Scientific Article

Abstract

Aim

To determine the characteristics, aetiology and management of facial swellings of odontogenic origin in the paediatric population.

Study design

Prospective study of children with facial swellings of odontogenic origin.

Methods

All children who presented to the Departments of Paediatric Dentistry of the Westmead Centre for Oral Health and the Children’s Hospital at Westmead with a facial swelling of odontogenic origin over a 12 month period were identified and included in the study. Treating clinicians completed a standardised data collection sheet to record information relating to patient demographics, medical history, dental history, history of current episode of facial swelling of odontogenic origin, examination findings and management. Data were entered in Microsoft® Excel and statistical analysis carried out using Statistical Analysis Software® version 9.3.

Results/statistics

Two hundred and fifty-three children were included in the study, with a mean age of 6.3 years. Sixteen percent of children were admitted for intravenous antibiotics, surgical management and supportive care. For the remaining children not admitted, a range of management approaches were undertaken. These included immediate surgical management with or without oral antibiotics, delayed surgical management following a course of oral antibiotics, or oral antibiotics alone, where the cause of the odontogenic infection had already been removed. For 2 % of children, a delayed surgical management approach was unsuccessful and the children were admitted.

Conclusions

Management options for children presenting with facial swellings of odontogenic origin include admission to hospital for intravenous antibiotics and acute surgical management, immediate surgical management with or without a course of oral antibiotics or initial management involving a course of oral antibiotics, with definitive dental treatment being provided after resolution of the acute odontogenic infection.

Keywords

Facial swelling Odontogenic infection Paediatric Dental abscess Dental caries 

Notes

Acknowledgments

The expert statistical analysis provided by Ms Liz Barnes is gratefully acknowledged.

References

  1. Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992;101(6):1644–55.PubMedCrossRefGoogle Scholar
  2. Bridgeman A, Wiesenfeld D, Hellyar A, Sheldon W. Major maxillofacial infections. An evaluation of 107 cases. Aust Dent J. 1995;40(5):281–8.PubMedCrossRefGoogle Scholar
  3. Bridgeman A, Wiesenfeld D, Newland S. Anatomical considerations in the diagnosis and management of acute maxillofacial bacterial infections. Aust Dent J. 1996;41(4):238–45.PubMedCrossRefGoogle Scholar
  4. Britt JC, Josephson GD, Gross CW. Ludwig’s angina in the pediatric population: report of a case and review of the literature. Int J Pediatr Otorhinolaryngol. 2000;52(1):79–87.PubMedCrossRefGoogle Scholar
  5. Bullock JD, Fleishman JA. The spread of odontogenic infections to the orbit: diagnosis and management. J Oral Maxillofac Surg. 1985;43(10):749–55.PubMedCrossRefGoogle Scholar
  6. Byers J, Lowe T, Goodall CA. Acute cervico-facial infection in Scotland 2010: patterns of presentation, patient demographics and recording of systemic involvement. Br J Oral Maxillofac Surg. 2012;50(7):626–30.PubMedCrossRefGoogle Scholar
  7. Castellanos-Ortega Á, Suberviola B, García-Astudillo LA, et al. Impact of the Surviving Sepsis Campaign protocols on hospital length of stay and mortality in septic shock patients: results of a three-year follow-up quasi-experimental study. Crit Care Med. 2010;38(4):1036–43.PubMedCrossRefGoogle Scholar
  8. Chow AW. Life-threatening infections of the head and neck. Clin Infect Dis. 1992;14(5):991–1002.PubMedCrossRefGoogle Scholar
  9. Costelloe C, Metcalfe C, Lovering A, Mant D, Hay AD. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ. 2010;340:c2096–107.PubMedCrossRefGoogle Scholar
  10. Dodson TB, Perrott DH, Kaban LB. Pediatric maxillofacial infections: a retrospective study of 113 patients. J Oral Maxillofac Surg. 1989;47(4):327–30.PubMedCrossRefGoogle Scholar
  11. Evers H, Haegerstam G. Handbook of dental local anaesthesia. Copenhagen: Schultz; 1981.Google Scholar
  12. Fardy CH, Findlay G, Owen G, Shortland G. Toxic shock syndrome secondary to a dental abscess. Int J Oral Maxillofac Surg. 1999;28(1):60–1.PubMedCrossRefGoogle Scholar
  13. Fedorowicz Z, Keenan JV, Farman AG, Newton T. Antibiotic use for irreversible pulpitis. Cochrane Database Syst Rev. 2005;18(2).Google Scholar
  14. Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med. 2005;6(1):2–8.PubMedCrossRefGoogle Scholar
  15. Goto CS, Abramo TJ. Initial approach to the child who presents with oral and dental infections. Semin Pediatr Infect Dis. 1996;7(1):55–62.CrossRefGoogle Scholar
  16. Handley T, Devlin M, Koppel D, McCaul J. The sepsis syndrome in odontogenic infection. J Intensive Care Soc. 2009;10(1):21–5.Google Scholar
  17. Kilham H, Alexander S, Wood N, Issacs D. Paediatrics manual: the children’s hospital at Westmead. Sydney: McGraw-Hill; 2009.Google Scholar
  18. Kinzer S, Pfeiffer J, Becker S, Ridder GJ. Severe deep neck space infections and mediastinitis of odontogenic origin: clinical relevance and implications for diagnosis and treatment. Acta Otolaryngol. 2009;129(1):62–70.PubMedCrossRefGoogle Scholar
  19. Krishnan V, Johnson JV, Helfrick JF. Management of maxillofacial infections: a review of 50 cases. J Oral Maxillofac Surg. 1993;51(8):868–73.PubMedCrossRefGoogle Scholar
  20. Kuo J, Lin YT, Lin YTJ. Odontogenic cellulitis in children requiring hospitalization. J Dent Sci. 2013;8(2):129–32.CrossRefGoogle Scholar
  21. Li X, Tronstad L, Olsen I. Brain abscesses caused by oral infection. Dent Traumatol. 1999;15(3):95–101.CrossRefGoogle Scholar
  22. Lin Y-T, Lu P-W. Retrospective study of pediatric facial cellulitis of odontogenic origin. Pediatr Infect Dis J. 2006;25(4):339–42.PubMedCrossRefGoogle Scholar
  23. Oral and Dental Expert Group. Therapeutic guidelines: oral and dental. Melbourne: Therapeutic Guidelines Limited; 2012.Google Scholar
  24. Sato FRL, Hajala FAC, Filho FWVF, Moreira RWF, de Moraes M. Eight-year retrospective study of odontogenic origin infections in a post-graduate program on oral and maxillofacial surgery. J Oral Maxillofac Surg. 2009;67(5):1092–7.PubMedCrossRefGoogle Scholar
  25. Seppänen L, Rautemaa R, Lindqvist C, Lauhio A. Changing clinical features of odontogenic maxillofacial infections. Clin Oral Investig. 2010;14(4):459–65.PubMedCrossRefGoogle Scholar
  26. Singh J, Straznicky I, Avent M, Goss AN. Antibiotic prophylaxis for endocarditis: time to reconsider. Aust Dent J. 2005;50(s2):S60–8.PubMedCrossRefGoogle Scholar
  27. Thikkurissy S, Rawlins JT, Kumar A, Evans E, Casamassimo PS. Rapid treatment reduces hospitalization for pediatric patients with odontogenic-based cellulitis. Am J Emerg Med. 2010;28(6):668–72.PubMedCrossRefGoogle Scholar
  28. Uluibau I, Jaunay T, Goss A. Severe odontogenic infections. Aust Dent J. 2005;50(Suppl 2):S74–81.PubMedCrossRefGoogle Scholar
  29. Unkel JH, McKibben DH, Fenton SJ, et al. Comparison of odontogenic and nonodontogenic facial cellulitis in a pediatric hospital population. Pediatr Dent. 1997;19(8):476–9.PubMedGoogle Scholar
  30. Wang J, Ahani A, Pogrel MA. A five-year retrospective study of odontogenic maxillofacial infections in a large urban public hospital. Int J Oral Maxillofac Surg. 2005;34(6):646–9.PubMedCrossRefGoogle Scholar
  31. Wen-Der Yun M, Hwang CF, Lui CC. Cavernous sinus thrombosis following odontogenic and cervicofacial infection. Eur Arch Otorhinolaryngol. 1991;248(7):422–4.Google Scholar
  32. Ylijoki S, Suuronen R, Jousimies-Somer H, Meurman JH, Lindqvist C. Differences between patients with or without the need for intensive care due to severe odontogenic infections. J Oral Maxillofac Surg. 2001;59(8):867–72.PubMedCrossRefGoogle Scholar
  33. Zhang C, Tang Y, Zheng M, et al. Maxillofacial space infection experience in West China: a retrospective study of 212 cases. Int J Infect Dis. 2010;14(5):e414–7.PubMedCrossRefGoogle Scholar

Copyright information

© European Academy of Paediatric Dentistry 2014

Authors and Affiliations

  1. 1.Department of Paediatric DentistryWestmead Centre for Oral HealthSydneyAustralia
  2. 2.Department of Paediatric DentistryThe Children’s Hospital at WestmeadSydneyAustralia
  3. 3.Discipline of Paediatric DentistryThe University of SydneySydneyAustralia

Personalised recommendations