Early recognition of life-threatening cervicofacial infections of dental origin

Aim: Cervicofacial infections of dental origin are a difficult and complex issue in oral and maxillofacial surgery. Recognition in due time of the situations which are likely to develop a life-threatening condition and the prompt medical surgical intervention, reduce significantly the rate of complications. Material and method: Between May 2000 and April 2004 in the Clinic of Oral and Maxillofacial Surgery of Timisoara, 14 patients with severe cervicofacial infections were hospitalized in emergency status and they needed complex medical surgical treatment in accordance with a plan (protocol) established together with the intensive care department. Results: Assessing the presented situations, we noticed a difficult, prolonged time of recovery, process which needed a hospitalization period of around 22 days. A decease was recorded because of cervical necrotizing fasciitis, the most severe form of cervicofacial infection. Discussions: The severity of the condition of patients with cervicofacial infections must be figured and energetic therapeutical attitude must be adopted as quickly as possible. The experience shows frequent resistance to antibiotics such as penicillin, ampicillin and oxacillin. The patients must be guided in due time to a clinic which is provided with an intensive care department, where surgical treatment must be administrated together with an intensive treatment in support of the general condition. Conclusions: The reduction of the vital risk of cervico-facial infections of dental origin will be done through attentive assessment of the general and local condition of out-patients, before dental extraction. The absence of treatment adapted to the situation and to the clinic development, increases meaningfully the rate of complications and the length of hospitalization, the lethal evolution not being excluded.