ORAL AND MAXILLOFACIAL INFECTIONS

Maxillofacial infections are one of the oldest disease processes treated by oral and maxillofacial surgeons. They commonly present to the office, or in severe cases to the hospital emergency room. Although the majority of infections can be treated in a non-emergent fashion, early recognition and correct management of severe infections can be life saving.

Knowledge of the surgical anatomy, and path of spread of infections in the head and neck is fundamental in correct diagnosis and treatment. The ability of severe infections of the sublingual, submandibular, and parapharyngeal spaces to cause airway compromise, cavernous sinus thrombosis, and the possibility or mediastinal spread of infection have been causes of mortality and morbidity, especially in the medically compromised patient that present late in the disease process.

Although a large majority of these infections originate from teeth some could arise from untreated jaw fractures, foreign bodies and salivary glands.

The common presentation is usually pain and swelling of recent onset, which was preceded by a toothache. It is therefore very important to maintain a good oral hygiene , to have regular dental check-ups and to seek urgent attention whenever dental discomfort is experienced.

Despite the availability of a wide spectrum of antimicrobial agents and increasing knowledge of microbiology, the treatment of odontogenic infections remains primarily surgical. Removal of the source of infection and establishment of adequate drainage for elimination of the purulent material is the mainstay treatment.

Adequate antibiotic coverage is however important and should not be overlooked.