Odontogenic fascial space infections in pregnancy - a study

ABSTRACT

Odontogenic infections are the most prevalent disease worldwide. These infections presenting initially as, localized periapical and periodontal abscess then perforate the cortical bone and spread causing facial cellulitis. Odontogenic infections spread along tissue planes involving initially primary and then secondary facial spaces depending upon the tooth involved and muscle attachments. Infections are common in pregnancy due to hormonal changes and altered immunological activity aggravating response to plaque accumulation and caries resulting in serious life threatening condition, like ludwigs angina. The present study carried out on 28 pregnant patients with severe odontogenic infections reporting to oral and maxillofacial unit of Khyber College of Dentistry, Peshawar, Khyber Pakhthunkhawa province of Pakistan. The age range was from 17 to 40 years and mean age of 24.78 SD +/- 5.043. Odontogenic infections were most common in the last trimester [50%] followed by late second trimester [28.5%]. The most common tooth involved is mandibular wisdom tooth [53.5%] and submandibular space [28%] being the most frequently involved. Patients presented with trismus, facial swelling and dysphagia on examination. Most patients were treated with incision and drainage under local or general anaesthesia depending upon the fitness of the patient and extraction of the offending tooth and intravenous antibiotic coverage