Head and neck infections; secondary to dental causes; diagnosis and treatment

ABSTRACT

To analyse the risk factors responsible for different head and neck infections secondary to dental causes. DESIGN: Retrospective study. Department of ENT and Head and Neck Surgery, Allied Hospital, Punjab Medical College, Faisalabad. October 2011 to September 2014. The study consisted of 50 patients who presented with history of head and neck infections secondary to dental causes in the department of ENT and Head and Neck Surgery at Allied Hospital Faisalabad. Patients of head and neck infections of either sex ranging from 12 to 57 years of age and having history of dental infections / extractions were included in the study. Patients having head and neck infections secondary to some other cause other than dental etiology were excluded from the study. SPSS software, version 10 was used to analyse the data. Chi square test was applied to analyse the data. In our study 62% patients with head and neck infections were males while 38% patients were females. Age ranged from 12 years to 57 years with mean age 33.68 years. 96% of our patients presented with deep neck abscesses while only 02% of the patients had osteomyelitis of maxilla and further 02% of the patients presented with necrotizing fasciitis of the submandibular region. 58% of the patients had dental infections whereas 42% patients were having dental extraction as the root cause responsible for these head and neck infections. Moreover, all the patients had poor oro-dental hygiene. It was also observed that 76% of the patients, having history of dental extraction, were treated by unqualified dental practitioners without adequate aseptic conditions. Twelve patients out of fifty [24%] were found to have diabetes mellitus and one patient each was suffering from malignancy and chronic renal failure. 10 [20%] of our patients were smokers. Some of the patients [16%] were having anemia. Two patients out of fifty [04%] were suffering from pulmonary tuberculosis. All these patients were managed with adequate parentral antibiotics and surgical interventions. We had to perform an emergency tracheostomy in one patient. All the patients had good response to the management without any complication. Dental infections and dental extractions are still an important cause for potentially life threatening head and neck infections in developing countries like Pakistan. Unhygienic dental practices and lack of proper dental care facilities along with immunocompromizing conditions such as diabetes mellitus are most common risk factors for these avoidable head and neck infections. Therefore it is necessary that unhygienic dental practices as well as practices by unqualified dental practitioners should be strictly banned