ABSTRACT
Cervicofacial infections of dental origin can cause life threatening emergency and we were anticipating that the prevalence of hospital admissions for this reason between the 26 th of March 2020 until the 8 th of June 2020 that the dental practices were closed would increase. We conducted a retrospective analysis of the hospital admissions for cervicfacial infections of dental origin during this period and the results were compared with the admissions the same period last year. Surprisingly there were less admissions in 2020 compared to 2019 which can be attributed to the government guidance to ''Stay at home", "Save lives", "Protect the NHS'' and the treatment provided by the Urgent Dental Care Centers that reduced the pressure on the country's health care system. Proportionately more admissions in 2020 were attributed to dental abscess from mandibular teeth compared to 2019 but there was a small decrease in the incision and drainage under general anesthetic and a small increase in the length of the hospital stay in 2020.Copyright © 2021
ABSTRACT
This study has done a systematic review of drug therapy and assessment of the occurrence of dental and neurological problems in patients affected by covid-19. There are various reasons that can cause an infection in the tooth. One of the most common causes of tooth infection is root canal treatments you have had in the past. Unfortunately, bacteria grow in this area and can lead to infection. Having an infection in the tooth can be very dangerous. Because it may spread to other parts of the body and cause serious problems. For this reason, it is very important to recognize the symptoms of infection. When a crack or cavity is formed on the tooth, if not treated in time, an infection may occur in the tooth. Because these are the gates that can pave the way for bacteria to enter your teeth. The most common type of disease is accompanied by episodes of severe pain that may be felt in the eyes, ears, lips, nose, forehead, cheeks, teeth or jaws, or anywhere on the face. The similarity of the symptoms of this complication with the symptoms of common dental diseases is a factor in misdiagnosis. This can lead to a series of unnecessary dental treatments that not only won't solve the problem, but may actually make it worse. Some patients undergo dental treatment at least once before the diagnosis of the disease. 1.
ABSTRACT
Dental infection can cause reduced mouth opening which may make tracheal intubation after induction of general anaesthesia difficult. Although it is widely quoted in the literature that reduced mouth opening secondary to dental infection might not improve post-induction of anaesthesia,1 the evidence base for this is limited. The 4th National Audit Project in Anaesthesia highlighted that airway complications often resulted from poor assessment, inadequate planning of management, and a reluctance to use advanced airway techniques.2 An improved understanding and awareness of the effect of dental infection on mouth opening could help highlight potential airway difficulty, improving planning of airway management and the use of appropriate techniques to do this. We conducted a prospective observational study at the Royal Hallamshire Hospital, Sheffield. After study approvals (REC ref: 18/LO/1134, IRAS ID: 264468) were obtained, 11 patients presenting with dental infection requiring surgical management under general anaesthetic were recruited between December 2018 and January 2020. Maximal mouth opening was measured immediately before and after the induction of general anaesthesia using a TheraBite® ROM scale.3 The presence of a number of parameters associated with the severity of dental infection was also recorded. The mean pre-induction maximal mouth opening of the study participants was 18 mm (standard deviation [SD], 5.16 mm) whereas the mean post-induction maximal mouth opening was 22.3 (5.56) mm. Although the maximal mouth opening of 3 (17%) patients improved by more than 10 mm after induction of anaesthesia, the other 8 (73%) patient’s maximal mouth opening improved by less than 2 mm. Unfortunately, there was a large under-recruitment to the study in part owing to difficulties resulting from the COVID-19 pandemic. The study was therefore underpowered to perform further statistical analysis of the influence of induction of anaesthesia on a patient’s maximal mouth opening or to examine the influence of the presence of parameters associated with the severity of dental infection on maximal mouth opening. To our knowledge, this is the first study to look at the change in maximal mouth opening after induction of anaesthesia as a primary endpoint in patients with dental infection. Even in the context of the small sample size, the finding that 73% of the patients in the study had a less than 2 mm improvement in maximal mouth opening after induction is clinically highly relevant. A lack of improvement in reduced mouth opening has significant implications on airway management. This study clearly shows there is a reasonable prospect of this scenario in patients with dental infection and supports the practice of assuming mouth opening will not improve after induction of anaesthesia when planning airway management in these patients. References 1. Morosan M, Parbhoo A, Curry N. Continuing Education in Anaesthesia Critical Care & Pain 2012;12: 257–62 2. Cook TM, Woodall N, Frerk C. On behalf of the Fourth National Audit Project. Br J Anaesth 2011;106: 617–31 3. TheraBite® Range of Motion Scale. Available from: accessed date as: 5th November 2021
ABSTRACT
Introduction: Since 2008 OMFS trauma and infection cases requiring surgery have been changed by the Recession and now COVID. Mersey Regional OMFS Unit in Aintree Hospital serves a 2 million population. All acute and semi-elective operating for trauma and infection is concentrated in the regional unit. Methods: Data were extracted from Theatre Management Software on operated cases from January 2008 to August 2021. Coding was verified by inspection against the text descriptions of the planned and actual surgery performed. Results: Between Jan 2008 and August 2021 3966 patients with mandibular fractures, 1302 with zygomatic fractures, 429 with orbital fractures and 2801 with dental/cervico-facial infections received primary surgery in the Regional Unit – a total of 8498 operations. Conclusions: Between 2008 and 2019 mandibular fractures operated on fell by almost half (49%). Severe dental infections were relatively unchanged except during the first lock-down when Liverpool Dental Hospital provided a telephone triaged ‘dental extraction service’ (with full PPE) which reduced cases operated on in Aintree by 70%. More detailed trends within the data will be discussed.
ABSTRACT
During the 2020 coronavirus pandemic, a lockdown was imposed in France during the first wave. An apparent decrease in incidence of cellulitis of odontogenic origin was noticed then. This study aimed to compare the incidence of cellulitis during this extraordinary period with the same period in 2018 and 2019, based on retrospective multicentric data. All maxillofacial surgery departments in French public hospitals were contacted. Responders were asked to include all patients admitted for the surgical drainage of a head and neck abscess of odontogenic origin during the first 2020 lockdown period, and in a similar time frame in 2018 and 2019 (control group), based on screening the French diagnostic and therapeutic classification of medical acts. We report a 44% significant nationwide decrease in the incidence of admissions for cellulitis. There were 187 patients in 2020 for 334 and 333 patients in 2018/2019 respectively. The reasons to explain this finding are hypothetical (organizational reasons leading to earlier management, patients' fear to seek for medical management, usual excess in surgical indications or concomitant decrease of non-steroidal anti-inflammatory drugs delivery). Whatever the explanation, it would be of great interest to find it out in order to improve the prevention of cellulitis.