Facial Cellulitis
Facial cellulitis occurring secondary to a dental abscess is a true dental emergency!
Untreated infection can spread to deep facial spaces resulting in airway compromise, sepsis, or infection of the orbit and brain.
Symptoms
- Pain, often with fever
- Facial swelling
- Patients with severe infection may exhibit:
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- Swelling involving orbit or deep spaces of the neck
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- Trismus and dysphagia
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- Unstable vital signs and other evidence of invasive infection
Treatment & Referral
- Localized cellulitis in select patients:
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- Outpatient oral antibiotics and analgesics
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- Prompt dental referral
- Severe cellulitis involving deep facial spaces or with sepsis:
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- Hospitalize with surgical consultation
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- CT imaging to rule out deep space involvement
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- IV antibiotics and appropriate analgesics
- Extraction or root canal to prevent recurrence
ICOHP
References
Bahl R, Sandhu S, Singh K, Sahai N, Gupta M. Odontogenic infections: Microbiology and management. Contemp Clin Dent. Jul 2014; 5(3):307-11
Flynn TR, Shanti RM, Levi MH, Adamo AK, Kraut RA, Trieger N. Severe odontogenic infections, part 1: prospective report. J Oral Maxillofac Surg. 2006 Jul;64(7):1093-103.
Demetris E. Rush, Nahed Abdel-Haq, Jian-Fu Zhu, Basim Aamar and Monica Malian. Clindamycin Versus Unasyn in the Treatment of Facial Cellulitis of Odontogenic Origin in Children. Clin Pediatr (Phila) 2007; 46; 154
Sanders JL, Houck RC. Dental Abscess. StatPearls [Internet]. 2020 August 26.