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:
    • Swelling involving orbit or deep spaces of the neck
    • Trismus and dysphagia
    • Unstable vital signs and other evidence of invasive infection

 

Treatment & Referral

  • Localized cellulitis in select patients:
    • Outpatient oral antibiotics and analgesics
    • Prompt dental referral
  • Severe cellulitis involving deep facial spaces or with sepsis:
    • Hospitalize with surgical consultation
    • CT imaging to rule out deep space involvement
    • IV antibiotics and appropriate analgesics
  • Extraction or root canal to prevent recurrence
ICOHP
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

Bratton TA, Jackson DC, Nkungula-Howlett T, Williams CW, Bennett CR. Management of complex multi-space odontogenic infections. J Tenn Dent Assoc. 2002 Fall;82(3):39-47.