Infections of the neck's deeper fascial layers and masseteric layers have a higher chance of causing impingement on the airway directly or indirectly through extreme trismus.
The source of the dental infection must ultimately be removed or controlled. Pain medication and antibiotics may be given if the patient is not systemically ill and appears to have a simple localized odontogenic infection or abscess. Igoumenakis and colleagues reported that in odontogenic maxillofacial infections, extraction of the causative tooth is associated with faster clinical and biological resolution of the infection compared with treatment that did not include extraction.
Tracheostomy was the prior method of choice for establishing the airway; as of recently, management through fiberoptic nasoendotracheal intubation while the patient is awake is preferred.
I&D may be performed if a periapical or periodontal abscess is identified, depending on the physician’s comfort level. After anesthesia of the tooth, locally or with a dental block, make an incision in the mucosa that is large enough to accommodate a quarter-inch Penrose drain. Bluntly dissect the abscess cavity with the tips of a hemostat. Suture in the Penrose drain with a silk suture and leave until suppurative drainage is no longer present (about 2-3 days).
For more on the treatment of dental infections, read here.
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Cite this: Jeff Burgess. Fast Five Quiz: What Do You Know About Dental Health? - Medscape - Oct 16, 2017.
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