HEAD AND NECK INFECTIONS

SECONDARY TO DENTAL CAUSES; DIAGNOSIS AND TREATMENT

Abstract

Objectives: To analyse the risk factors responsible for different head and neck
infections secondary to dental causes. DESIGN: Retrospective study. Settings: Department of
ENT and Head & Neck Surgery, Allied Hospital, Punjab Medical College, Faisalabad. Period:
October 2011 to September 2014. Patients and Methods: 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 & Neck Surgery at Allied Hospital Faisalabad. Inclusions criteria:
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. Exclusion Criteria: Patients
having head and neck infections secondary to some other cause other than dental etiology
were excluded from the study. Data Analysis: SPSS software, version 10 was used to analyse
the data. Chi square test was applied to analyse the data. Results: 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. Treatment: 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. Conclusions:
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.