Management of odontogenic infections and sepsis: an update

Abstract

The management of odontogenic infections has improved over recent decades, but further improvements are still required. The ongoing education of GDPs and their dental teams on this issue continues to be important, especially during the current COVID-19 pandemic, where remote triage poses additional difficulties and challenges.Odontogenic infections can lead to sepsis, a potentially life-threatening condition caused by the body's immune system responding in an abnormal way. This can lead to tissue damage, organ failure and death. A patient with non-odontogenic-related infection could also present with sepsis at a dental practice. Early recognition and prompt management of sepsis improves outcomes. GDPs and their dental teams should be trained in the recognition and management of sepsis. Age-specific sepsis decision support tools have been developed by the UK Sepsis Trust to help dental staff recognise and manage patients with suspected sepsis.The aim of this article is to provide an update on the management of odontogenic infections and sepsis.

Fig. 1

a) Even a mild pericoronitis b) if left untreated may progress to the formation of an abscess that could expand in the submandibular and submental spaces c) or further to the neck and pretracheal spaces d) requiring extensive drainage and airway protection though a tracheostomy

Fig. 2

'Triage of commonly presenting dental problems' from Management of acute dental problems during COVID-19 pandemic, reproduced with kind permission from the SDCEP

Fig. 3

GDP sepsis decision support tool for primary dental care should be applied to all adults and young people aged 12 years and over with fever (or recent fever), symptoms presenting with a source of orofacial/dental infection (including post-operative infection) or have clinical observations outside normal limits, reproduced with kind permission from the UK Sepsis Trust

Fig. 4

'GDP paediatric sepsis decision support tool for primary dental care' should be applied to all children aged between 5-11 years who have a suspected source of orofacial/dental infection (including post-operative infection) or have clinical observations outside the normal range, reproduced with kind permission from the UK Sepsis Trust

Fig. 5

'GDP paediatric sepsis decision support tool for primary dental care' should be applied to all children aged <5 years who have a suspected source of orofacial/dental infection (including post-operative infection) or have clinical observations outside the normal range, reproduced with kind permission from the UK Sepsis Trust