A five-year retrospective study of odontogenic maxillofacial infections in a large urban public hospital.

The aim of this study was to analyze the etiology, presentation, management and outcome of odontogenic maxillofacial infections seen in an urban population that has only one major public hospital, which is also the only level I trauma center. All patients admitted to the Oral and Maxillofacial Surgery Service of San Francisco General Hospital with odontogenic infections over a 5-year period were included. Age, gender, site of infection, investigations performed, treatment carried out and outcomes were studied. Length of hospital stay and any readmissions were also noted. A total of 250 patients were admitted with maxillofacial infections, and in 157 cases the infection was odontogenic in origin. Males outnumbered females (102:55). Children had a preponderance of maxillary buccal infections whilst adults had more mandibular infections. Hospital stays ranged from 1 to 23 days, and only one patient required re-admission. A wide range of antibiotics were prescribed and 122 patients required dental extractions. Odontogenic maxillofacial infections are a public and personal health issue with potential life-threatening complications. This study identifies potential risk factors and suggests that early dental extraction, incision and drainage, coupled with intravenous antibiotic therapy, is the most effective treatment. Antibiotic therapy can be empirical since in no case where cultures were performed did this alter the antibiotic management.