Oral Cellulitis

Swelling may be accompanied by tenderness, firm tissue, redness, or a marked mass effect. Stridor, breathlessness, and respiratory distress are warning signs of threatened airway function.

Dental caries, apical abscesses, and other minor dental infections can seed an odontogenic infection. These infections are usually polymicrobial, so treatment is broadly directed even after culture results.

The infection is classified by the tissues and spaces involved and by its severity or progression. It can spread from the mouth into facial and deep neck spaces.

More extensive infections, immunodeficiency, and significant medical comorbidity increase the need for intravenous antibiotics and inpatient resuscitation and monitoring.

Examination identifies swelling and tissue changes. Point-of-care ultrasound can identify many minor abscesses, while contrast CT of the face and neck helps distinguish cellulitis from abscess and assess suspected deep spread.

Treatment uses antibiotics and control of the dental source. An abscess may need needle aspiration, incision and drainage, temporary drainage, or extraction of the offending tooth with antibiotics.

The clinical work can include imaging, antibiotics, drainage, temporary drain placement, or removal of the offending tooth, so the treatment components depend on the infection's extent.

Odontogenic infection can compromise neurovascular structures and airway patency. Rarely, it can progress to necrotizing fasciitis, which requires rapid airway assessment and surgical debridement.

Good dental hygiene and prompt identification of caries, apical abscesses, and other minor dental infections reduce the chance of preventable spread.