Factors influencing onset and course of odontogenic pediatric facial cellulitis

Background

A severe consequence of unmet dental needs and failed treatment is the development of facial cellulitis of odontogenic origin (FCOO). Pediatric patients seek treatment for nontraumatic and urgent dental conditions at hospitals at higher rates relative to other medical conditions. Determining the factors influencing the onset and course of care for FCOO can have profound effects on medical systems.

Methods

The electronic health records of patients who sought treatment at a pediatric hospital dental clinic and received a diagnosis of FCOO were reviewed. Data collected were descriptive variables related to the course of care for their FCOO, the associations between FCOO and the presence or absence of a dental home, the use of advanced behavior guidance in the treatment of FCOO, and any associations between children and adolescents with a special health care need and FCOO.

Results

Data were collected from 201 participants with a mean (SD) age of 7.5 (4.1) years. The etiology of facial swelling was caries (73.1%), failed dental restorative treatment (22%), oral pathology (2.9%), or dental trauma (2%).

Conclusions

Patients without history of a first dental visit, patients without an established dental home, younger patients, and patients with a special health care need required a more intensive course of care for FCOO than their counterparts.

Practical Implications

The dental home should be advocated for, but in clinical practice it may not facilitate certain patients’ needs for routine and emergency oral health care. If an inpatient stay for FCOO becomes necessary, interdisciplinary communication between the medical and dental team members is necessary.