Presentation and management of facial swellings of odontogenic origin in children.

AIM

To determine the characteristics, aetiology and management of facial swellings of odontogenic origin in the paediatric population.

STUDY DESIGN

Prospective study of children with facial swellings of odontogenic origin.

METHODS

All children who presented to the Departments of Paediatric Dentistry of the Westmead Centre for Oral Health and the Children's Hospital at Westmead with a facial swelling of odontogenic origin over a 12 month period were identified and included in the study. Treating clinicians completed a standardised data collection sheet to record information relating to patient demographics, medical history, dental history, history of current episode of facial swelling of odontogenic origin, examination findings and management. Data were entered in Microsoft(®) Excel and statistical analysis carried out using Statistical Analysis Software(®) version 9.3.

RESULTS/STATISTICS: Two hundred and fifty-three children were included in the study, with a mean age of 6.3 years. Sixteen percent of children were admitted for intravenous antibiotics, surgical management and supportive care. For the remaining children not admitted, a range of management approaches were undertaken. These included immediate surgical management with or without oral antibiotics, delayed surgical management following a course of oral antibiotics, or oral antibiotics alone, where the cause of the odontogenic infection had already been removed. For 2% of children, a delayed surgical management approach was unsuccessful and the children were admitted.

CONCLUSIONS

Management options for children presenting with facial swellings of odontogenic origin include admission to hospital for intravenous antibiotics and acute surgical management, immediate surgical management with or without a course of oral antibiotics or initial management involving a course of oral antibiotics, with definitive dental treatment being provided after resolution of the acute odontogenic infection.