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References

Steele JG, Treasure ET, O'Sullivan I, Morris J, Murray JJ Adult Dental Health Survey 2009: transformation in British oral health 1968–2009. Br Dent J. 2012; 213:523-527
Thomas SJ, Highes C, Atkinson C, Ness AR, Revington PJ Is there an epidemic of admissions for surgical treatment of dental abscess in the UK?. Br Med J. 2008; 336:1219-1220
Freeman R Reforming NHS dentistry. Equitable distribution of affordable dental services is still possible. Br Med J. 2008; 336:1202-1203
Moles DR, Frost C, Grundy C Inequalities in availability of National Health Service general dental practitioners in England and Wales. Br Dent J. 2001; 190:548-553
Vieira F, Allen SM, Stocks RM, Thompson JW Deep neck infection. Otolarngol Clin North Am. 2008; 41:459-483
Ellis H, 11th edn. Blackwell: Oxford; 2006
Handley T, Devlin M, Koppel D, McCaul J The sepsis syndrome in odontogenic infection. J Intensive Care Med. 2009; 10:21-25
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Robertson D, Smith AJ The microbiology of the acute dental abscess. J Med Microbiol. 2009; 58:155-162
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A guide to deep neck space fascial infections for the dental team

From Volume 43, Issue 8, October 2016 | Pages 745-752

Authors

Barry Main

PhD, MRCS(Ed), MFDS(Ed), MB ChB(Hons), BDS(Hons), BMSc(Hons)

Lecturer and Specialty Registrar, Division of Oral and Maxillofacial Surgery, School of Oral and Dental Science, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY

Articles by Barry Main

John Collin

BSc(Hons), MBChB, MRCS BDS(Hons)

Specialty Registrar in Oral and Maxillofacial Surgery, Division of Oral and Maxillofacial Surgery, School of Oral and Dental Science, University of Bristol, Lower Maudlin Street, Bristol BS1 2LY

Articles by John Collin

Margaret Coyle

BA, BDentSc, MFDS RCSI, MB BCh BAO, FRCS(OMFS)

Consultant Oral and Maxillofacial Surgeon, Gloucestershire Royal Hospital, Gloucester, GL1 3NN

Articles by Margaret Coyle

Ceri Hughes

BDS, FDS RCS, MBChB, FRCS(OMFS), FRACDS(OMS)

Specialist Registrar, Department of Oral and Maxillofacial Surgery, Southmead Hospital, Bristol.

Articles by Ceri Hughes

Steven Thomas

BDS(Lond), MB, BCh(Wales), PhD(Q'ld), FDS RCS, FRCS(Eng), FRCS(OMFF)

Professor and Consultant in Oral and Maxillofacial Surgery, Division of Oral and Maxillofacial Surgery, School of Oral and Dental Science, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY, UK

Articles by Steven Thomas

Abstract

The majority of serious dental infections can be prevented by early treatment of the local pathology. Patients with potentially life-threatening neck space infections arising from the oral cavity may, however, still present in dental practice. This paper outlines the pertinent surgical anatomy and pathophysiology, signs and symptoms, and key early-stage management of these severe infections.

CPD/Clinical Relevance: The dental team should be able to assess patients presenting with potential neck space involvement from a dental or oral infection. They should be able to instigate appropriate early treatment, and identify those requiring prompt referral for assessment and management.

Article

Despite overall improvements in the oral health of the population,1 reports in the literature suggest an increase in the incidence of patients being managed for the complications of dental abscess by maxillofacial teams in the UK.2 An analysis of in-patient episodes for NHS Trusts in England showed a doubling in admissions and bed days required for the operative management of dental abscess in the period 1998–1999 and 2005–2006.2 The reasons for this are not entirely clear but it may, in part, reflect changes in the delivery of, and access to, dental services in the UK.3 There is also evidence that the incidence of dental abscess is related to socio-economic deprivation.4 These statistics reveal that, in many cases, dental infection is not being addressed at an early stage and, therefore, patients are presenting late with potentially serious sequelae.

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