74 Cervico-facial infections following dental extraction

Introduction: Tooth extraction is the definitive treatment for resolution of dental infections and pathology. Some patients require hospital admission for management of subsequent post extraction sepsis with its associated morbidity. The objective of the study was to evaluate the incidence, risk factors and impact associated with cervico-facial infection post routine dental extractions. Method: A retrospective study was carried out of all patients admitted with cervico-facial infection following dental extraction over 17 months. Clinical records were analysed for demographic data, type, number and nature of tooth extraction along with circumstances prior to admissions. Results: Of 201 patients admitted with loco-regional infection 43 met the criteria. 44% of these patients had no medical history of note. Extractions were most commonly of wisdom teeth (47%), with 35% multiple and 53% surgical extractions. 67% of patients had oral antibiotics before admission. Sixty percent of patients presented via A&E although 51% of patients had prior dental review. Seventy-nine percent of patients required incision and drainage under GA. Six patients (14%) spent between them 34 days in Intensive Care Unit. 54% of patients had resultant scarring and one suffered antibiotic anaphylaxis. Conclusion: Post extraction sepsis can be associated with morbidity and mortality. This may be reduced by identification of those at risk along with more aggressive initial management at post extraction reviews. Medical history was not as strongly linked as expected. Multiple and/or more complex extractions of wisdom teeth are associated with a high risk.