Odontogenic Infections in a Regional Hospital in Kuwait: 7 Years Retrospective Study

Objective: We review our experience with odontogenic infections requiring hospitalization, to identify etiological factors, the most frequently affected anatomical spaces, prognostic signs, bacterial pathogens and adequacy of initial empiric antibiotic therapy, surgical interventions, and the influence of these variables on the length of hospitalization.

Methods: A retrospective study of all patients hospitalized for management of odontogenic maxillofacial space infections from May 2013 to May 2020 was performed utilizing the admission database of the Oral & Maxillofacial Surgery Unit and computerized hospital information system of Al-Farwaniya Hospital in Kuwait. The databases were manually searched and the relevant data analyzed.

Results: The records of 95 (6.6% of all admitted) patients diagnosed with acute odontogenic infections were analyzed. They were 63 males and 32 females, M:F ratio 2:1. The age of patients ranged from 4 to 71 with a mean 32 and a median of 30 years. Twenty patients suffered from underlying medical conditions. The most frequently affected anatomical space was the submandibular one. In 85 patients the causative tooth was still present at the time of admission. Causative teeth were most frequently lower molars (n=72). An extraoral incision was performed in 74 patients, intraoral incision in 10 patients. All still present causative teeth were extracted in the same session. The length of hospital stays varied from 1 to 19 days with mean 4.5 days and modus 3 days.

Conclusions: No statistically significant relation was found between length of hospital stay and patient age, initial WBC value, CRP value, presence of diabetes, or adequacy of empiric antibiotic treatment. We believe that the overwhelming majority of hospital admissions for odontogenic infections could be prevented by timely and competent treatment including the extractions of causative teeth in outpatient settings.