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Management of Odontogenic Infections in Children

Odontogenic Infections

Infections in the head and neck are serious and must be treated with consideration of the risk of spread. Bacterial infections of the face can be life threatening if inappropriately treated. Children will usually present much earlier than adults and it is important to remember that such infections in young children will progress more rapidly than in adults, but similarly, once managed appropriately, will also resolve faster.

Principles of Care

Table 36.1 Common antibiotic dosages for children.

History and Presentation

Children usually present early with acute infection that is most commonly a cellulitis rather than an abscess and a frank collection of pus. The child may be febrile and acutely unwell and there would usually be a history of previous toothache. Following several days of pain, a swelling may arise overnight with a relief of pain. This is due to the infection breaching the cortical plate of bone and then spreading through fascial planes. Lymph nodes may be enlarged.

Organisms Involved and Antibiotics

Typical odontogenic infections in children present with mixed flora that are principally Gram-positive facultative anaerobes including streptococci, Fusobacterium and Bacteroides subspecies. In this regard, it is important to choose an antibiotic that has a broad spectrum with activity against these organisms. Fortunately most oral organisms are sensitive to the synthetic penicillins and amoxicillin, or a first-generation cephalosporin should be the drug of first choice. Erythromy/>

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