Overlooked Dental Infections in Children

Introduction The local head and neck anatomy allows the spreading of a localized pre-existent dental infection. The consequences of such cases may be fatal. Certain head and neck spaces are connected either by conjunctive connective tissue, either by lymph or blood vessels. Dental infections may easily spread to surrounding areas by means of diffusion through the maxillary sinus. The maxillary sinus is thus the main pathway that spreading dental infections start on. The following paper aims at exposing the importance of studying dental infections' spreading pathways and the necessity of having a correct and multidisciplinary approach in treating them. Matherial and method We present two cases of dental infections with consequent sinusal, orbital and pharyngeal complications in children. Results and Discussions The first case presents a thirteen-year-old girl, with an overlooked dental infection on her upper jaw (maxillary bone). The infection had consequently spread to the maxillary sinus and into the bony orbit. The second case presents a twelve-year-old boy with pansinusitis, peritonsillar abscess and left orbital cellulitis. The boy had a radicular root remnant on his upper left maxillary bone. The imagery confirmed the positive diagnosis in both cases. The patients underwent dental treatments in both cases, while under a complete course of antibiotics. Anthral punction and lavage (maxillary sinus washout) was performed daily in both cases. The main fascial spaces of the head and neck are inter-linked with each other and may lead to the spreading of a localized dental infection towards the peritonsillar or peripharyngeal spaces. Through the maxillary sinus, the infection may spread towards the bony orbit. This particular pathway greatly elevates the risk of a very serious and life-threatening complication: cavernous sinus thrombosis. Conclusion Overlooked dental infections may spread through certain pathways towards the sinuses, towards the bony orbit or towards the pharyngeal spaces. Sometimes, aggressive infections may exhibit certain complications caused by the spreading process. In rare cases, these complications can be life-threatening, so the early and correct diagnosis and correct treatment are highly important.