Odontogenic Orofacial Infections in Pediatrics: Pathogenesis, Diagnostic Challenges, and Advanced Interdisciplinary Management in Clinical Practice
Abstract
Background: Odontogenic orofacial infections in children are common, potentially serious conditions originating from dental caries, pulpal disease, or periodontal pathology. Historically linked to high mortality, they remain a frequent reason for emergency department visits. Pediatric patients, often first seen by non-dental clinicians, present unique diagnostic and management challenges.
Aim: This article provides a comprehensive review of the pathogenesis, clinical presentation, and evidence-based management of pediatric odontogenic infections, emphasizing an interdisciplinary approach for optimal outcomes.
Methods: A detailed narrative review synthesizes current literature on the microbial etiology, pathophysiological spread, and risk factors for severe infection. It evaluates diagnostic strategies, including clinical examination and imaging (e.g., panoramic radiograph, CT scan), and analyzes therapeutic protocols from major dental and medical guidelines.
Results: The pathophysiology involves polymicrobial flora spreading from necrotic pulp or periodontal pockets along fascial planes, risking deep neck space infections like Ludwig’s angina. High-risk groups include children with diabetes, immunosuppression, or poor access to dental care. Diagnosis hinges on recognizing “red flag” symptoms (trismus, dysphagia, airway compromise). Management prioritizes definitive source control via drainage, endodontic therapy, or extraction. Antibiotics (e.g., amoxicillin) are adjunctive for systemic signs, not a substitute for dental intervention. Analgesia favors NSAID/acetaminophen combinations over opioids.
Conclusion: Successful management requires early recognition, accurate risk stratification, and prompt referral to dental specialists. A coordinated, interprofessional team approach is essential to prevent life-threatening complications and ensure effective treatment.
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Copyright (c) 2025 Yahya Ahmed Mohammed Baroot, Wardah Abdullah Mohammed Alotaibi, Athari Abeed Moadi Alotibi, Asma Mohammed Eisa Zalah, Omar Ahmed Darraj, Mohammad Nasser Hamdan Al Aftan, Hamdan Nasser Hamdan Alotaibi, Ibrahim Ahmed Abdo Khabrani, Hind Abdullah Al-Matroodi, Talal Mohammad Alotaiby, Ibrahim Mohammed As'ad, Hashemih Ali Mohammed Fattahi, Mohammad Soliman Jaber Alfaifi, Hassan Yazeed Yahya Ghazwani, Kholoud Omar Gramish, Kawther Mohsen Rizq Alkathere, Abdulrahman Abdullah Alamri
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