Objectives: The aims of this retrospective study were to investigate the clinical characteristics of pediatric facial cellulitis of odontogenic origin and to compare the clinical differences between upper and lower facial infections and between genders.
Methods: Fifty-six children (28 boys and 28 girls) diagnosed with facial cellulitis of odontogenic origin during the year 2003 were selected for study. The average age was 5.72 ± 2.70 years. Clinical investigations included sex, location of cellulitis, peak occurrence month, symptoms of infection, preference of first visit, hospitalization status, timing of surgical or dental interventions, need for incision and drainage, source of infection, and management of the primary odontogenic origin. Children were divided into upper face and lower face groups depending on the location of the infection. The χ2 and Student t tests were computed to assess the differences in the various study variables between upper and lower face infections and gender.
Results: Upper and lower face infections were reported in 57.1 and 42.9% of children, respectively. The source of infection was mostly from the deciduous posterior teeth. The clinical symptoms included a frequent toothache before swelling, and less commonly fever and trismus. Hospitalization was needed in 53.6% of the patients, and the mean length of hospitalization was 5.03 ± 3.80 days. Surgical intervention such as incision and drainage was needed in only 25% of the cases. The majority of the patients had either surgical or dental interventions after subsidence of the swelling. The peak occurrence month was February. The source of infection in the upper face infections was significantly different from that of lower face infections (P < 0.01). Other study variables were not statistically significant for upper and lower face infections (P > 0.05).
Conclusions: The differences in upper and lower face infections and differences in gender were not clinically significant. Surgical or dental interventions can be delayed through the proper use of antibiotics. With correct diagnosis, antibiotic treatment and appropriate timing for surgical or dental interventions, rapid resolution of the infection is expected.
From the Chang Gung Memorial Hospital, Kaohsiung Medical Center, and Chang Gung University College of Medicine, Taiwan
Accepted for publication November 11, 2005.
E-mail Joe0430@ms13.hinet.net. Reprints not available.