Patients with severe odontogenic infections receive insufficient dental treatment before hospitalization - a retrospective cross-sectional study.

Abstract

Objectives: The aim was to provide an in-depth characterization of patients hospitalized with severe odontogenic infections (SOI), especially in relation to the origin of the infection. Furthermore, the aim was to generate an overview of which kind of treatment the patients had received before hospitalization and to analyze risk factors for prolonged length of hospital stay.

Material and methods: The study was a retrospective cross-sectional study, which included patients hospitalized at the University Hospital of Copenhagen, Denmark, with SOI from November 2012 through 2019. Data were extracted from medical hospital records. Analysis was performed using the χ2 test, analysis of variance, multiple correspondence analysis (MCA), and logistic regression.

Results: A total of 384 eligible patients were included. The most frequent origin of infection was apical periodontitis (46.9%), infection after tooth extraction (25.8%), multiple infectious foci (8.6%), and pericoronitis (6.0%). Significant differences in concomitant diseases (p = 0.017) were found between the groups of origin of infection. The MCA model showed little to no ability to generate an in-depth characterization of the group of patients. Eleven patients (2.9%) were treated with incision and drainage before hospitalization, and 131 patients (34.3%) received no kind of antibiotic before hospitalization.

Conclusion: The results indicate that clusters of variables could not be related to the origin of infection. In general, patients received insufficient treatment before hospitalization. Future studies should define risk factors for developing SOI and examine dental records of dental treatment before hospitalization.

Clinical relevance: To improve prehospital treatment with patients with SOI, general dental practitioners should treat the origin of the infection, attempt drainage, and optimize the prescription of antibiotics.