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ORO-FACIAL FASCIAL SPACE INFECTION IN A PAEDIATRIC GAMBIAN POPULATION: A REVIEW OF 93 CASES.

V N Okoje1, K U Omeje2, E Okafor3

  • 1Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Oyo State, Nigeria and Sabbatical consultant to Edward Francis Small Teaching Hospital Banjul, Gambia.

Journal of the West African College of Surgeons
|February 8, 2021
PubMed
Summary

Oro-facial fascial space infections in Gambian children are often caused by neglected dental caries, primarily affecting the submandibular space. Prompt dental care and specialist training are crucial to reduce the significant 5.4% mortality rate.

Keywords:
GambiaOro-facialfascial spaceinfectionsodontogenicpaediatric

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Pediatric Dentistry
  • Infectious Diseases

Background:

  • Oro-facial fascial space infections are a severe complication of neglected dental care, particularly in children with high caries experience.
  • These infections can progress rapidly in pediatric patients, posing a higher mortality risk compared to adults.

Purpose of the Study:

  • To document and evaluate the epidemiological patterns of oro-facial fascial space infections in the pediatric population of The Gambia.
  • To identify common clinical features, causative factors, and treatment outcomes for these infections.

Main Methods:

  • A 4-year descriptive retrospective survey (May 2015 - April 2019) of pediatric patients managed for oro-facial fascial space infections.
  • Data collected included sociodemographic, medical, and dental history; clinical features; and treatment interventions.
  • Statistical analysis using SPSS, employing chi-square and student t-tests for categorical and numerical variables, respectively.

Main Results:

  • Ninety-three pediatric patients (3 months - 16 years) were analyzed; 87.1% presented with fever, facial swelling, and toothache.
  • The majority (87.1%) of infections were odontogenic, commonly involving the submandibular space and posterior teeth, especially the first permanent molars.
  • A 5.4% mortality rate was observed, with younger children (mean age 3.0 years) having a significantly higher risk of death.

Conclusions:

  • Fever, facial swelling, and toothache are key symptoms of oro-facial fascial space infections in Gambian children, often stemming from odontogenic sources.
  • Submandibular space and posterior teeth, particularly first permanent molars, are frequently affected.
  • The high burden of dental caries necessitates improved dental surgeon training, public advocacy for regular check-ups, and prompt treatment to mitigate severe outcomes and mortality.