Severe odontogenic infections in patients with mental disorders: the challenge of ineffective initial treatment

This study clarified possible delays and deficiencies in severe odontogenic infection (OI) treatment in patients with mental disorders.

Data of hospitalized patients with severe OI were evaluated retrospectively. The outcome variable was preceding health care visits prior to hospitalization. The primary predictor was patient's mental disorder. Explanatory variables were age, sex, smoking, heavy alcohol use, immunocompromised disease or medication, and time span from beginning of symptoms to hospitalization. Also, factors leading to intensive care unit (ICU) care were evaluated.

Preceding visits prior to hospitalization were found in 61 (35.5%) out of 172 patients with OI. In total, 27 patients (15.7%) had a current mental disorder, more commonly in women (26.0%) than in men (8.1%) (P = .001). Patients with mental disorders had preceding health care visits related to the current infection notably more often than patients without recent psychiatric history (51.9% vs. 32.4%), P = .053. Patient-related treatment delay remained nonsignificant. Heavy alcohol use (P = .010) and smoking (P = .025) predicted ICU treatment, but no association with patient's mental disorder was found.

A patient's mental disorder can complicate diagnosis of OI. Effective and timely treatment requires the professional's ability to simultaneously identify the patient's mental health challenges and progressing OI.