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The association of travel distance and severity of odontogenic infections

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Abstract

Background

Odontogenic infections (OI) are a preventable disease commonly managed in a tertiary hospital setting. Prevention of severe infections and hospitalisation relies on timely access to primary dental care. This study outlines the pre-hospital treatment of patients presenting to hospital with OIs and the association between travel distance from the patients’ residence to a tertiary hospital oral and maxillofacial surgical (OMS) unit.

Methods

This study analysed patients who initially presented hospital with an OI. Patient demographics, pre-hospital treatment, and clinical markers of severity were recorded. The travel distance from the patient’s residence to the hospital was recorded in kilometers, along with any inter-hospital transfer via road/air ambulance.

Results

Two hundred twenty-seven patients were included in this study, 17.2% required an inter-hospital transfer. Of these patients, 70.3% had prior treatment before hospitalisation, and antibiotics without source control was the most frequent treatment (83.1%). The mean travel distance for patients with more severe markers of infection significantly greater than patients with minor infections (p = < .001). Patients who required an inter-hospital transfer accounted for most cases with airway compromise requiring ICU admission.

Conclusion

This study found that most patients presenting to hospital with an OI had received antibiotics alone as treatment before hospitalisation. The travel distance from a tertiary hospital with OMS services had a significant correlation to more severe infections. This has important public health implications for the allocation of preventative dental services, and patient access to OMS services.

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Data availability

The data that support the findings of this study are available from Barwon Health but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of Barwon Health.

References

  1. Hwang T, Antoun JS, Lee KH (2011) Features of odontogenic infections in hospitalised and non-hospitalised settings. Emerg Med J 28(9):766–769

    Article  PubMed  Google Scholar 

  2. Ylijoki S, Suuronen R, Jousimies-Somer H, Meurman JH, Lindqvist C (2001) Differences between patients with or without the need for intensive care due to severe odontogenic infections. J Oral Maxillofac Surg 59(8):867–72; discussion 72–3.

  3. Fu B, McGowan K, Sun H, Batstone M (2018) Increasing use of intensive care unit for odontogenic infection over one decade: incidence and predictors. J Oral Maxillofac Surg 76(11):2340–2347

    Article  PubMed  Google Scholar 

  4. Jundt JS, Gutta R (2012) Characteristics and cost impact of severe odontogenic infections. Oral Surg Oral Med Oral Pathol Oral Radiol 114(5):558–566

    Article  PubMed  Google Scholar 

  5. Kinzer S, Pfeiffer J, Becker S, Ridder GJ (2009) Severe deep neck space infections and mediastinitis of odontogenic origin: clinical relevance and implications for diagnosis and treatment. Acta Otolaryngol 129(1):62–70

    Article  PubMed  Google Scholar 

  6. Opitz D, Camerer C, Camerer DM, Raguse JD, Menneking H, Hoffmeister B et al (2015) Incidence and management of severe odontogenic infections-a retrospective analysis from 2004 to 2011. J Craniomaxillofac Surg 43(2):285–289

    Article  PubMed  Google Scholar 

  7. Stathopoulos P, Igoumenakis D, Shuttleworth J, Smith W, Ameerally P (2017) Predictive factors of hospital stay in patients with odontogenic maxillofacial infections: the role of C-reactive protein. Br J Oral Maxillofac Surg 55(4):367–370

    Article  CAS  PubMed  Google Scholar 

  8. Fu B, McGowan K, Sun JH, Batstone M (2020) Increasing frequency and severity of odontogenic infection requiring hospital admission and surgical management. Br J Oral Maxillofac Surg 58(4):409–415

  9. Carter L, Lowis E (2007) Death from overwhelming odontogenic sepsis: a case report. Br Dent J 203(5):241–242

    Article  CAS  PubMed  Google Scholar 

  10. Maria A, Rajnikanth K (2010) Cervical necrotizing fasciitis caused by dental infection: A review and case report. Natl J Maxillofac Surg 1(2):135–138

    Article  PubMed  PubMed Central  Google Scholar 

  11. Liau I, Han J, Bayetto K, May B, Goss A, Sambrook P et al (2018) Antibiotic resistance in severe odontogenic infections of the South Australian population: a 9-year retrospective audit. Aust Dent J 63(2):187–192

    Article  CAS  PubMed  Google Scholar 

  12. Seppanen L, Rautemaa R, Lindqvist C, Lauhio A (2010) Changing clinical features of odontogenic maxillofacial infections. Clin Oral Investig 14(4):459–465

    Article  PubMed  Google Scholar 

  13. Flynn TR, Shanti RM, Levi MH, Adamo AK, Kraut RA, Trieger N (2006) Severe odontogenic infections, part 1: prospective report. J Oral Maxillofac Surg 64(7):1093–1103

    Article  PubMed  Google Scholar 

  14. Ricciardo P, Bobinskas A, Vujcich N, Nastri A, Goss A (2015) Survey of Australasian oral and maxillofacial surgeons 2011–scope and workforce issues. Int J Oral Maxillofac Surg 44(12):1569–1573

    Article  CAS  PubMed  Google Scholar 

  15. Flynn TR, Shanti RM, Hayes C (2006) Severe odontogenic infections, part 2: prospective outcomes study. J Oral Maxillofac Surg 64(7):1104–1113

    Article  PubMed  Google Scholar 

  16. Uluibau IC, Jaunay T, Goss AN (2005) Severe odontogenic infections. Aust Dent J 50(4 Suppl 2):S74-81

    CAS  PubMed  Google Scholar 

  17. Nadig K, Taylor NG (2018) Management of odontogenic infection at a district general hospital. Br Dent J 224(12):962–966

    Article  CAS  PubMed  Google Scholar 

  18. Clohessy J, Hoffman G, Cope D (2021) Geographic remoteness from a multidisciplinary team is associated with an increased clinical staging of head and neck cancer: a Newcastle (Australia) study. Int J Oral Maxillofac Surg Int J Oral Maxillofac Surg 51(7):862–868

  19. Daniell JR, Dolja-Gore X, McDowell L, Udovicich C, Rowe D, Iseli TA et al (2021) The impact of travel distance to treatment centre on oral tongue squamous cell carcinoma survival and recurrence. Int J Oral Maxillofac Surg 51(7):854–861

  20. Carter LM, Layton S (2009) Cervicofacial infection of dental origin presenting to maxillofacial surgery units in the United Kingdom: a national audit. Br Dent J 206(2):73–78

    Article  CAS  PubMed  Google Scholar 

  21. Uittamo J, Lofgren M, Hirvikangas R, Furuholm J, Snall J (2020) Severe odontogenic infections: focus on more effective early treatment. Br J Oral Maxillofac Surg 58(6):675–680

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors acknowledge Dr. Li Yang Lim (LLY5391@gmail.com) for providing the illustration in Fig. 1.

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Authors and Affiliations

  1. Department of Dentistry and Oral Health, La Trobe University, Bendigo, VIC, Australia

    Anton Sklavos, Kai Lee & Mohd Masood

  2. Department of Oral and Maxillofacial Surgery, Barwon Health, Geelong, VIC, Australia

    Anton Sklavos & Kai Lee

Authors
  1. Anton Sklavos
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  2. Kai Lee
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Contributions

AS, KL, and MM contributed to the conception and design of study. AS completed the data collection, analysis, and drafting of the manuscript. All authors contributed to the final review. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Anton Sklavos.

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Ethics approval and consent to participate

Ethical approval for this project was obtained via Barwon Health Research Ethics Committee Project ID: 72758. Local reference number #20/223. Patient permission was not applicable.

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The authors declare that they have no competing interests.

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Sklavos, A., Lee, K. & Masood, M. The association of travel distance and severity of odontogenic infections. Oral Maxillofac Surg 28, 245–252 (2024). https://doi.org/10.1007/s10006-022-01135-1

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  • DOI: https://doi.org/10.1007/s10006-022-01135-1

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