A dental infection may spread locally and then systemically, resulting in increased morbidity and mortality. Evidence of spread is an indication for immediate evaluation.


Findings in the head and neck associated with infection spread:

(1) trismus

(2) elevated tongue and floor of mouth

(3) drooling

(4) periorbital cellulitis

(5) regional lymphadenopathy



(1) difficulty speaking

(2) difficulty swallowing

(3) difficulty breathing


Systemic findings associated with infection spread:

(1) fever (pyrexia)

(2) tachycardia

(3) tachypnea

(4) hypotension

(5) elevated white blood cell count

(6) dehydration

(7) poor glucose control (if diabetic)


Major concerns:

(1) airway obstruction

(2) sepsis

(3) spread to orbit and central nervous system

(4) thrombosis


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