Laboratory Studies
In dental infections, a CBC count with differential is not mandatory, but a large outpouring of immature granulocytes may indicate the severity of the infection.
Blood cultures in patients who are toxic may help guide management if the course is prolonged.
Imaging Studies
Panorex and periapical dental films are used to identify involvement of tooth and surrounding bone in the infectious process. A limited facial series may also be performed to help visualize the offending area if these studies are not available; cooperation and communication with the radiology technician and radiologist is necessary.
A soft-tissue radiograph of the neck can be used to identify gas-producing infections and determines any mass effect that may potentially compromise the airway.
CT scan may be used for severe fascial plane infections to determine the extent, size, and location of the infectious process. Soft tissue planes may be seen; with increasing infection, inflammation, and fat streaking, the planes may be difficult to differentiate from adjacent muscle. CT scan helps elucidate abscesses, venous thrombosis, and lymph node involvement.
MRI is not yet favored because of cost and limited availability. CT scan is preferred for rapid visualization of odontogenic infections.
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Obvious swelling of the right cheek.
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Side view. Fluctuant mass extending toward the buccal side of the gum end to the gingival-buccal reflection.
