Dental Infections in Emergency Medicine Workup

Updated: Jan 04, 2018
  • Author: Lynnus F Peng, MD; Chief Editor: Jeff Burgess, DDS, MSD  more...
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Workup

Laboratory Studies

See the list below:

  • 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.

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Imaging Studies

See the list below:

  • 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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