Odontogenic infections are among the most frequent pediatric dental emergencies and may lead to serious systemic complications if not managed properly.
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Video 🔽 Management of antibiotics in odontogenic infections in pediatric dentistry ... We share two videos on the correct use and management of the most used antibiotics in infections of odontogenic origin in pediatric dentistry.This academic article presents an updated overview of their causes, clinical presentation, therapeutic approach, and prevention strategies, based on current evidence and international recommendations.
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✅ Introduction
Pediatric odontogenic infections originate in the dental or periodontal tissues and commonly arise from untreated caries, dental trauma, or eruptive complications. According to the American Academy of Pediatric Dentistry (AAPD, 2023) and the World Health Organization (WHO, 2023), these infections require prompt intervention to avoid serious outcomes, including cellulitis, airway obstruction, and sepsis. Early diagnosis and rational antibiotic use are critical in reducing risks and improving patient outcomes.
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PDF 🔽 Pharmacological treatment of oral infections in pediatric dentistry - Recommendations and dose calculation ... In comparison, the metabolism of a drug in a child is different from that of an adult, so the administration of an antibiotic should be taking into account the diagnosis, age and weight of the pediatric patient.✅ Etiology and Risk Factors
The most frequent causes include:
° Advanced dental caries: The main entry route for bacteria into the pulp and periapical tissues.
° Dental trauma: Which exposes the pulp to bacterial contamination.
° Complicated tooth eruption: Such as pericoronitis in erupting molars.
° Poor oral hygiene and high-sugar diets: Major modifiable risk factors for infection.
✅ Clinical Signs and Symptoms
Typical features include:
° Persistent toothache
° Facial swelling
° Intraoral or extraoral abscess
° Fever, trismus, and general discomfort
° Regional lymphadenopathy
Diagnosis involves a comprehensive clinical examination supported by radiographs (periapical or panoramic) and, when necessary, blood tests (Fuks & Peretz, 2022).
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Video 🔽 Are Antibiotics Enough To Treat A Tooth Infection? ... Night pain is one of the characteristic signs of dental infection and one of the reasons for most consultation in dental emergencies.✅ Current Management Guidelines
1. Early Diagnosis
Timely diagnosis is crucial. Delayed treatment increases the risk of systemic spread and hospitalization. Pediatricians and general dentists should be trained to recognize signs of odontogenic infections and refer appropriately.
2. Clinical Treatment
° Abscess drainage: Via incision or puncture depending on site and severity.
° Pulp therapy or extraction: Based on the degree of structural damage.
° Antibiotics: Indicated only for systemic involvement (fever, facial cellulitis, trismus). Amoxicillin-clavulanate is first-line, while clindamycin is used for penicillin-allergic patients (AAPD, 2023).
3. Pain and Inflammation Control
Use of over-the-counter analgesics like acetaminophen or ibuprofen under professional guidance is effective for symptom relief.
✅ Prevention and Long-Term Strategies
Effective prevention includes:
° Early dental visits: By age 1 or upon eruption of the first tooth.
° Oral hygiene education: For caregivers and children.
° Fluoride applications and sealants: For high-risk teeth.
° Routine check-ups every 6 months: To detect early-stage caries.
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Odontogenic infections in children are highly preventable yet remain a public health concern in underserved communities. Misuse of antibiotics and delayed care often worsen outcomes. Studies show that infections of dental origin are a leading cause of pediatric facial cellulitis and hospital admissions for deep-space infections (Thikkurissy et al., 2020).
There is also a pressing need to address antimicrobial resistance. Inappropriate prescriptions for viral or non-infectious conditions continue to contribute to global resistance patterns (WHO, 2023). Proper clinical judgment and caregiver education are vital components of comprehensive care.
Conclusion
Managing pediatric odontogenic infections effectively involves prompt diagnosis, evidence-based treatment, and sustained preventive efforts. Dental professionals, physicians, and families must work collaboratively to ensure oral health is prioritized from early childhood. Rational antibiotic use, regular dental assessments, and public health education are key pillars for minimizing complications.
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PDF 🔽 Pharmacological treatment of oral infections in pediatric dentistry - Recommendations and dose calculation ... In comparison, the metabolism of a drug in a child is different from that of an adult, so the administration of an antibiotic should be taking into account the diagnosis, age and weight of the pediatric patient.📚 References
✔ American Academy of Pediatric Dentistry. (2023). Guideline on oral health care for the pediatric patient. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: AAPD.
✔ Fuks, A. B., & Peretz, B. (2022). Pediatric Endodontics: Current Concepts in Pulp Therapy for Primary and Young Permanent Teeth (2nd ed.). Springer. https://doi.org/10.1007/978-3-030-80157-0
✔ Thikkurissy, S., Miller, C., Casamassimo, P. S., & Berg, J. (2020). Management of dental infections in children: A review. Journal of the American Dental Association, 151(3), 180–187. https://doi.org/10.1016/j.adaj.2019.12.004
✔ World Health Organization. (2023). Antimicrobial resistance: global report on surveillance 2023. Geneva: WHO. https://www.who.int/publications/i/item/9789240071928
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