Original Articles

Odontogenic Cervicofacial Infection in Pregnancy: A Need for Oral Care

Abstract

Objective: During pregnancy, changes occur in the oral environment with gingivitis predominating. The development of odontogenic infections within the period of pregnancy may endanger the life of the mother as well as that of her unborn baby.
Materials and methods: A retrospective observational study of cases of cervicofacial infection in women during pregnancy was conducted at the oral and maxillofacial surgery clinic of a northern Nigerian tertiary health care center from January 2006 to June 2018.
Results: Seventy women were managed for cervicofacial infection during the period reviewed, out of which 20 women (28.6%) presented during pregnancy. Their mean age was 33.8 ± 9.35 years with a range of 20 to 55 years. The 30-39 years age bracket had the highest frequency (40%) and the mean duration of pregnancy at presentation was 24.9 ± 11.12 weeks with a range between 10 to 36 weeks. Majority (n=15, 75.0%) presented in the 3rd trimester. At presentation, the frequently involved fascial space was unilateral submandibular space (n=10; 50.0%), All the patients had incision/drainage/decompression on the dental chair under local anesthesia (2% lidocaine with 1:80,000 adrenaline). The mean length of hospital stay was 13.9 ± 6.2 days with a range of 6 to 26 days. The mortality rate was 15% (n=3 cases).
Conclusion: There is a need for oral health evaluation in pregnant women during ante-natal visits to prevent these complications. Oral health education should also form part of teachings received by women both in the ante-natal and postnatal clinics.

1. Wong D, Cheng A, Kunchur R, Lam S, Sambrook PJ, Goss AN. Management of severe odontogenic infections in pregnancy. Aust Dent J 2012; 57: 498–503.
2. Sanz M, Kornman K, working group 3 of the joint EFP/AAP workshop. Periodontitis and adverse pregnancy outcomes: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. J Clin Periodontol 2013; 84: 164–9.
3. Giglio JA, Lanni SM, Laskin DM, Giglio NW. Oral health care for the pregnant patient. J Can Dent Assoc 2009; 75: 43-8.
4. Silk H, Douglass AB, Douglass JM, Silk L. Oral
Health during Pregnancy. Am Fam Physician 2008; 77: 1139-44.
5. Kloetzel MK, Huebner CE, Milgrom P. Referrals for Dental care during pregnancy. J Midwifery Womens Health 2011; 56: 110-7.
6. Fomete B, Agbara R, Osunde OD, Ononiwu CN. Cervicofacial infection in a Nigerian tertiary health institution: a retrospective analysis of 77 cases.
J Korean Assoc Oral Maxillofac Surg 2015; 41: 293-8.
7. Osunde OD, Anyanechi CE, Etim BA, Fomete B. Demographic and clinical characteristics of patients presenting with Cervico-Facial Cellulitis at the University of Calabar Teaching Hospital, Nigeria. Cross River Journal of Medicine 2017; 1: 15-24.
8. Doumbia-Singare K, Timbo SK, Keita M, Ag Mohamed A, Guindo B, Soumaoro S. Cervico-facial cellulitis during pregnancy: about a series of 10 cases in Mali. Bull Soc Pathol Exot 2014; 107: 312-6.
9. Gyébré Y, Gouéta A, Zaghré N, Sérémé M, Ouédraogo BP, Ouoba K. Complications of Cervicofacial Cellulitis Supported in University Hospital Yalgado Ouedraogo. International Journal of Otolaryngology and Head & Neck Surgery 2016; 5: 115-20.
10. Blankson PK, Parkins G, Boamah MO, Abdulai AE, Ahmed AM, Bondorin S, et al. Severe odontogenic infections: a 5-year review of a major referral hospital in Ghana. The Pan African Medical Journal 2019; 32: 71.
11. Han X, An J, Zhang Y, Gong X, He Y. Risk Factors for Life-Threatening Complications of Maxillofacial Space Infection. J Craniofac Surg 2016; 27: 385-90.
12. Han YW, Redline RW, Li M, Yin L, Hill GB, McCormick TS. Fusobacterium nucleatum Induces Premature and Term Stillbirths in Pregnant Mice: Implication of Oral Bacteria in Preterm Birth. Infect Immun 2004; 72: 2272–9.
13. Han YW, Fardini Y, Chen C, Iacampo KG, Peraino VA, Shamonki JM, et al. Term Stillbirth Caused by Oral Fusobacterium nucleatum. Obstet Gynecol 2010; 115: 442–5.
14. Aziz Z, Aboulouidad S, Bouihi ME, Fawzi S, Lakouichmi M, Hattab NM. Odontogenic cervico-facial cellulitis during pregnancy: about 3 cases. Pan Afr Med J 2020; 36: 258.
15. Omeje KU, Omeje IJ, Agbara R. Severe Cervicofacial Cellulitis in Pregnancy- A Review of 18 Cases. Iran J Otorhinolaryngol 2020; 32: 93-100.
16. Razafindrabe JAB, Randriamanatenasoa VH, Andrianasolo MF, Radaviarison JB, Rasoarimasy VO, Rakotovao JD. Epidemiological and clinical aspect of dental cellulitis in Antananarivo. J Med Sci 2007; 7: 1108-11.
17. Miloundja J, Assini Eyogho SF, Mandji lawson JM, Ondounda M, Koumba JS, Lekassa P, et al. Diffuse cervico-facial cellulitis: 32 cases in Libreville. Sante 2011; 21: 153-7.
18. Osunde OD, Bassey GO, Ver-or N. Management of Ludwig's Angina in Pregnancy: A Review of 10 Cases. Ann Med Health Sci Res 2014; 4: 361–4.
19. Hobson DT, Imudia AN, Soto E, Awonuga AO. Pregnancy Complicated by Recurrent Brain Abscess after Extraction of an Infected Tooth. Obstet Gynecol 2011; 118: 467–70.
20. Abramowicz S, Abramowicz JS, Dolwick MF. Severe Life Threatening Maxillofacial Infection in Pregnancy Presented as Ludwig’s Angina. Infect Dis Obstet Gynecol 2006; 2006: 51931.
21. Han YW, Houcken W, Loos BG, Schenkein HA, Tezal M. Periodontal Disease, Atherosclerosis, Adverse Pregnancy Outcomes, and Head-and-Neck Cancer. Adv Dent Res 2014; 26: 47-55.
Files
IssueVol 15, No 1 (March 2021) QRcode
SectionOriginal Articles
Published2021-04-25
DOI https://doi.org/10.18502/jfrh.v15i1.6065
Keywords
Mouth Infection Pregnancy Mortality Health Education

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Fomete B, Agbara R, Omeje K, Oguntayo A. Odontogenic Cervicofacial Infection in Pregnancy: A Need for Oral Care. J Fam Reprod Health. :1-7.