Odontogenic infection
Identify the source, space involvement, systemic illness, airway risk and need for drainage or urgent escalation. Definitive source control is central.
Understand
Odontogenic infection follows fascial planes and can threaten airway, nutrition and systemic health. Drainage and removal of the source are central to control.
Assess
Assess breathing, voice, swallowing, tongue position, trismus, hydration, observations and the involved space. Ask about diabetes or immunosuppression and look for a drainable collection.
Apply
Escalate airway or sepsis concerns immediately and coordinate surgery, anaesthesia and medical care as needed. Antibiotics support indicated care but do not replace source control.
Key distinctions
Infection can spread above or below the mylohyoid and into deeper spaces; bilateral floor-of-mouth involvement is especially concerning. Vital signs, airway function, swallowing and hydration matter more than dental radiographic size. Source control may involve extraction, endodontic treatment or drainage, with antibiotics and inpatient support when indicated. Escalation for airway risk precedes detailed imaging.
Think through a case
A patient with floor-of-mouth swelling, muffled voice and dysphagia requires immediate airway-focused escalation, even if the visible tooth swelling seems small.
The distinction to remember
Do not wait for a dramatic fever or CT before seeking urgent help when airway features are present.
Test your recall
What makes a dental swelling an emergency?
Show answer
Airway compromise, rapidly spreading infection or systemic deterioration.