Facial Swelling Caused by Dental Infection

‍The Problem

A 5-year-old male was seen in a medical emergi-care center with a chief complaint from the parent of pain and “his face is swollen”. He was also febrile (showing symptoms of a fever). The patient was diagnosed with a rapidly developing facial cellulitis (infection spreading into the soft tissues of the face), of probable dental origin. The child was given a shot of Rocephin, and was prescribed an oral antibiotic and an over-the-counter pain medication. The patient was then given a dental referral for further evaluation and treatment.

Note: Untreated facial cellulitis from a dental infection can lead to multiple systemic health complications, blindness, difficulty breathing, and in rare cases, death.

Diagnosis

Upon dental exam, the facial swelling had resolved in response to the antibiotics. This intraoral image reveals the swelling was now localized and associated with an upper left second primary (“baby”) molar that had a large cavity (dental caries) present. This presentation and diagnosis is considered urgent, and treatment should be rendered as soon as possible. The tooth will require extraction (removal). A discussion of the recommendation for a space maintainer should take place.

Inter-Professional Collaboration For Ideal Patient Care

This case is an excellent example of how healthcare providers, equipped with a  in their facility, are able to triage a patient and obtain a teledentistry consult for an initial diagnosis and treatment plan, followed by a referral for appropriate treatment. This inter-professional collaboration through telehealth capabilities leads to effective and efficient health care, and can reduce appointment numbers, time, and exposure to others during these times of COVID-19.

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‍Dr. Richard Simpson, DMD

Dr. Richard is a board certified pediatric dentist in private practice.

His achievements include:

• Diplomate in the American Board of Pediatric Dentistry

• Fellow in the American College of Dentists

• Fellow in the International College of Dentists

• Fellow in the American Academy of Pediatric Dentistry

• Advisory Board Member of The TeleDentists

• Advisory Board Member of Holland Healthcare

Dr. Richard’s experience and active interests include telehealth, child advocacy, health disparities, policy, and advancing improved medical-dental access to care. Dr. Richard is also a veteran with 15 years of military service.