Is there an epidemic of admissions for surgical treatment of dental abscesses in the UK?

doi:10.1136/bmj.39549.605602.BE

From trainee to consultant, BMJ Group offers doctors around the world tailored information, special events, learning resources and recruitment services at every step along their career path.

... by doctors, for doctors, for patients
We are open for entries!

Online learning

BMJ Learning

High-quality CME / CPD for doctors and other healthcare professionals. BMJ Learning features hundreds of accredited, peer-reviewed learning modules in text, video, and audio formats. Find out more

Courses and Qualifications

BMJ Masterclasses

BMJ Masterclasses, led by experts, help clinicians to use the latest evidence and recent guidelines in practice and meet their CPD/CME requirements. Find out more

Exam Preparation

The leading provider of online exam preparation, helping over 167,000 healthcare professionals to pass their exams. Find out more

onExamination

Search all BMJ comment articles:

From

Limit by

Our online table of contents is updated at least twice each day. Read all articles published in the last 7 days.
Keep up to date with cardiology: Access the latest cardiovascular medicine resources from across BMJ Group.
The BMJ iPad app brings you the best of print and online, including live links to the latest news, blogs, video, and podcasts. Get the BMJ iPad app.
OPEN ACCESS: All research articles are freely available online, with no word limit. Find out more about the BMJ's open access policy. Submit your paper.
Countdown to London 2012: BMJ Group's Olympics portal highlights latest Olympics and sports medicine-themed research, comment and learning

Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

Steven J Thomas, consultant maxillofacial surgeon and senior lecturer1,
Charlotte Atkinson, lecturer in nutrition2,
Ceri Hughes, consultant maxillofacial surgeon1,
Peter Revington, consultant maxillofacial surgeon3,
Andrew R Ness, professor of epidemiology2

¹Division of Oral and Maxillofacial Surgery, University of Bristol, Bristol BS1 2LY
²Department of Oral and Dental Science, University of Bristol, Bristol BS1 2LY
³North Bristol NHS Trust, Bristol BS16 1LE

Correspondence to: S J Thomas Steve.Thomas{at}bristol.ac.uk

Accepted 8 March 2008

Steven J Thomas and colleagues think that recent changes in dental care provision have led to increased numbers of hospital admissions for dental abscess, and they suggest that access to routine and emergency dental care needs to be reviewed

Three complicated cases of dental abscess that presented in Bristol over a six month period in 2006 prompted us to investigate the frequency of admission for surgical treatment of dental abscess. Analysis of routine data on hospital admissions indicates that the number of admissions for surgical drainage of dental abscess has increased since the turn of the century.

Summary points

Dental sepsis is preventable
Dental sepsis can have serious local and systemic consequences
Dental abscess may present to both medical and dental practitioners
Hospital admissions for drainage of dental abscess have doubled in the past 10 years
Access to routine and emergency dental care needs to be reviewed

Three complicated cases of dental abscess

Case 1

In March 2006, a 48 year old woman was referred by her general practitioner to the accident and emergency department with a submandibular swelling, which had been present for a week. She was diagnosed as having a right submandibular abscess secondary to a carious infected tooth. She was started on antibiotics and the abscess was drained. After two days she became increasingly unwell. She was tachypnoeic, hypotensive, and oliguric. Computed tomography showed that she had a fluid collection extending from the neck to the aortic arch (fig 1)⇓. She underwent a left thoracotomy and pus was drained from around the trachea and aortic arch. She was transferred to the critical care unit for ventilation and haemofiltration. Chest radiographs were consistent with a diagnosis of adult respiratory distress syndrome. Her lung and renal function improved gradually. She spent 22 days on the critical care unit and a further 22 days on the surgical ward. …