Delay in the Referral of Pregnant Patients with Fascial Spaces Infection: A Cross-Sectional Observational Study from Khartoum Teaching Dental Hospital, Sudan.

Abstract

Odontogenic infections have the potential to develop rapidly into deep-space infections and compromise the airway. This problem is aggravated by pregnancy because of the physiological changes. This study aimed to determine the causes of referral delay for pregnant patients presenting with fascial space infections. Ten pregnant patients with severe odontogenic infections reported to the outpatient clinic at Khartoum Teaching Dental Hospital included in the study during the study period included in the study. Patients with any systemic disease excluded. Demographic data were taken followed by history and then extraoral and intraoral examinations. A predesigned case report form was completed for each patient including the cause of referral delay, the offending teeth, space involved, and trimester at the time of presentation. The age range was from 18 to 35years, and the mean age was 26.5years SD ± 6.3. The odontogenic infections were most common in the last trimester (60%), followed by the late second trimester (40%).The most common tooth involved was the mandibular wisdom tooth (50%), and the submandibular space was the most frequently involved fascial space (70%). All patients were admitted and treated with incision and drainage under local anesthesia; the offending tooth was extracted and intravenous antibiotic and fluids were administered. Patients were on daily dressing until they were discharged on oral antibiotics. Two patients with Ludwig's angina progressed to necrotizing fasciitis. Misconceptions among women regarding dental treatment during pregnancy were the most common cause of the delay. The myths and misconceptions should be addressed by dentists and prenatal care providers about oral health during pregnancy, and obstetricians' awareness increased that oral health needs special attention during pregnancy.