San Diego Center for Oral and Facial Surgery

Infections and Pathology

Infections of the Head and Neck

Infections of the head and neck can occur for multiple reasons. These reasons are listed in the following table:

Site of Origin Usual Presenting Signs and Symptoms
Tooth Toothache due to a severe cavity, advanced gum disease, or impaction of a tooth.
Sinuses Pain or pressure under or behind the eyes with nasal discharge and congestion. 
Throat Pain in the throat caused by a viral or bacterial infection of the tonsils or throat area.
Skin Redness, irritation, and swelling around a blemish of the skin.

Oral and maxillofacial surgeons are usually the ones to treat head and neck infections if they result from dental origin. Often a nonvital tooth with a dead (necrotic) pulp can abscess. This means that bacteria have colonized the necrotic pulp and are spreading from the tooth root into the surrounding bone. The infection destroys bone and spreads into the surrounding soft tissue causing swelling, redness, and pain. The destruction of bone is evidenced  by a dark area surrounding the tip (apex) of the tooth root on an x-ray.

If the infection is not treated or is inadequately treated, it can spread to other vital areas such as the neck, throat, chest or brain and become life threatening. Any facial swelling related to an infected tooth should be immediately evaluated by an oral and maxillofacial surgeon. Although some infections will only require treating the source of the infection (such as a root canal or tooth extraction) and antibiotics, others may require surgical drainage of the infection and possible hospitalization.

Infections caused by impacted third molars and abscessed teeth can spread into the surrounding tissues of the head and neck. In this case, the infection spread into the soft tissue spaces of the neck resulting in near collapse of the airway and a life threatening emergency. Months previous to this, the patient was advised to have her third molars removed; however, the patient failed to comply with the recommended treatment. The patient was taken to the hospital where emergency medical and surgical treatment were initiated. The patient survived and recovered well afterwards.

 

Pathology

A vast array of pathologic conditions can occur in the head and neck region. No condition is too small to see your oral and maxillofacial surgeon, dentist, or physician for a thorough examination.

Extensive destruction of the right lower jaw due to a bone tumor known as an ameloblastoma. Although this type of tumor is usually benign, ameloblastoma can cause extensive damage. This is due to the fact that this tumor is generally slow growing and produces little symptoms until extensive damage has occurred. The right half of the lower jaw was removed and subsequently reconstructed using rib and hip bone.