The association of travel distance and severity of odontogenic infections

Background: Odontogenic infections (OI) are a preventable disease which are commonly managed in a tertiary hospital setting. Prevention of severe infections and hospitalisation relies on timely and accessible primary dental care. This study outlines the pre-hospital treatment of patients presenting to hospital with OI’s and the association between travel distance from patients’ residence to a tertiary hospital Oral and Maxillofacial surgical (OMS) unit. Methods: This study analysed patients who initially presented hospital with an OI. Patient demographics, pre-hospital treatment and clinical markers of severity were recorded. The travel distance from the patient’s residence to the hospital was recorded in km, along with any inter-hospital transfer via road/air ambulance. Results: 227 patients were included in this study, 17.2% required an inter-hospital transfer. Of these patients 70.3% had prior treatment before hospitalisation, and antibiotics without source control was the most frequent treatment (83.1%). The mean travel distance for patients with more severe markers of infection significantly greater than patients with minor infections (p=<.001). Patients who required an inter-hospital transfer accounted for most cases with airway compromise requiring ICU admission. Conclusion: This study found that the majority of patients presenting to hospital with an OI had received antibiotics alone as treatment before hospitalisation. The travel distance from a tertiary hospital with OMS services had a significant correlation to more severe infections. This has important public health implications for the allocation of preventative dental services.