Delayed Diagnosis of Dental Abscess Results in Facial Disfigurement

Case Overview

This case involves a previously healthy twenty-five-year-old male with no significant past medical history. He presented to a dentist with a sudden onset of tooth pain, trismus, and severe swelling of the jaw. At the initial visit, no x-rays or other diagnostic studies were performed. The patient’s dentist referred him to an oral specialist when he returned to the practice four days later complaining of worsening of his symptoms. The oral specialist prescribed analgesia for relief of the pain and muscle relaxants. No examination was performed at this time despite the severity of the patient’s symptoms. The patient collapsed at home the following day. He was found unconscious by his roommate who called an ambulance. It was apparent that the patient was unconscious for an extended period of time before he was discovered. He was admitted to hospital. Subsequently, a large abscess was discovered two days after admission. A tracheostomy was put in place and surgery for the removal of neck and jaw muscles were required to prevent the spread of the infection to surrounding tissue. The delay in treatment resulted in further radical treatment. The patient now has a permanent injury and facial disfigurement.