Unravelling Odontogenic Infections: Insights from 278 Patients in an Indian Tertiary Care Setting

Background : Odontogenic infections (OIs) pose a significant public health burden in low- and middle-income countries (LMICs) due to socioeconomic barriers and limited dental care access. This study characterizes OIs in an Indian tertiary care setting, evaluating clinical features, management, and outcomes. Methods : A retrospective cohort study of 278 patients with OIs (July 2022–July 2025) was conducted at a government tertiary care center in Western India. Data on demographics, clinical characteristics, comorbidities (e.g., diabetes mellitus [DM], malnutrition), risk factors (e.g., smoking, gutka chewing), diagnostics, management (e.g., incision and drainage [I&D], antibiotics), and outcomes were analyzed using chi-square tests, logistic regression, and Kaplan-Meier survival analysis. Results : Periapical abscesses (45.0%) and Ludwig’s angina (18.0%) were predominant, driven by poor oral hygiene (70.1%), smoking (39.9%), and uncontrolled DM (34.9%). Aggressive I&D (71.9%), modified incisions for Ludwig’s angina, and antibiotic sensitivity testing (ABST)-guided therapy (25.2%) achieved a 99.3% resolution rate. Complications (15.1%) included osteomyelitis (6.1%) and sepsis (6.1%), with a 0.7% mortality rate. DM (OR 3.5, 95% CI 2.0–6.1) and smoking (OR 2.8, 95% CI 1.5–4.9) predicted complications. Conclusion : OIs in LMICs are exacerbated by socioeconomic and clinical factors. Cost-effective interventions (e.g., sanitary pads, suction drains) and early management improve outcomes. Recommendations include enhanced oral health education, diagnostic access, and antibiotic stewardship.