Abstract
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 chisquare 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. CONCLUSIONS: OIs in LMICs are exacerbated by socioeconomic and clinical factors. Costeffective interventions (e.g., sanitary pads, suction drains) and early management improve outcomes. Recommendations include enhanced oral health education, diagnostic access, and antibiotic stewardship.