We reviewed eight patients with necrotizing fasciitis of odontogenic origin
. There were three women and five men, mean age 58 (range 46-72), and none
had any associated medical condition such as diabetes. All cases had sympto
ms of toothache for a mean duration of 34 days (range 26-42) before they so
ught treatment. Infection originated in the molar teeth region, and initial
ly presented as an odontogenic or periodontal abscess. The clinical feature
s of necrotizing fasciitis became apparent only after the superficial fasci
a had been invaded. The transient unusually reddish hue for a dark skin mig
ht be explained by the fact the deep fascia and muscles were affected befor
e the superficial fascia and skin. Necrosis of the skin began in the subman
dibular region and progressed downwards. The necrotic area was less than th
e extent of infection. Antimicrobial treatment, debridement, and fasciotomy
improved healing. Delay before appropriate treatment had an adverse affect
on outcome, and one patient died. (C) 2001 The British Association of Oral
and Maxillofacial Surgeons.