The maxillary canine space can become directly involved as the result of infections from the maxillary canines. The infection from these long teeth can involve the canine space, the area superior to the muscles of facial expression. The resultant swelling obliterates the nasolabial fold on the affected side [obliteration of the nasolabial fold on the right side of patient’s face in the image below].

Superior spread of CSI, if not treated, may cause orbital/periorbital cellulitis or cavernous sinus thrombosis, both very serious infections requiring aggressive surgical interventions.  Emergency treatment for such infections include establishing drainage [detail described in previous post “Don’t Let the Sun Set on Pus!“], removing the source of infection through access, instrumentation, irrigation and placing intracanal medicament and prescribing antibiotics if indicated.  Antibiotics alone is not sufficient.

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