Subperiosteal orbital abscess from odontogenic origin: A case report

•Subperiosteal orbital abscess is a rare complication of a dental infection.•Antibiotics alone are ineffective and do not guarantee arrest of the infection spread.•The possible route of infection spread should be determined, and is illustrated in this report.•Postseptal infections require a more aggressive approach compared to preseptal infections.•In case of an orbital infection, intraoral examination and dental radiography may not be overlooked. Subperiosteal orbital abcess is a rarely reported complication of odontogenic infections and can be associated visual impairment and neurological symptoms. Because of fast infection spreading, delay in diagnosis and treatment can result in permanent damage. A 55-year old presented with a right-sided subperiosteal orbital abscess originating from a decayed first upper molar. The associated loss of vision improved only after a extraoral surgical drainage. Three years later, recurrent headaches, photobia and ptosis still persist. Our case demonstrates a rare but potentially hazardous complication of untreated dental infections. The effect of antibiotics is often overestimated, and lack of treatment may lead to serious sequelae, certainly when the orbital infection is located posterior to the orbital septum. When intraoral drainage is insufficient, the infection should be accessed extraorally. Orbital infections require a thorough clinical evaluation, including the oral cavity as dental infections may be overlooked. Dental radiograpy plays a major role. Prompt and adequate treatment is crucial in preventing further spreading of odontogenic infections.