Abscess and Drainage

A dental abscess is a painful bacterial infection of a tooth or the surrounding gum tissue that forms pus. Abscess drainage is the removal of pus to relieve pain and prevent the subsequent spread of infection. Primary management of dental abscesses simply involves drainage and is followed with definitive management with root canal or tooth extraction depending on the situation and nature of the abscess, if needed.

• To release pus within the abscess to alleviate pain.
• To allow the body to recover by removing the abscess and treating the infection 
• To prevent infection from spreading to healthy tissues and bloodstream as it can cause fatal diseases like septicemia.
• To reduce pain & pressure in the affected area
• To assist in restoring oral health and help avert serious complications.

Abscess drainage is usually indicated in patients with:

• Severe, pulsating tooth pain that can radiate to the jaw or ear.
• Gum, cheek or jaw swelling. An unpleasant taste in the mouth or bad breath.
• Fever, which also may suggest that infection is spreading.
• An untreated cavity, gum disease or dental trauma in the mouth.

Understanding the type of abscess will aid in deciding the course of action:

• Periapical Abscess: Located at the root tip of a tooth, usually caused by advanced decay or trauma.
• Periodontal Abscess: Develops within the gum tissue (often due to gum disease)
• Gingival Abscess: Forms in the gum tissue, often because food or other foreign bodies get stuck in the gums.

Generally the following steps are involved in the process:

• Diagnosis & Examination: The dentist conducts a clinical examination to establish the severity and exact location of the abscess.
• Anesthesia Application: Local anesthesia is applied to provide comfort and numb the area.
• Incision & Drain: A cut is made so the pus can pour out, relieving pressure and pain.
• Irrigation & Cleaning: The area is cleaned and irrigated with a sterile solution to wash away bacteria and debris.
• Placement of drain (if required): In the event of substantial infection, a drain may be placed temporarily to continue draining the accumulation. If the infection is suspected to be bacterial, antibiotics are given to help eliminate the infection and stop the spread.
• Continue Treatment & Follow-up: You may require additional dental treatments (eg: root canal therapy or extraction) to treat the underlying cause of the abscess.

• Fast relief: Delivers immediate symptom and pressure relief.
• Infection control:Stops the infection from getting into nearby tissues and into the blood.
• Restoration of function: Assists in restoring the regular ability to eat and talk.
• Averting oral health diseases: Detecting and treating problems in the early stages diminishes the likelihood of suffering tooth loss and other complications.

• Minimally invasive: Typically done under local anesthesia, making for a quick, low-pain outpatient procedure.
• High success rate: If done early, long-term treatment success rates are high.
• Cost-effective: Dealing with an infection sooner rather than later can help avoid more invasive — and expensive — dental treatments down the line.

Abscess drainage relieves the immediate pain but the long-term success depends on treatment of the underlying condition. With adequate follow-up treatment (eg, root canal or periodontal therapy), the affected tooth can be well retained for several years.

The drainage procedure usually takes 15–30 mins. If additional treatments are required, the entire course of treatment can take weeks.

Incision and drainage of an abscess can run anywhere between: 

• Drainage Procedure: ₹1,500–₹3,500.
• Placement of Drain (if required): ₹3,000–₹15,000.
• Antibiotics: ₹200–₹2,000.
• Other Treatments (like: root canal or extraction)₹ 3,000– ₹ 20,000

Although abscess drainage is a common and relatively safe procedure, potential complications include:

• Swelling or pain immediately after treatment (temporary).
• Residual fluid may require further intervention.
• A reaction to anesthesia or prescribed antibiotics.
• Repeated infection if the underlying cause is not completely remedied.

• Not a final solution: Unlike a teeth cleaning, temporary drainage does not solve the problem; other dental work may also be necessary.
• Post operative discomfort: Minor pain and swelling may occur for a few days.
• Serious infections: On very rare occasions, a serious infection may need treatment in hospital, and, without treatment, can also be life threatening.

• Root Canal Treatment: Removal of infected pulp because save the tooth.
• Gum Treatment: In the case of a periodontal abscess, the first step in treatment may involve deep cleaning along with a specific antibiotic regimen.

• Medical management: All antibiotics and pain medications as prescribed should be continued.
• Warm salt water rinse: Gently rinse your mouth out with warm salt water multiple times throughout the day to maintain cleanliness in the area.
• Diet: Do not chew on the afflicted side until the area heals completely.
• Oral hygiene: Brush and floss as needed to assist in the healing process.
• Follow-up: Go to every follow-up appointment to ensure the injury is healing properly and to discuss any remaining issues.