Surgical Incision and Drainage

Dr. Reena Talwar
Authored By:
Dr. Reena Talwar

Surgical incision and drainage is a commonly used technique in oral surgery to treat dental infections which have progressed to oral swellings. If cavities of the teeth are left untreated, they can eventually progress to infections that spread into the jaw bones and later into the surrounding soft tissues. Not only is this process extremely painful for the individual, but it is also extremely dangerous. This is because untreated dental infections which have penetrated into the surrounding tissues can lead to a spreading of the infection to the brain or heart in a short period of time, causing severe illness and potentially death.

The first sign of a dental infection that has penetrated through the jaw bone into the surrounding soft tissues, other than pain, is a noticeable swelling of the individualā€™s mouth and/or face.

The way in which these types of infections are treated first begins with a complete review of the patientā€™s medical and dental history. It is crucial for the clinician to know the history of the current infection in order to develop an appropriate treatment plan to treat the infection.

In some situations, the tooth responsible for the infection may be salvaged. This is based on clinical assessment of the tooth and the relative prognosis for treating the infection by retaining the tooth. In most instances however, the tooth in question is often extracted in conjunction with performing the incision and drainage procedure. In this case, the extraction is performed at the same time as the surgical incision and drainage procedure.

The procedure is generally performed in an out patient setting under local anesthetic. For those individuals who are extremely apprehensive, oral and or intravenous sedation can be utilized in conjunction with the local anesthetic.

In general, once the region of the infection has been appropriately anesthetized or ā€œfrozenā€, a small incision/cut is made in the gums at the most prominent point of the oral swelling. The pus (purulence) is then drained and the site is irrigated with sterile saline solution. In certain instances where a significant amount of swelling and pus are present or when the infection has been long standing, the clinician may elect to place a rubber drain to keep the surgical site patent. This allows for any residual drainage of pus to occur and prevents the need for any further surgery at this site. The drain must be removed by the clinician in 24 to 72 hours after placement. The patient is required to follow-up with the clinician on a regular basis during the healing period. The timeline for follow-up is determined by the clinician based on his/her clinical assessment of the patient.

The patients are often placed on antibiotic therapy following the surgical procedure for a period of 7 to 10 days. A prescription for pain medication is also often provided.

Surgical incision and drainage is a routinely performed procedure for locally spreading dental infections which has demonstrated excellent outcome for patients.