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Incision and drainage (I&D), also known as clinical lancing, are minor surgical procedures to release pus or pressure built up under the skin, such as from an abscess, boil, or infected paranasal sinus.
Localised dental abscesses may be appropriately treated by intra-oral drainage via tooth extraction, opening of root canals and/or intra-oral incision and drainage. Wherever there are signs of spreading cervico-facial infection or significant systemic disturbance, however, patients should be referred urgently further management. [citation needed]
If the tooth is to be removed, drainage will occur via the socket. Otherwise, if pus is already discharging from the periodontal pocket, this can be encouraged by gentle irrigation and scaling of the pocket whilst massaging the soft tissues. If this does not work, incision and drainage is required, as described in Dental abscess Treatment.
Depending on the amount of drainage, a patient may have the drain in place one day to weeks. Drains will have protective dressings that will need to be changed daily/as needed. The routine use of drains for surgical procedures is diminishing as better radiological investigation and confidence in surgical technique have reduced their necessity.
If the infection involves multiple primary spaces or any of the secondary spaces previously mentioned, then incision and drainage with culture-guided antibiotics may be indicated. Since most mouth infections are polymicrobial, penicillin is an appropriate initial choice of antibiotic because of its activity against Streptococcus and gram ...
A dental abscess is a localized collection of pus associated with a tooth. The most common type of dental abscess is a periapical abscess , and the second most common is a periodontal abscess . In a periapical abscess, usually the origin is a bacterial infection that has accumulated in the soft, often dead, pulp of the tooth.
If the space contains pus, the usual treatment is by incision and drainage. The site of the incision is intra-oral, made lateral to sublingual plica. Incision of the plica itself can result in a ranula, or an incision placed medial to the plica can damage Wharton's duct, the sublingual artery and veins and the lingual nerve.
The pus can be removed by a number of methods including needle aspiration, incision and drainage, and tonsillectomy. [1] Incision and drainage may be associated with a lower chance of recurrence than needle aspiration but the evidence is very uncertain. Needle aspiration may be less painful but again the evidence is very uncertain. [13]