Drain and treat: A rubber dam technique for acute periapical abscess

Abstract

Patients often report to the dental hospital with a complaint of toothache with extraoral swelling. Worried patients visit the dentist with a lot of apprehension. Acute dental infections with intraoral and extraoral swellings can be emergency and challenging to
manage. Reduced mouth opening and severe pain may not allow the dentist to create an orthograde access to root canals. It ensues when the bacteria spread from the dental pulp to the surrounding periapical tissues accompanied by the formation of pus. If left untreated, these infections can be excruciatingly painful and pose a severe risk of spreading to facial spaces and finally, they may propagate to deep neck areas or ascend to intracranial sinuses. Hence, knowledge of its clinical management is of utmost importance. An acute periapical abscess has to be accurately diagnosed to render proper management of these maladies. Treating dentists should have a basic understanding of the pathophysiology, the suitable usage of antibiotics, the medical history of the patient, and standard treatment protocols. Therefore, this case report describes the management of an acute periapical abscess which was an emergency, and its conservative management.