Why You May Need an Incision & Drainage Procedure

Abscesses are swollen pockets of soft tissue that are filled with pus, the thick, pale yellow or green liquid that often accompanies an infection. You can get abscesses anywhere in your body, including your mouth.

If you have a dental abscess, Robert S. Nance, DDS, MS, PA, an expert endodontist in Statesville and Hickory, North Carolina, removes the infection with an incision and drainage (I&D) procedure. Here’s why you might need an I&D and why it’s essential to treat an abscess as soon as possible. 

Infections don’t stay put

When your tooth aches, or if your gums are swollen or tender, you may be tempted to ignore it or dull the pain with over-the-counter analgesics. However, a painful or tender tooth, gum, or even discomfort in your mouth could be a sign of an abscess. Symptoms of an oral abscess include:

You may even experience a fever, which is your body’s attempt to fight the infection in your mouth. The infection in an untreated abscess can travel through your bloodstream to infect other teeth, your gums, your bones, and even spread to other organs in your body. Without I&D, an abscess could even cause life-threatening septic shock.

Types of abscesses

Any of the soft tissues in your mouth can develop an abscess. The three types of abscesses are:

Periodontal and gingival

Most common in adults, periodontal abscesses occur in the periodontium, the tissues — including your gums — that hold your teeth in place. The infection that causes the abscess often originates in the alveolar (i.e., jaw) bone.

Periodontal abscesses that are limited to the gums alone are called gingival abscesses. You’re more likely to develop gingival abscesses if you have gum disease, including gingivitis.


Periapical abscesses occur inside a tooth, usually around the the top of the tooth root. These types of abscesses are more common in children, who are prone to dental caries (i.e., cavities). However, anyone can develop periapical abscesses at any age, particularly if they have poor oral health habits.


A third, rarer type of oral abscess is called pericoronitis. This type of abscess occurs as a result of an infection in the gum flap that covers the tooth. However, it hasn’t yet erupted through the gums.

Hard to live with, easy to treat

The pain, discomfort, and swelling of an abscess can make your day-to-day life painful. You may start to adjust how you chew your food, in order to spare yourself pain, which could adversely affect your digestion and diet, too. However, an abscess is easily treated with I&D.

Dr. Nance and his team first numb the area around your abscess with local anesthesia. He then carefully incises your gums or drills into your infected tooth with specialized tools.

Once he opens the abscess and reaches the infection, he removes the infected material and drains the collected pus. He then flushes the area to remove any lingering bacteria or debris. If all of the infected material and pus has been removed, he closes the incision with a few sutures or fills the previously infected tooth.

In some cases, he may place a drain in the site of the removed abscess, so that any pus your body continues to produce will drain away. He removes the drain within three days and then either sutures your gums or fills your tooth.

Our team gives you explicit aftercare instructions so that your treatment area stays infection-free. You may need to gargle with salt water several times a day. You should continue to brush and floss as normal, taking care not to irritate your incisions.

If you suspect you have an abscess, or if your mouth or teeth are painful or sensitive, make an appointment for an evaluation and possible I&D today. Contact our team by phone or online form. 

You Might Also Enjoy...

Who Needs Apexification?

If you have a damaged tooth that’s not fully formed, you need a procedure to prepare it for a reparative root canal. Find out how apexification prepares your tooth for a root canal here.

What Happens If My Root Canal Fails?

A root canal should save a tooth — but what if it’s not successful? While these procedures usually work the first time, there are times when things don’t go according to plan. Take a moment to learn why and how to spot the signs of a problem.
4 Traumatic Dental Injuries and How They're Treate

4 Traumatic Dental Injuries and How They're Treate

If you knock out or break a tooth, you may think that all is lost. Visions of implants or dentures may paralyze you and keep you from taking the actions that can save your tooth. Act fast when there’s a dental emergency to get the treatment you need.
Gum Disease and Diabetes 

Gum Disease and Diabetes 

Were you aware that November is Diabetes Awareness Month? Or that gum disease and diabetes have important links that impact your health? How and why are two such seemingly unrelated conditions related? Find out here.