Managing Acute Apical Abscess
Like all acute clinical scenarios, acute apical abscesses have a way of presenting themselves just when you don’t want them to. And though there is always a temptation to prescribe antibiotics and schedule the patient for a more convenient time, Dr. Rodrigo Cunha, an endodontist from Winnipeg, believes that antibiotics alone should not be the primary course of action.
In this edition of CDA Oasis Live with Dr. John O’Keefe, Director of Knowledge Networks, Dr. Cunha explains that antibiotics should only be used an adjunct to the primary treatment option - drainage.
He walks through the three common drainage techniques available, outlines the anesthesia options, and shares valuable details of his own best practice regarding follow up procedures, analgesics, and when to prescribe antibiotics.
We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.
Until next time!
CDA Oasis Team
Question Dr. Cunha: One, most often, if I go through the I and D, no purulence comes as true pus has not formed, usually is more like a localized cellulitis. So, no relief, do you leave the drain in, and prescribe antibiotics to focus the infection? Secondly, the literature is replete with all the bad things about antibiotics, including AAE and CAE, where generally AB’s NOT recommended. Irrespective, most often upon questioning my patient on return, they have been placed on “covering” AB’s. Same for OMFS. Is there something I am missing, the GP consensus is that due to title, specialists can “get away” with this? I would appreciate you viewpoint here. I get it every case is individual, however in managing cases by myself, and reviewing AB admin. criteria, the percentage I place on AB’s significantly lower than Specialists.