Sir, I write further to an article published in the BDJ on 25 September entitled Management of odontogenic infections and sepsis: an update.1

Firstly, while recommending incision placement, the authors mention making the same on healthy skin or mucosa. It would be important to include here that skin incisions must be made as aesthetically as possible, keeping them parallel to (or in) existing skin tension lines.2 This would not only serve the purpose of the procedure but also enhance cosmetic outcomes.

The dimensions of the incision must allow for adequate access of the haemostat. An adequately sized incision enhances irrigation and avoids excessive build-up of pressure within the abscess cavity.2

Secondly, the authors recommend opening the haemostat 'at the depth of penetration'; a more specific way to ascertain this is to insert the haemostat till the resistance of healthy tissue is felt.2Apart from a microbiological swab, a syringe can also be utilised to obtain a sample of the drainage. This should ideally be sent for culture sensitivity testing (CST). The article describes dentists being guardians against antibiotic resistance, especially due to the fallout from the pandemic. This makes recommending CST even more important in cases where the abscess has clinically worsened in follow up appointments and antibiotic treatment is necessitated.

Thirdly, the authors have also mentioned wrong antibiotic choice and/or dosage as a cause for treatment failure. Utilising CST would help to circumvent this and move away from protracted empirical regimens and their associated issues.

Finally, the authors make the correct suggestion of never closing a haemostat while it is inside the wound. It would be informative for readers to know that the reason behind this is to avoid damaging any vital structures in the vicinity. Knowing the reason and its gravity would serve to underscore such a suggestion.