No difference between irrigating and non-irrigating drains in the management of severe odontogenic infection


Dental infections all too frequently result in cellulitis or abscess formation. Treatment often requires incision and draining allow with extraction of the tooth. Simple non-irrigating gravity drains have been in use for more than a century while catheter type drains which allow the possibility of daily irrigation are increasingly popular.   The aim of this trial was to assess whether the use of irrigating drains in patients with severe odontogenic infection compared with non-irrigating drains result in a shorter length of stay (LOS).

Consecutive patients with severe odontogenic infections who required incision and drainage were randomized to irrigating drains (red rubber catheters n=24) or non-irrigating drains (Penrose drains, n= 22). The primary outcome was length of stay.

  • The mean LOS after surgery for the irrigating and non-irrigating groups was 2.8 and 3.3 days, respectively. The mean difference of 0.5 days (95% confidence interval, 0.6 to 1.6 days) was not significant (P = .38).
  • There was no statistically significant difference in overall length of stay, length of stay after surgery, temperature, or need for additional procedures between the 2 treatment groups.

The authors concluded

The use of non-irrigating drains appears to be equally efficacious as irrigating drains in the management of severe odontogenic infection.


This is is a relatively small study and, as the authors point out no power calculation was carried out so it may have been underpowered.


Bouloux GF, Wallace J, Xue W. Irrigating Drains for Severe Odontogenic Infections Do Not Improve Outcome. J Oral Maxillofac Surg. 2012 Jun 20. [Epub ahead of print] PubMed PMID: 22726703.




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Derek Richards

Derek Richards is the Director of the Centre for Evidence-based Dentistry, Editor of the Evidence-based Dentistry Journal, Consultant in Dental Public Health with Forth Valley Health Board and Honorary Senior Lecturer at Dundee & Glasgow Dental Schools. He helped to establish both the Centre for Evidence-based Dentistry and the Evidence-based Dentistry Journal. He has been involved with teaching EBD and a wide range of evidence-based initiatives both nationally and internationally since 1994.

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