Sir, we write further to the paper on the management of odontogenic infections and sepsis.1 We totally agree that early recognition and prompt management of sepsis improves outcomes. As mentioned in the paper, there is a strong belief that once the abscess is formed, surgical drainage is mandatory to achieve resolution. We would like to draw attention to a few additional considerations in managing such situations, which are as follows:

  1. 1.

    Regarding elimination of the source of the infection, if the cause of infection is odontogenic and there is a possibility of saving the tooth, initiation of root canal treatment (RCT) with drainage of the abscess through the canal using copious amount of saline irrigation should be used before incision and drainage is attempted

  2. 2.

    If drainage of the abscess through the root canal is difficult, a sterile #10 or #15 K file can be used for slight over instrumentation beyond the apical constriction. This helps in achieving apical patency which aids in drainage of the abscess through the canal.2 A considerable amount of time should be given for this procedure. Once the abscess is drained, root canal therapy can be continued or if time is a constraint, a closed dressing should be given, and the patient recalled after 24 hours for review and continuation of the RCT

  3. 3.

    Thorough root canal debridement during the first session is vital for minimising the possibility for spread of infection in addition to incision and drainage of the abscess.3

In our clinical experience of over ten years in managing odontogenic infection and sepsis, initiation of RCT with drainage through the canal is effective in reducing patients' pain, swelling and minimising the risk of spread of infection to tissue spaces.