Indications Periodontal or periapical abscess or cellulitis (ie, that began as a periapical abscess and is now spreading into adjacent soft tissues) Contraindications Absolute contraindications Signs of rapidly spreading infection (eg, high fever, tachycardia, tachypnea) or upper airway obstruction (eg, stridor, muffled voice): Such patients should be rapidly evaluated and managed in an emergency department.