Dental problems

Dentoalveolar Injuries

1. Tooth Fracture
2. Tooth Subluxation
3. Tooth Avulsion
4. Bleeding Dental Socket

Odontogenic Infections

1. Dental Caries (Pulpitis)

1. Periapical Abcess

Trench Mouth (Acute Necrotizing Ulcerative Gingivitis)

Background

1. Severe gingival disease
2. Must distinguish from herpes gingivostomatitis
   1. Herpes has more systemic signs, less bleeding, lack of interdental papilla involvement
3. Associated with immunosuppression, especially HIV

Clinical Features

1. Triad of:
   1. Pain
   2. Ulcerated or "punched out" interdental papillae
   3. Gingival bleeding
2. Secondary signs:
   1. Fetid breath
   2. "Wooden teeth" feeling
   3. Teeth mobility
   4. Fever
   5. Malaise

Treatment

1. Chlorhexidine 0.01% oral rinse BID
2. Metronidazole 500mg PO TID
3. Dental debridement and scaling

See Also

• Acute Alveolar Osteitis (Dry Socket)
• Dental Numbers

Source

• ER Atlas
• Tintinalli
• UpToDate

Authors:

Claire, Jordan Swartz, Michael Holtz, Neil Young, robot, Ross Donaldson, Mark Russell