Dental problems: Difference between revisions

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==Dentoalveolar Injuries==
==Types==
{{Template:Dental Problems DDX}}


#[[Tooth Fracture]]
{{Maxillofacial trauma DDX}}


===[[Tooth Subluxation]]===
{{Facial swelling DDX}}
#Extrusive Luxation
##Reposition tooth
##F/u within 24hr for stabilization
##Temporizing measure: Periodontal pack in which tooth is bonded to its two neighboring teeth on both sides
#Lateral Luxation
##More extensive injury than extrusive luxation
###Associated with cracking or fracture of the surrounding alveolar bone
##Treatment
###Attempt repositioning of tooth
###Apply temporary splinting with periodontal dressing
###F/u within 24hr for stabilization
#Intrusive Luxation
##Most serious because of significant damage to alveolar socket and periodontal ligament
##Treatment
###Allow tooth to erupt on its own


===[[Tooth Avulsion]]===
==See Also==
#Dental emergency
*[[Dental numbers]]
#Often associated with alveolar ridge fracture
*[[Maxillofacial trauma]]
 
*[[Diagnoses by Body Part (Main)]]
#Where is the tooth?
## May be intruded, aspirated, swallowed, or embedded in the oral mucosa
###Consider facial films, CXR
#Adult
##Replace avulsed tooth as soon as possible (as long as no alveolar ridge fx, no severe socket injury)
###If reimplanted within 1hr 66% chance of good outcome
###Rinse tooth in saline, suction socket (if necessary), reimplant tooth, bond tooth to neighboring teeth
###Manipulate tooth only by the crown
##Storage solution (in order of efficacy): Hank's balanced salt solution > Milk > saliva > saline
##Penicillin or clindamycin
#Child
##Do not reimplant primary teeth
###Refer to pedodontist for space maintainer
 
===[[Bleeding Dental Socket]]===
# Apply pressure by having pt bite on gauze or tea bag
 
== Odontogenic Infections ==
=== [[Dental Caries (Pulpitis)]] ===
#Two types: reversible pulpitis and irreversible pulpitis
##Reversible Pulpitis
###Duration of pain is short (seconds)
###Associated with noxious stimuli (cold or heat)
##Irreversible Pulpitis
###Duration of pain is long (hours) and intense
###Associated with noxious stimuli or may occur spontaneously
###Tx = root canal or extraction
 
=== [[Periapical Abcess]] ===
#Treatment
##I&D
##Penicillin VK 500mg PO QID OR Clindamycin 300mg PO QID
##Dental referral
 
=== [[Trench Mouth (Acute Necrotizing Ulcerative Gingivitis)]] ===
====Background====
#Severe gingival disease
#Must distinguish from herpes gingivostomatitis
##Herpes has more systemic signs, less bleeding, lack of interdental papilla involvement
#Associated with immunosuppression, especially HIV
====Clinical Features====
#Triad of:
##Pain
##Ulcerated or "punched out" interdental papillae
##Gingival bleeding
#Secondary signs:
##Fetid breath
##"Wooden teeth" feeling
##Teeth mobility
##Fever
##Malaise
====Treatment====
#Chlorhexidine 0.01% oral rinse BID
#Metronidazole 500mg PO TID
#Dental debridement and scaling


==See Also==
==References==
*[[Acute Alveolar Osteitis (Dry Socket)]]
<references/>
*[[Dental Numbers]]


[[Category:ENT]]
[[Category:ENT]]
 
[[Category:ID]]
== Source ==
[[Category:Trauma]]
*ER Atlas
[[Category:Symptoms]]
*Tintinalli
*UpToDate

Revision as of 00:49, 12 February 2017

Types

Dentoalveolar Injuries

Odontogenic Infections

Other

Maxillofacial Trauma

Facial Swelling

See Also

References