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| ==Dentoalveolar Injuries== | | ==Types== |
| | {{Template:Dental Problems DDX}} |
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| #[[Tooth Fracture]]
| | {{Maxillofacial trauma DDX}} |
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| ===[[Tooth Subluxation]]===
| | {{Facial swelling DDX}} |
| #Extrusive Luxation
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| ##Reposition tooth
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| ##F/u within 24hr for stabilization
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| ##Temporizing measure: Periodontal pack in which tooth is bonded to its two neighboring teeth on both sides
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| #Lateral Luxation
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| ##More extensive injury than extrusive luxation
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| ###Associated with cracking or fracture of the surrounding alveolar bone
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| ##Treatment
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| ###Attempt repositioning of tooth
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| ###Apply temporary splinting with periodontal dressing
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| ###F/u within 24hr for stabilization
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| #Intrusive Luxation
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| ##Most serious because of significant damage to alveolar socket and periodontal ligament
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| ##Treatment
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| ###Allow tooth to erupt on its own
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| ===[[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?
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| ## May be intruded, aspirated, swallowed, or embedded in the oral mucosa
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| ###Consider facial films, CXR
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| #Adult
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| ##Replace avulsed tooth as soon as possible (as long as no alveolar ridge fx, no severe socket injury)
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| ###If reimplanted within 1hr 66% chance of good outcome
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| ###Rinse tooth in saline, suction socket (if necessary), reimplant tooth, bond tooth to neighboring teeth
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| ###Manipulate tooth only by the crown
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| ##Storage solution (in order of efficacy): Hank's balanced salt solution > Milk > saliva > saline
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| ##Penicillin or clindamycin
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| #Child
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| ##Do not reimplant primary teeth
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| ###Refer to pedodontist for space maintainer
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| ===[[Bleeding Dental Socket]]===
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| # Apply pressure by having pt bite on gauze or tea bag
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| == Odontogenic Infections ==
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| === [[Dental Caries (Pulpitis)]] ===
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| #Two types: reversible pulpitis and irreversible pulpitis
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| ##Reversible Pulpitis
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| ###Duration of pain is short (seconds)
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| ###Associated with noxious stimuli (cold or heat)
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| ##Irreversible Pulpitis
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| ###Duration of pain is long (hours) and intense
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| ###Associated with noxious stimuli or may occur spontaneously
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| ###Tx = root canal or extraction
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| === [[Periapical Abcess]] ===
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| #Treatment
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| ##I&D
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| ##Penicillin VK 500mg PO QID OR Clindamycin 300mg PO QID
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| ##Dental referral
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| === [[Trench Mouth (Acute Necrotizing Ulcerative Gingivitis)]] ===
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| ====Background====
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| #Severe gingival disease
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| #Must distinguish from herpes gingivostomatitis
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| ##Herpes has more systemic signs, less bleeding, lack of interdental papilla involvement
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| #Associated with immunosuppression, especially HIV
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| ====Clinical Features====
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| #Triad of:
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| ##Pain
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| ##Ulcerated or "punched out" interdental papillae
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| ##Gingival bleeding
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| #Secondary signs:
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| ##Fetid breath
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| ##"Wooden teeth" feeling
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| ##Teeth mobility
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| ##Fever
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| ##Malaise
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| ====Treatment====
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| #Chlorhexidine 0.01% oral rinse BID
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| #Metronidazole 500mg PO TID
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| #Dental debridement and scaling
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| ==See Also== | | ==References== |
| *[[Acute Alveolar Osteitis (Dry Socket)]]
| | <references/> |
| *[[Dental Numbers]]
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| [[Category:ENT]] | | [[Category:ENT]] |
| | | [[Category:ID]] |
| == Source ==
| | [[Category:Trauma]] |
| *ER Atlas
| | [[Category:Symptoms]] |
| *Tintinalli
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| *UpToDate
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