Difference between revisions of "Dental problems"

(Dentoalveolar Injuries)
 
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==Dentoalveolar Injuries==
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==Types==
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{{Template:Dental Problems DDX}}
  
# '''Fracture'''
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{{Maxillofacial trauma DDX}}
## Enamel
 
### Routine f/u
 
### Nothing to do
 
## Enamel + dentin (yellowish)
 
### Adult
 
#### Next day f/u
 
#### Consider placing calcium hydroxide paste over fracture site as needed for comfort
 
### Child
 
#### Place calcium hydroxide paste
 
##### More important in children than adults because children have less dentin to protect the pulp
 
### Immediate referral
 
## Enamel + dentin + pulp (reddish)
 
### Immediate referral (dental emergency)
 
### If no dentist is available, place moist cotton over exposed pulp and cover with foil or seal with canal sealant
 
### Consider antibiotics (penicillin or clindamycin)
 
# '''Subluxation'''
 
## Minimally mobile
 
### Soft diet for 14 days
 
## Markedly mobile
 
### Immediate referral for stabilization
 
### Temporizing measure: Periodontal pack in which tooth is bonded to its two neighboring teeth on both sides
 
# '''Avulsion'''
 
## Dental emergency
 
## 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)
 
#### Rinse tooth in saline, socket is suctioned (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</span>
 
### Tetanus vaccine if indicated
 
### Consider antibiotics (penicillin or clindamycin)
 
## Child
 
### Do not reimplant primary teeth
 
#### Refer to pedodontist for space maintainer
 
# '''Bleeding Socket'''
 
## Apply pressure by having pt bite on gauze or tea bag
 
  
==Odontogenic infections==
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{{Facial swelling DDX}}
===Dental Carie/Pulpitis===
 
#dental referral only
 
 
 
===Periapical vs. Periodontal Abcess===
 
#drain
 
#PCN V
 
 
 
Exquisite pain to percussion suggests an underlying periapical abscess,
 
 
 
More commonly, fluctuant abscesses are a result of periodontal abscesses and are best treated with an incision and drainage
 
  
 
==See Also==
 
==See Also==
Acute Alveolar Osteitis (Dry Socket)
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*[[Dental numbers]]
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*[[Maxillofacial trauma]]
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*[[Diagnoses by Body Part (Main)]]
  
Dental Numbers
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==References==
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<references/>
  
 
[[Category:ENT]]
 
[[Category:ENT]]
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[[Category:ID]]
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[[Category:Trauma]]
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[[Category:Symptoms]]

Latest revision as of 00:49, 12 February 2017