Difference between revisions of "Dental problems"

Line 4: Line 4:
 
** Enamel
 
** Enamel
 
*** Routine f/u
 
*** Routine f/u
*** Nothing to do�
+
*** Nothing to do
 
** Enamel + dentin (yellowish)
 
** Enamel + dentin (yellowish)
 
*** Adult
 
*** Adult
 
**** Next day f/u
 
**** Next day f/u
**** Consider placing calcium hydroxide paste over fracture site as needed for comfort<span style="line-height: 20px"></span>
+
**** Consider placing calcium hydroxide paste over fracture site as needed for comfort<span style="line-height: 20px"></span>
*** Child�
+
*** Child
 
**** Place calcium hydroxide paste
 
**** Place calcium hydroxide paste
***** More important in children than adults because children have less dentin to protect the pulp�
+
***** More important in children than adults because children have less dentin to protect the pulp
**** Immediate referral�
+
**** Immediate referral
 
** Enamel + dentin + pulp (reddish)
 
** Enamel + dentin + pulp (reddish)
 
*** Immediate referral (dental emergency)
 
*** Immediate referral (dental emergency)
 
*** If no dentist is available, place moist cotton over exposed pulp and cover with foil or seal with canal sealant
 
*** 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)
+
*** Consider antibiotics (penicillin or clindamycin)
 
* '''Subluxation'''
 
* '''Subluxation'''
 
** Minimally mobile
 
** Minimally mobile
Line 22: Line 22:
 
** Markedly mobile
 
** Markedly mobile
 
*** Immediate referral for stabilization
 
*** Immediate referral for stabilization
*** Temporizing measure: �Periodontal pack in which tooth is bonded to its two neighboring teeth on both sides
+
*** Temporizing measure: Periodontal pack in which tooth is bonded to its two neighboring teeth on both sides
 
* '''Avulsion'''
 
* '''Avulsion'''
 
** Dental emergency
 
** Dental emergency
 
** Where is the tooth?
 
** Where is the tooth?
 
*** May be intruded, aspirated, swallowed, or embedded in the oral mucosa
 
*** May be intruded, aspirated, swallowed, or embedded in the oral mucosa
**** Consider facial films, CXR�
+
**** Consider facial films, CXR
 
** Adult
 
** Adult
 
*** Replace avulsed tooth as soon as possible! (as long as no alveolar ridge fx, no severe socket injury)
 
*** 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
 
**** Rinse tooth in saline, socket is suctioned (if necessary), reimplant tooth, bond tooth to neighboring teeth
**** Manipulate tooth only by the crown�
+
**** Manipulate tooth only by the crown
*** <span style="line-height: 20px">Storage solution (in order of efficacy): Hank's balanced salt solution > Milk > saliva > saline</span>
+
*** Storage solution (in order of efficacy): Hank's balanced salt solution > Milk > saliva > saline</span>
*** <span style="line-height: 20px">Tetanus vaccine if indicated��</span>
+
*** Tetanus vaccine if indicated
*** Consider antibiotics (penicillin or clindamycin)�<span style="line-height: 20px">�</span><span style="line-height: 20px">�</span>
+
*** Consider antibiotics (penicillin or clindamycin)
 
** Child
 
** Child
 
*** Do not reimplant primary teeth
 
*** Do not reimplant primary teeth
**** Refer to pedodontist for space maintainer<span style="line-height: 20px">�</span>
+
**** Refer to pedodontist for space maintainer
* <span style="line-height: 20px">'''Bleeding Socket'''</span>
+
* '''Bleeding Socket'''
** <span style="line-height: 20px">'''�'''�Apply pressure by having pt bite on gauze or tea bag</span>
+
** Apply pressure by having pt bite on gauze or tea bag
  
 
==Odontogenic infections==
 
==Odontogenic infections==
 +
===Dental Carie/Pulpitis===
 +
#dental referral only
  
 
+
===Periapical vs. Periodontal Abcess===
+
#drain
 
+
#PCN V
Dental Carie/Pulpitis==
 
 
 
 
 
 
 
 
dental referal only
 
 
 
 
 
 
Periapical vs. Periodontal Abcess==
 
 
 
 
 
drain
 
 
 
PCN V
 
 
 
 
  
 
Exquisite pain to percussion suggests an underlying periapical abscess,
 
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
 
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)
 
Acute Alveolar Osteitis (Dry Socket)
  
 
Dental Numbers
 
Dental Numbers
 
 
 
  
 
[[Category:ENT]]
 
[[Category:ENT]]

Revision as of 04:59, 13 March 2011

Dentoalveolar Injuries

  • Fracture
    • 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
      • 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

Dental Carie/Pulpitis

  1. dental referral only

Periapical vs. Periodontal Abcess

  1. drain
  2. 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

Acute Alveolar Osteitis (Dry Socket)

Dental Numbers