Difference between revisions of "Dental problems"

(Created page with "==Avulsion== Q1min = inc 1% failure rate (~100min --> no point in replanting) *missing tooth check jaw x-ray & ?CXR/stomach ==Fracture (Ellis)== I (enaml) --> do nothin...")
 
Line 1: Line 1:
==Avulsion==
+
==Dentoalveolar Injuries==
  
  
Q1min = inc 1% failure rate
+
* Fracture
 
+
* Enamel
(~100min --> no point in replanting)
+
* Routine f/u
 
+
* Nothing to do
*missing tooth check jaw x-ray & ?CXR/stomach
+
* 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
 
   
 
   
  
==Fracture (Ellis)==
+
==Odontogenic infections==
  
 
I (enaml) --> do nothing, dentist f/u
 
 
II (dentin) --> 1dy F/U
 
 
III (pulp; bleeds) --> immed dental
 
  
 
   
 
   
  
==Bleeding Socket==
+
Dental Carie/Pulpitis==
  
 
pressure
 
 
tea bag
 
 
gel foam
 
  
 
   
 
   
 
==Dental Carie/Pulpitis==
 
 
  
 
dental referal only
 
dental referal only
Line 39: Line 57:
 
   
 
   
  
==Periapical vs. Periodontal Abcess==
+
Periapical vs. Periodontal Abcess==
  
  
Line 48: Line 66:
 
   
 
   
  
==Impacted Molar==
+
Exquisite pain to percussion suggests an underlying periapical abscess,
 
 
 
 
NS soakes
 
  
 
   
 
   
  
*sy infect --> abx, urgent f/u
+
More commonly, fluctuant abscesses are a result of periodontal abscesses and are best treated with an incision and drainage
  
 
   
 
   
  
==See Also==
+
===See Also:===
  
  
ENT: Acute Alveolar Osteitis (Dry Socket)
+
Acute Alveolar Osteitis (Dry Socket)
  
ENT: Dental Numbers
+
Dental Numbers
  
  

Revision as of 23:38, 1 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==



dental referal 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:

Acute Alveolar Osteitis (Dry Socket)

Dental Numbers