Difference between revisions of "Dental problems"
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== Odontogenic infections == | == 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) === | |
− | + | #Severe gingival disease with inflamed, friable, ulcerated gingiva w/ gray pseudomembrane | |
− | + | #Present with fever, foul breath, strong metallic taste | |
− | + | #Anaerobic flora are most common source | |
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− | === Trench Mouth (Acute Necrotizing Ulcerative Gingivitis) | ||
− | #Severe gingival disease with inflamed,friable,ulcerated gingiva | ||
− | #Present with fever,foul breath,strong metallic taste | ||
− | #Anaerobic flora are most | ||
#Treat with peridex and PO Abx covering oral flora, dental referral | #Treat with peridex and PO Abx covering oral flora, dental referral | ||
#Admission with parenteral Abx in patients with severe/systemic symptoms | #Admission with parenteral Abx in patients with severe/systemic symptoms | ||
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==See Also== | ==See Also== |
Revision as of 21:42, 15 November 2011
Contents
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
- Place calcium hydroxide paste
- Immediate referral
- Adult
- 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
- May be intruded, aspirated, swallowed, or embedded in the oral mucosa
- Adult
- Replace avulsed tooth as soon as possible (as long as no alveolar ridge fx, no severe socket injury)
- 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
- Tetanus vaccine if indicated
- Consider antibiotics (penicillin or clindamycin)
- Replace avulsed tooth as soon as possible (as long as no alveolar ridge fx, no severe socket injury)
- Child
- Do not reimplant primary teeth
- Refer to pedodontist for space maintainer
- Do not reimplant primary teeth
Bleeding 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
- Reversible Pulpitis
Periapical Abcess
- Treatment
- I&D
- Penicillin VK 500mg PO QID OR Clindamycin 300mg PO QID
- Dental referral
Trench Mouth (Acute Necrotizing Ulcerative Gingivitis)
- Severe gingival disease with inflamed, friable, ulcerated gingiva w/ gray pseudomembrane
- Present with fever, foul breath, strong metallic taste
- Anaerobic flora are most common source
- Treat with peridex and PO Abx covering oral flora, dental referral
- Admission with parenteral Abx in patients with severe/systemic symptoms
See Also
Acute Alveolar Osteitis (Dry Socket)
Source
ER Atlas