Dental problems

Revision as of 04:59, 13 March 2011 by Rossdonaldson1 (talk | contribs)

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