Dental problems

Revision as of 23:38, 1 March 2011 by Robot (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==



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