Dental problems: Difference between revisions

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

dental referral 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

@@ Line 4: / Line 4: @@
 ** Enamel
 *** Routine f/u
-*** Nothing to do�
+*** Nothing to do
 ** Enamel + dentin (yellowish)
 *** Adult
 **** 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
-***** 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)
 *** 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)�
+*** Consider antibiotics (penicillin or clindamycin)
 * '''Subluxation'''
 ** Minimally mobile
@@ Line 22: / Line 22: @@
 ** Markedly mobile
 *** 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'''
 ** Dental emergency
 ** Where is the tooth?
 *** May be intruded, aspirated, swallowed, or embedded in the oral mucosa
-**** Consider facial films, CXR�
+**** 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�
+**** 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
 *** 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==
+===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,
 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)
 Dental Numbers
 [[Category:ENT]]