Acute Dental Problems Flashcards
when should the timescale be for emergency care
within 60 minutes and then appropriate subsequent follow up treatment
when should the timescale be for urgent care
within 24 hours unless condition worsens
when should the timescale be for non-urgent care
within 7 days unless condition worsens
what should the timescale be for self care
patient can manage symptoms by themselves
when are antibiotics appropriate
when there is evidence of spreading or systemic infection or for a patient who is immunocompromised
what drugs that we prescribe might interact with warfarin
NSAIDs
azole antifungals
antibiotics
what type of drugs might result in myopathy if taken with azoles, erythromycin and clindamycin
statins
what disease can be exacerbated by use of NSAIDs
asthma
when a patient presents with acute dental problem what should the basic assessment entail of
medical history
clinical assessment
exam of oral mucosal tissue
encourage to attend again for review
if you did not know where to find information on drug interactions and dental drugs where could you look
SCDEP drug prescribing for dentistry
BNF drug interactions
if a patient presents with pain in the mouth or jaw what possible non-dental differential diagnosis must you consider
myocardial infarction
if a patient presents with jaw pain and has signs of MI or overdose what do you do
NHS24 or 999
if a child presents with pain in an erupting tooth what do you do
advise optimal analgesia, soft brushing and rinse after food
use self care unless it worsens
what do you do if a patient presents with pain and analgesia cannot control the pain
give urgent dental care
if an adult has pain in an erupting tooth what do you do
advise chlorhexidine mouthwash, optimal analgesia
urgent dental care
if a patient has pain due to recent extraction what is advised
analgesia
avoid smoking
maintain good OH
urgent dental care
if a patient presents with pain due to orthodontic appliance/sharp tooth or denture what is done
advise analgesia
remove sharp parts
non-urgent dental care
if a patient has pain from an ulcer what is done
advise analgesia
avoid stimuli
non-urgent dental care
why is chlorhexidine not suitable for children under 7
taste and limited ability to rinse without swallowing
what do you do if a swelling is rapidly increasing or obstructing the airway or close to the eye
emergency care 999 NHS24
what do you do if the patient is systemically unwell
emergency care 999 NHS24
what do you do if a swelling is slowly increasing in size and is hot or firm to touch
consider antibiotic prescribing
give urgent dental care
what do you do if the patient’s swelling is not increasing in size but is in pain
assess if systemic reason (MI) or consider overdose of medication
what do you do if a patient is bleeding from a recent extraction
advise rinsing with salt water
bite on wet gauze
maintain pressure for 20mins
what do you do if a patient is bleeding from recent extraction and is on blood thinners or is not on blood thinners but bleeding will not stop
emergency treatment
what do you do if a patient is bleeding but has not had an extraction/trauma
non urgent care if not persistent bleeding to assess dentally
emergency care if persistent bleeding
what do you do if a patient has had a head injury and dental trauma
emergency care
in what situations with trauma would a patient be sent to emergency care in hospital
head injuries
cannot open and close jaws
large lacerations
suspected inhalation of tooth
in trauma what situation is it best to be seen as soon as possible
avulsion of adult tooth
when would patients with ulcers be seen in emergency care
when they are dehydrated and showing signs of severe dehydration
if a patient with an ulcer for the first time is systemically unwell with multiple ulcers or is taking medication/have underlying medical condition what do we do
advise analgesia
send for urgent medical care
if a patient appears with sign of stroke what do you do
999
if the patient has altered sensation not due to dental treatment what do you do
give urgent care
if a patient has altered sensation probably due to recent dental treatment what do you do
advise to contact within 7 days if worsens
if a patient has abnormal appearance with white/red speckled lesions present for more than 3 weeks what do you do
refer to local rapid access pathway
what are the key signs and symptoms of acute apical abscess
pain
swelling of gingiva, face or neck
fever
lethargy
what is the initial management of acute apical abscess
determine if airway compromised - 999 if it is or analgesia and urgent dental care if not
what is the subsequent care of acute apical abscess
incise and drain
drain through canal and irrigate
advise analgesia (NSAIDs)
extract if appropriate
what is an acute apical abscess
acute inflammation of soft tissues surrounding the tip of the root of a tooth often caused by decay or pulp necrosis
what is acute pericoronitis
infection under operculum
