Acute dental problems

Question 1

management of acute apical abscess

Answer 1

1. assess if airway compromised
2. initiate drainage via extirpation or extraction
3. recommend NSAIDs

Antibiotics only if spreading infection or systemic symptoms

Question 2

management of acute pericoronitis

Answer 2

1. assess if airway compromised
2. ultrasonic scaling to remove foreign bodies
3. irrigation with saline or chlorhexidine
4. recommend analgesia, advise chlorhexidine or salty water mouth wash

antibiotics only if spreading infection

Question 3

management of ANUG

Answer 3

1. ultrasonic scaling (with LA most likely)
2. recommend chlorhexidine mouthwash
3. OHI and smoking cessation if appropriate
4. prescribe metronidazole if required

Question 4

reversible vs irreversible pulpitis

Answer 4

reversible - positive or exaggerated response to sensibility testing, not TTP
irreversible - pain may be spontaneous, keep awake at night, may last for hours, worse with heat

Question 5

symptoms of dry socket

Answer 5

pain (onset 24-48 hours after extraction)
unpleasant taste
occasional swelling

Question 6

treatment of dry socket

Answer 6

irrigation with saline (NOT CHX)
alvogyl
possible sutures

antibiotics only if signs of infection

Question 7

what age can chlorhexidine mouthwash be prescribed

Answer 7

7 and older

Question 8

name 4 medical conditions that may cause oral ulceration

Answer 8

viral infections e.g HIV, hand foot and mouth disease
bacterial infections - syphillis
mucocutaneous diseases - lichen planus, vesicullobullous diseases
haematological disease - leukemia, anaemia
gastrointestinal disease - coeliac disease, UC

Question 9

if loose dentures present as an emergency/ sudden occurrence what should you be wary of

Answer 9

stroke (loss of muscular support)
malignancy (growth)

Question 10

if fractured or displaced orthodontic appliance attends as an emergency what must be assessed first

Answer 10

assess for possibility of inhalation - can all pieces be accounted for

Question 11

stroke vs bells palsy distinguishing features

Answer 11

stroke - forehead is spared
stroke also arm weakness, speech difficulties, rapid onset of symptoms

Question 12

signs and symptoms of salivary gland infection/ obstruction (5)

Answer 12

pain in major gland
swelling
dry mouth
dehydration
fever

Question 13

inhaler technique for patients with candida

Answer 13

rinse mouth with water immediately after inhaler use
use spacer

Question 14

if fluconazole and miconazole contraindicated, what antifungal should be used

Answer 14

nystatin