Complications In Exodontia Flashcards
How can bleeding be classified?
Operative: at the time of operation
Post-opative:
- reactionary - hours after procedure
- secondary - several days post op
What are some examples of operative complicatiions?
Damage to structures planned o be left undisturbed
Intra-operative bleeding
Failure to complete operation
How can secondary bleeding be managed?
Usually relates to infected wounds in soft tissues e.g. 10 days following tonsillectomy
Who ahould the patient contact in case of bleeding?
The dentist that took the tooth out or a colleague. Only to a hospital if there is an on call oral surgeon.
How should the dental pratitioner react to the patients call?
History taking: how long ago extraction? How have they been taking care of the socket?
Instructions: Keep calm, clean mouth, apply pressure to site with gauze 10 mins before changing (can also use tea bags) If bleing persists after 30-60 mins: Examination of patient Clean mouth Determine site of bleeding Control bleeding
What are the possible sites of bleeding?
Gingival attachment Walls of socket Apex of tooth Damage to soft tissue Lacerations
How can bleeding be controlled?
Dry pack pressure
Hot saline pack - initially then dry pack. Hells in identification of bleeding site
LA plus suture over socket then dry pack
LA and suture with topical agent packing into site is the most common method for haemostasis
What are some examples of post-op complciations?
1) haemmorhage
2) abnormal socket healing
3) pain, swelling and trismus
4) loss of sensation
What are some examples of abnormal socket healing?
Dry socket
- acutely painful extraction socket usu 2-10 days postoperatively
Excessive granulation
- management invovles radiograph of the socket, then LA and removal of excess tissue, tissue should be sent to histopathology
What can cause trismus post extraction?
May be normal
Traumatic
Occasional infection
- check for pus, fever, positive c-reactive protein in blood test
