complications in oral surgery cont Flashcards
What are the three broad categories of complications in oral surgery?
🏥 Pre-operative,
🛠️ Peri-operative, and
🩹 Post-operative.
What are some common and significant complications in oral surgery?
😖 Pain,
🩸 Bleeding,
🦠 Infection,
🦴 MRONJ,
🕳️ Alveolar osteitis (dry socket),
👃 Oro-antral communication/fistula (OAC/F), ⚡ Nerve injury,
💥 Fracture,
😮 Inhaled/swallowed objects, and 😬 Trismus.
What are the 4 types of post-operative pain?
🔥 Inflammatory, 🔌 Neuropathic, 🦷 Odontogenic, and ❓ Non-odontogenic.
What factors can increase post-operative pain?
🪓 Bone removal and 😰 Anxiety.
What is the principle behind effective pain management?
“By the clock ⏰, by the mouth 👄, and by the ladder 🪜.”
What are the stepped options for pain relief?
💊 Paracetamol OR Ibuprofen
💊 Paracetamol AND Ibuprofen
💊 Paracetamol + Ibuprofen + Opioid
💉 Sometimes steroids
When does post-operative swelling usually peak?
⏱️ 12–24 hours post-op, but can last up to 72 hours.
Can swelling occur without infection?
✅ Yes, swelling is an immune response and doesn’t always indicate infection.
What is the difference between infection and inflammation?
Inflammation 🔥 can occur without infection.
Infection 🦠 always causes inflammation and involves pathogens.
Who is at higher risk of post-op infections?
🚬 Smokers/vapers, 👶👵 extremes of age, 🧼 poor oral hygiene/nutrition, 🧑🎓 inexperienced operators, 🧬 immunocompromised individuals.
What are systemic signs of infection?
🤒 Pyrexia, ❤️🔥 Tachycardia, 🤕 Lymphadenopathy, and 📉 Changes in blood profile.
What are local signs of infection?
🔥 Heat, 😡 Redness, 🐘 Swelling, 😖 Pain, and ❌ Loss of function.
What organisms are involved in most dental infections?
🧫 Mixed, polymicrobial (Gram-positive and anaerobic).
👉 ~70% respond to Amoxicillin + Metronidazole.
What can untreated dental infections lead to?
⚠️ Sepsis – a life-threatening condition due to a dysregulated immune response.
What are inflammatory causes of trismus?
🤕 Surgery trauma, excessive tissue manipulation, oedema.
What are muscular causes of trismus?
💪 Myofascial pain/spasm, 🦷 prolonged mouth opening, 💉 needle trauma from LA.
What are infectious causes of trismus?
🧪 Site infection, 🦷 pericoronitis, or deep space infections.
What other conditions can trismus be related to?
🦴 TMJ dysfunction or 🩸 haemarthrosis.
What history questions should you ask to assess bleeding risk?
🩸 History of tonsillectomy, 🩺 obstetrics/gynaecology history, and 🪒 shaving/cuts.
Which conditions increase bleeding risk?
🍺 Liver disease
🩸 ITP
🧬 Haematological malignancy
🚰 Chronic renal failure
❤️→🍺 Heart failure with liver involvement
🧬 Inherited/coagulation disorders
What medications can increase bleeding risk?
💊 Antiplatelets, anticoagulants, cytotoxics, and NSAIDs.
When is post-op bleeding considered excessive?
⏰ After 12 hours post-op.
How do you manage post-op bleeding?
🤗 Reassure
🧻 Pressure with wet gauze (30 mins)
😴 Rest
💉 Identify bleeding point if persists
🧼 Suction, LA, cautery, ligation, bone wax
💊 Consider tranexamic acid, FBC, BCP, clotting screen, 🧑⚕️ haematology referral
What is dry socket?
😖 Severe pain 1–3 days post-op due to disintegration/loss of blood clot in the socket. May have bad taste or halitosis.
