Dental Flashcards

1
Q

What are some causes of orofacial pain

A
  • maxillary sinusitis
  • TMJ
  • angina pectoris
  • referred pain
  • **trigeminal neuralgia
  • herpes zoster
  • cluster headaches
  • hutchinson’s sign**
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2
Q

Where does dental pain of pulpal origin come from

A

nerve, vascularized connective tissues
pulpalgia: inflammatory changes to pulp

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3
Q

What are some periodontal origins of dental pain

A

gingivitis, periodontitis, acute periodontal abscess

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4
Q

What are some post-extraction complications (dental)

A
  • infection
  • bleeding
  • pain
  • swelling
  • dry socket
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5
Q

How do you treat dry socket

A

anesthesia, irrigation, packing, pain meds

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6
Q

How is enamel repaired/rejuvinated

A

With fluoride

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7
Q

Describe the 3 major layers of a tooth and what is inside

A

Enamel, dentine, pulp cavity

in the pulp cavity: root canal, nerve & blood vessels

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8
Q

What is the function of the gums

A

keep tooth in place and to prevent cavities to the underlying dentine from food/microbes

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9
Q

What are the tissues that make up the periodontium

A

gingiva, periodontal ligament, alveolar bone

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10
Q

What is the function of saliva

A
  • natural defense against cavities
  • removes carbs & neutralizes low pH caused by acid formation
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11
Q

Describe the diagnostics for dental concerns

A

Attempt to replicate dental symptoms
- percuss with tongue depressor
- palpate
- thermal (ice water)
- biting pressure

(put gloves on and then wash them off so they don’t taste gross)

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12
Q

When should kids first go to the dentist

A
  • 6 mos (with a tooth)
  • eruption of first tooth
  • or when they can sit up in the chair
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13
Q

What can you store an avulsed tooth in

A
  • milk
  • saline
  • mouth
  • NOT WATER
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14
Q

Describe the sxs of dry socket

A
  • loss of clot/exposed bone in socket
  • usually mandibular molars
  • increase in acute throbbing pain after 2-5 days
  • pain radiating to ear
  • analgesics ineffective until irrigation procedure/packing done
  • fetid odor
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15
Q

What are some oral pathologies related to derm

A
  • pyogenic granuloma
  • oral leukoplakia
  • SCC
  • angular cheilitis
  • tumors of the mucosa
  • HSV 1
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16
Q

Describe the etiology of pulpalgia

A

Inflammatory changes to pulp

Secondary to dental caries, cracked teeth, trauma, hyperocclusion (high filling), recent dental restorations

17
Q

Describe the clinical presentation of pulpalgia

A

Reversible: sharp hypersensitive reaction precipitated by thermal stimulus or function

Irreversible: prolonged, unstimulated, spontaneous, pain persisting after removal of thermal stimulus

18
Q

Describe the etiology/RF for dental caries

A

Aka tooth decay

Bacterial infection, commonly strep mutans causing destruction of the calcified tooth structure

Can lead to rampant decay (RF: children, vasoconstricting drugs, dry mouth)

19
Q

Describe the clinical presentation of dental caries

A

3 stages
1. Early: within enamel, reversible with fluoride, watch tooth in adults or fill in kids/people who don’t go to the dentist often
2. In dentine layer: needs filling, +/- symptoms
3. Into pulp: toothache, requires extraction or root canal

20
Q

Describe the treatment for dental caries

A

Fluoridated toothpaste, fillings, extraction or root canal

Extensive treatment for rampant decay

Refer to dentists

Give NSAIDs (ibuprofen 400mg q 6hr)

21
Q

Describe the treatment for a tooth avulsion

A

Wash then reposition or bite gauze until dental consult, can store in milk, saline, mouth, avoid water

Emergency dental tx within 1 hr

Tetanus booster, systemic abx (penicillin, amoxicillin)

22
Q

Describe the clinical presentation of dental abscesses

A

Acute pain to palpation, fluctuant mass, purulent exudate, bad taste in mouth

+/- sinus tract coming out to the cheek

23
Q

Describe the treatment for a dental abscess

A

Abx (PCN, amoxicillin), pain meds, I&D if appropriate

Dental consult

24
Q

Describe the etiology of odontogenic space infection

A

Can be secondary to an untreated dental abscess, usually from a mandibular molar

Sublingual, submandibular, and bilateral buccal space infections at the same time

25
Describe the clinical presentation of odontogenic space infections
Rapid onset, severe trismus, drooling, inability to swallow, tachypnea, dyspnea, bull neck, airway compromise, minimal/no fluctuance, cavernous sinus thrombosis Ludwig’s Angina
26
Describe the treatment for odontogenic space infection
Aggressive! I&D, parenteral abx, supportive care, tooth extraction
27
Describe the etiology for periodontitis/periodontal disease
Inflammation of supporting tissues of teeth caused by different microorganisms +/- Progression from gingivitis Progressive destruction of periodontal ligament & alveolar bone Exacerbated by plaque
28
Describe clinical presentation of periodontal disease
Gingivitis, gingival hyperplasia, can cause chronic disease problems d/t bacterial flora changing from gram+ to gram- & disseminating intravascularly (CV, Endo, pregnancy, smoking implications)
29
Describe the etiology of TMJ disorder
Malocclusion, trauma, arthritis Usually unilateral
30
Describe the clinical presentation of TMJ
Painful jaw movement, may be referred to face/neck, HA, clicking, popping, crepitus, locking
31
Describe the treatment for TMJ
NSAIDs, avoid high-chew foods, stress reduction, moist heat, dental referral May spontaneously resolve