Dental Flashcards
What are some causes of orofacial pain
- maxillary sinusitis
- TMJ
- angina pectoris
- referred pain
- **trigeminal neuralgia
- herpes zoster
- cluster headaches
- hutchinson’s sign**
Where does dental pain of pulpal origin come from
nerve, vascularized connective tissues
pulpalgia: inflammatory changes to pulp
What are some periodontal origins of dental pain
gingivitis, periodontitis, acute periodontal abscess
What are some post-extraction complications (dental)
- infection
- bleeding
- pain
- swelling
- dry socket
How do you treat dry socket
anesthesia, irrigation, packing, pain meds
How is enamel repaired/rejuvinated
With fluoride
Describe the 3 major layers of a tooth and what is inside
Enamel, dentine, pulp cavity
in the pulp cavity: root canal, nerve & blood vessels
What is the function of the gums
keep tooth in place and to prevent cavities to the underlying dentine from food/microbes
What are the tissues that make up the periodontium
gingiva, periodontal ligament, alveolar bone
What is the function of saliva
- natural defense against cavities
- removes carbs & neutralizes low pH caused by acid formation
Describe the diagnostics for dental concerns
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)
When should kids first go to the dentist
- 6 mos (with a tooth)
- eruption of first tooth
- or when they can sit up in the chair
What can you store an avulsed tooth in
- milk
- saline
- mouth
- NOT WATER
Describe the sxs of dry socket
- 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
What are some oral pathologies related to derm
- pyogenic granuloma
- oral leukoplakia
- SCC
- angular cheilitis
- tumors of the mucosa
- HSV 1
Describe the etiology of pulpalgia
Inflammatory changes to pulp
Secondary to dental caries, cracked teeth, trauma, hyperocclusion (high filling), recent dental restorations
Describe the clinical presentation of pulpalgia
Reversible: sharp hypersensitive reaction precipitated by thermal stimulus or function
Irreversible: prolonged, unstimulated, spontaneous, pain persisting after removal of thermal stimulus
Describe the etiology/RF for dental caries
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)
Describe the clinical presentation of dental caries
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
Describe the treatment for dental caries
Fluoridated toothpaste, fillings, extraction or root canal
Extensive treatment for rampant decay
Refer to dentists
Give NSAIDs (ibuprofen 400mg q 6hr)
Describe the treatment for a tooth avulsion
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)
Describe the clinical presentation of dental abscesses
Acute pain to palpation, fluctuant mass, purulent exudate, bad taste in mouth
+/- sinus tract coming out to the cheek
Describe the treatment for a dental abscess
Abx (PCN, amoxicillin), pain meds, I&D if appropriate
Dental consult
Describe the etiology of odontogenic space infection
Can be secondary to an untreated dental abscess, usually from a mandibular molar
Sublingual, submandibular, and bilateral buccal space infections at the same time
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
Describe the treatment for odontogenic space infection
Aggressive!
I&D, parenteral abx, supportive care, tooth extraction
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
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)
Describe the etiology of TMJ disorder
Malocclusion, trauma, arthritis
Usually unilateral
Describe the clinical presentation of TMJ
Painful jaw movement, may be referred to face/neck, HA, clicking, popping, crepitus, locking
Describe the treatment for TMJ
NSAIDs, avoid high-chew foods, stress reduction, moist heat, dental referral
May spontaneously resolve
