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EENT/ID > Dental > Flashcards

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
Q

Describe the clinical presentation of odontogenic space infections

A

Rapid onset, severe trismus, drooling, inability to swallow, tachypnea, dyspnea, bull neck, airway compromise, minimal/no fluctuance, cavernous sinus thrombosis

Ludwig’s Angina

26
Q

Describe the treatment for odontogenic space infection

A

Aggressive!

I&D, parenteral abx, supportive care, tooth extraction

27
Q

Describe the etiology for periodontitis/periodontal disease

A

Inflammation of supporting tissues of teeth caused by different microorganisms

+/- Progression from gingivitis

Progressive destruction of periodontal ligament & alveolar bone

Exacerbated by plaque

28
Q

Describe clinical presentation of periodontal disease

A

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
Q

Describe the etiology of TMJ disorder

A

Malocclusion, trauma, arthritis

Usually unilateral

30
Q

Describe the clinical presentation of TMJ

A

Painful jaw movement, may be referred to face/neck, HA, clicking, popping, crepitus, locking

31
Q

Describe the treatment for TMJ

A

NSAIDs, avoid high-chew foods, stress reduction, moist heat, dental referral

May spontaneously resolve

EENT/ID (15 decks)

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