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ADK > Dental emergency > Flashcards

Dental emergency Flashcards

1
Q

what do you use to take a pain history

A

socrates

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2
Q

If there is an periapical radiolucency, no normal response to EPT, pain on precussion, no localised deep pocketing and intra oral swelling
what is the diagnosis

A

acute apical abscess

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3
Q

If there is an periapical radiolucency, no normal response to EPT, pain on precussion, no localised deep pocketing and no intra oral swelling
what is the diagnosis

A

symptomatic apical periodontitis

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4
Q

If there is an periapical radiolucency, no normal response to EPT, pain on precussion, localised deep pocketing and localised vertical bone loss
what is the diagnosis

A

primary endodontic lesion or root fracture

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5
Q

If there is an periapical radiolucency, no normal response to EPT, no pain on precussion, swelling or draining sinus tract
what is the diagnosis

A

chronic apical abscess

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6
Q

If there is an periapical radiolucency, no normal response to EPT, no pain on precussion, no swelling or draining sinus tract
what is the diagnosis

A

asymptomatic apical periodontitis

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7
Q

If there is an periapical radiolucency, normal response to EPT, no pain on precussion
what is the diagnosis

A

potential cracked tooth

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8
Q

If there is an periapical radiolucency, normal response to EPT, pain on precussion, and suppuration from pocket
what is the diagnosis

A

periodontal abscess

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9
Q

If there is an periapical radiolucency, normal response to EPT, pain on precussion, and no suppuration from pocket
what is the diagnosis

A

occlusal trauma

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10
Q

what is the first line of antibiotic for periapical abscess

A
  • amoxicillin 500mg TDS for 5 days
  • metronidazole (allergy to penicillin) 400mg TDS for 5 days
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11
Q

what is the second line of antibiotic for periapical abscess

A
  • clindamycin 150mg QDS for 5 days
  • co-amoxiclav 375mg TDS for 5 days
  • clarithromycin 250mg BD for 7 days
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12
Q

what is the first line of antibiotic for periodontal abscess

A
  • metronidazole 400mg TDS for 5 days
  • amoxicillin (allergy to metronidazole) 500mg TDS for 3 days
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13
Q

what is the second line of antibiotics for periodontal abscess

A
  • clindamycin 150mg QDS for 5 days
  • co-amoxiclav 375mg TDS for 5 days
  • clarithromycin 250mg BD for 7 days
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14
Q

what is the first line of antibiotic for necrotising periodontal disease or pericoronitis

A
  • metronidazole 400mg TDS for 3 days
  • amoxicillin (allergy to metronidazole) 500mg TDS for 3 days
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15
Q

what is the first line of antibiotic for sinusitis, dry socket, oro-antral communication and sialadenitis

A
  • metronidazole 400mg TDS for 7 days
  • doxycycline (allergy to metronidazole) 100mg 2 caps 1st day the OD for 7 days
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16
Q

what are some indications for antibiotics

A

limited mouth opening, facial swelling, systemic infection, immunocompromised patient, elevated temperature >38 degrees

17
Q

what are the immediate management of adults with dental infections

A

establish drainage, extirpate, debride pockets, prescribe antibiotics, recommend appropriate analgesia routine, consider extraction

18
Q

when would you refer to A&E/maxillofacial department

A

difficulty breathing, involvement of orbital area/closure of eye, difficultly in swallowing/unable to stick tongue out, swelling rapidly increasing in size, evidence of infection of facial spaces

19
Q

what are the differential diagnosis for pain after extraction

A

dry socket, retained root/bone fragment, infection, LA related trauma, haematoma, MRONJ, OAC, ORN, fractured maxillary tuberosity, step deformation, dislocated/fractured mandible

20
Q

what is the management of a cracked tooth when the crack doesn’t extend to the pulp chamber floor

A

restore with composite, copper bond or temporary crown with occlusal reduction, assess after 2-3 months or earlier if symptomatic, if symptomatic, RCT +/- crown or XLA if hopeless prognosis

21
Q

what is the management of a cracked tooth when the crack is subgingival and insufficient coronal tissue

A

extract

22
Q

what is the management of a cracked tooth when the crack extends to pulp chamber floor but is restorable

A

RCT +/- crown

23
Q

what are the symptoms of pericoronitis

A

pain on biting, localised, pyrexia

24
Q

what are the signs of pericoronitis

A

inflammed operculum, sigsn of trauam (keratosis, ulceration), trauma from opposing tooth, intra/extra oral swelling, lymphodenopathy

25
Q

what are the treatment/management options

A

debride area around inflamed tooth, irrigate with saline and instruct patient on OH routine, consider adjusting traumatic occlusion or removing operculum or opposing tooth, prescribe antibiotics if indicated, extract tooth

26
Q

what are the risk factors of dry socket

A

smoking, alcohol, immunocompromised, oral contraceptive, mandibular teeth, posterior teeth, previous dry socket, poor compliance with POI, traumatic extraction

27
Q

what are the signs and symptoms of dry socket

A

pain 24-48 hours after extraction, inflamed non-healing socket, lost. blood clot, trapped food debris or bad taste/odour

28
Q

what is the treatment/management of dry socket

A

curettage the socket, irrigate with saline and instruct targeted OH, pack the socket with a eugenol based dressing (alvogyl) review after 1 week

ADK (15 decks)

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