dental toothache

Question 1

indicators of infection in severe toothache

Answer 1

gum swelling
obvious abscess
recent antibiotics for the same problem
woken from sleep by dental pain
severe pain not relieved by simple analgesia
recent unsuccessful attempt to manage the same problem
pyrexia and/or malaise
facial swelling

Question 2

what should you do if the child has signs of acute infection

Answer 2

take history and examination
contact dental department
analgesia
EMLA
nil by mouth

Question 3

numbering system for teeth

Answer 3

Question 4

intrusive luxation of the tooth

Answer 4

if >50% fast and refer to ddental team urgently

Question 5

avulsed primary tooth

Answer 5

confirm tooth found
do not replant
refer to community services
dispense chlorhexidine oral gel

Question 6

avulsed permanent tooth

Answer 6

contact dental team urgently
replent ASAP
if unable to replant, store in hank’s balanced salt solution
re-implantation antibiotic prophylaxis is necessary for any patient for whom a transient bacteraemia would be problematic

Question 7

uncomplicated crown fracture

Answer 7

involve the outermost layers of the tooth and do not require urgent treatment

Question 8

complicated crown fracture

Answer 8

involve the inner portion of the tooth, the dental pulp
O/E the pink/red or bleeding centre is highly sensitive to stimulation
higher priority

Question 9

why shouldn’t you replant an avulsed primary tooth

Answer 9

you may damage the permanent tooth

Question 10

how should you handle an avulsed tooth

Answer 10

by it’s crown, never touch the root

Question 11

how can you stabilise reppositioned teeth

Answer 11

household aluminium foil extending at least two teeth either side of the repositioned teeth