ENT 5 Flashcards
dental pain/abscess - hx and clinical presentation
2
- facial swelling, dental pain
- prior dental work or prior infection
dental pain/abscess - complicating factors
3
- immunosuppressed
- anticoags
- bleeding disorders
dental pain/abscess - physical exam, what suggest severe/deep space infection
2
- trismus or elevation/protrusion of the tongue
- inability to swallow saliva or hot potato voice
dental pain/abscess - physical exam
4 (inspect, palpate, percuss, inspect)
- inspect for facial and gingival swelling, erythema, obvious trauma, dental caries
- palpate gingiva for tenderness, induration, crepitus, warmth
- percuss tooth in questions for tenderness
- inspect and palpate neck for swelling, tenderness, crepitus, lymphadenopathy
dental pain/abscess - img/testing
none usually; in concern for infection, consider CT w/ IV contrast
dental pain/abscess - non trauma tx
2
pain control (NSAID)
dental/intraoral nerve block
dental pain/abscess - infection tx
4
7-14 days
Penicillin VK 500 mg PO q6H
amoxicillin/clavulanate 875 mg PO BID
severe pnc allergy - clindamycin 450 mg PO q8h
dental pain/abscess - f/u
w/ dentist in 24-48 hours
dental pain/abscess - when to refer to ER
2
- deep space infection of face or neck
- evidence of systemic infection
oral laceration/trauma - history and clinical presentation
3
- facial swelling
- signs of injury
- difficult speaking/moving jaw
oral laceration/trauma - physical exam
3
- obvious trauma, bleeding
- facial and gingival swelling, damage to teeth
- misalignment of upper and lower teeth
oral laceration/trauma - img/testing
concern for mandibular/facial fx - CT of face w/o contrast
oral laceration/trauma - tx avulsion of primary and secondary teeth
primary - refer to dentist
secondary - replace teeth immediately, consult dentist
oral laceration/trauma - unable to replace tooth
put in milk, refer to dentist
oral laceration/trauma - intraoral lacerations tx for small/superficial
no repair/sutures
oral laceration/trauma - intraoral lacerations repair or sutures needed when
3
- large lacerations >2 cm
- deep lacerations that may trap food
- cheek lacerations that interfere w/ chewing
oral laceration/trauma - gingival bleeding
direct pressure 10-15 mins then consider injection lidocaine w/ epi, hemostatic agent i.e. TXA, or surgicel if available
parotitis/sialadenitis
inflammation of the parotid gland (salivary gland that sits in front of and below each ear)
inflammation of the parotid gland (salivary gland that sits in front of an posterior to the ear)
parotitis/sialadenitis
parotitis/sialadenitis - etiology
6
viral
bacterial
obstructive
infiltrative
neoplastic
iatrogenic
parotitis/sialadenitis - what accounts for 50% of all benign salivary disorders
obstructive parotitis/sialadenitis
parotitis/sialadenitis - acute sx
5
- pain
- swelling
- fever
- viral prodrome
- purulent discharge from Stensen’s duct (near 2nd upper molar)
parotitis/sialadenitis - commonly linked with other conditions
5
Sjogern’s syndrome
amyloidosis
HIV
malnutrition
bulimia
parotitis/sialadenitis - ask about use of what med
anticholinergic meds can cause this - especially in elderly
