Management Dental Emergency

Question 1

Give 3 examples of viral infections?

Answer 1

1. Herpes - varciella-zoster
2. MMR - measles (Koplik spots in mouth), mumps (parotid swelling - MMR 70% effective against), rubella
3. Cocksackie virus - herpangina- ulcer SP, EBV - glandular fever

Question 2

Give some examples of bacterial infections?

Answer 2

Impetigo
Scarlet fever - streptococcal
ANUG
Meningitis

Question 3

How can dental abscess spread?

Answer 3

Fascial plains sub-lingual
Sub-mandibular
Pharyngeal venous
Ocular

Question 4

How to describe swelling?

Answer 4

Site, size, surface, texture, colour

Question 5

What are the 4 main components of examination?

Answer 5

1. Hx
2. EO exam
3. IO exam
4. Special investigation

Question 6

What should be inc in hx taking?

Answer 6

PC and Hx PC - SOCRATES
Medical hx
Dental hx
Social hx

Question 7

What should be inc in EO and IO exam?

Answer 7

EO: swelling, lymph nodes, temperature, TMJ
IO: soft tissue and hard tissues

Question 8

What special investigations could be undertaken?

Answer 8

Radiograph
Vitality
Bloods

Question 9

What would you see in primary herpes?

Answer 9

Fever, headache, malaise, mild dysphagia , lymphadenopathy, oral ulceration
14 day duration

Question 10

Tx of primary herpes?

Answer 10

Admission on dehydration/ fever

Tx: fluids, analgesics, antipyretics, chlorhexidine, antivirals, cross infection

Question 11

How tx dental abscess?

Answer 11

Drainage, ab if spreading/infection/systemic involvement, analgesics/ antipyretics, follow uo

Question 12

When consider admission for dental abscess?

Answer 12

Spreading infection, truisms, dehydration, dysphagia

Question 13

Problems with local anaesthesia when infection?

Answer 13

Decreased effectiveness - acidic environment will neutralise
Risk spreading infection - create excess pressure that can drive bacteria into system