management of periodontal emergencyes Flashcards
what % of general population suffer orofacial pain in preceding 6 months?
22%
What is a periodontal abscess?
area of periodontal breakdown with pus.
Whats the prevelance of periodontal abscess?
3rd most dental emergency
7-14% of all dental emergencies
how are abscesses classified?
gingival
periodontal
what areas do gingival abscesses effect?
marginal and interdental gingiva
whats the main cause of gingival abscess?
impacted foreign objects
periodontal abscess effect what areas?
same as gingival but pockets are deeper, includes furcations, and vertical osseus defects
usually located beyond the mucogingival line
what can you expect on Radiographic evaluation of absscesses
look for bone loss around the crest which may extend into apical region
calculus, foreign material
describe an acute abscess
mild to severe discomfort localized red, ovoid swelling mobility tooth elevation in socket tenderness exudation elevated temperature regional lymphadenopathy
describe an chronic abscess
no pain, or dull pain localized inflammatory lesion slight tooth elevation intermittent exudation fisulous tract often associated with dep pocket usually without systemic involvement
how to treat periodontal abscesses
drain, SRP, periodontal surgery, systemic antibiotics, tooth removal
when should you be worried about endodontic problems?
if the abscess extends into apical region which may cause pulpal necrosis
requires pulp testing
under what conditions does periodontal abscesses require immediate treatment?
cellulitis
fever
regional lymphadenopathy
immunocompromised people
what causes primary herpetic gingivostomatitis?
herpes simplex virus 1
how is primary herpetic gingivostomatitis aquired?
contact with infected lesion or body fluids
what are signs and symptoms of herpetic gingivostomatitis?
prodomal state ( fever & malaise) pain cervical adenitis fever ( 103-104) dehydration
oral manifestation of primary herpetic gingivostomatitis
diffuse erythematous lesions on gingiva and oral mucosa including lips, cheeks, pharynx and palate
vesicles rupture leaving lesions with red elevated halo like marginswith necrotic center
how is primary herpetic gingivostmatitis treated?
viscous lidocaine to help soothe lesions
they also need to rehydrate so give them gatorade or somthign
what 2 medications can you give someone with primary herpetic gingivostomatitis?
acyclovir- initial episode or intermittent therapy ( 200mg orally every 4 hours up to 5 times a day for 10 days)
valacyclovir- 2 grams twice a day for 1 day.
Define pericoronitis
inflammation of oral soft tissues surrounding the crown of a partially erupted tooth
radiates pain to ear, throat, and floor of mouth
treatment of pericoronitis depends onwhat 3 things
severity of inflammation
systemic complications
advisability of retaining the involved tooth
immediate treatment of pericoronitis involves what?
systemic antibiotics
incision may be necessary to drain and relieve pressure
definitive treatment of pericoronitis involves……
surgical incision called operculectomy
extraction of either offendingor opposing tooth
whats the antibiotic of choice to treate pericoronitis?
amoxicillin of amoxicillin with clavulanic acid
