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Module 5 - Endodontics > Managment of Endo Pain > Flashcards

Managment of Endo Pain Flashcards

1
Q

What is an endodontic emergency?

A

Pain or swelling caused by inflammation/ infection of the pulpal/ periapical tissues.

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2
Q

What are the 2 common causes of endodontic emergencies?

A
  • Caries
  • Deep/ defective restorations.
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3
Q

What is the indicated dose of ibuprofen for pain? (+ maximum dose).

A

2 x 200mg tablets up to 4 times a day
- MAXIMUM DOSE 2.4g.

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4
Q

What is the indicated dose of paracetamol for pain? (+ maximum dose).

A

2 x500mg tablets up to 4 times daily.
- MAXIMUM DOSE 4g.

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5
Q

What are the 3 antibiotics indicated for the treatment of dental infection?

A

Amoxicillin, metronidazole, phenomethylpenicillin.

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6
Q

Dose of amoxicillin for dental infection

A

1 x 500mg capsules 3 times daily.

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7
Q

Dose of metronidazole for dental infection

A

1 x 400mg tablet 3 times daily.

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8
Q

Dose of phenoxymethylpenicillin for dental infection.

A

2 x 250mg tablets 4 times daily.

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9
Q

What is dentine hypersensitivity

A
  • EXAGERRATED RESPONSE to application of stimulus to dentine, cannot be ascribed to any other defect or pathology.
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10
Q

What are stimuli of dentine hypersensitivity

A

Cold, air, hypertonic solution

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11
Q

What nerves are activated during dentine hypersensitivity and how (physiological process).

A
  • SHORT, SHARP pain.
  • Rapid fluid flow in dentinal tubules  HYDRODYNAMIC ACTIVATION OF ALPHA DELTA FIBERS.
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12
Q

What is the treatment for dentine hypersensitivity?

A

DESENSITIZING AGENTS.
- Disturb the transmission of nerve impulses. (potassium nitrate)
- Block dentinal tubules (FLUORIDES, OXALATES, VARNISHES, ADHESIVE SYSTEMS, BIOGLASS, CASEIN-PHOSPHOPEPTIDE, LAZER)

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13
Q

What is used to disturb the transmission of nerve impulses for dentine hypersensitivity?

A

Potassium nitrate.

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14
Q

What is felt during reversible pulpitis? Stimuli?

A
  • Sharp pain that lasts a few seconds.
  • Stimuli: cold, sweet, sour, salty.
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15
Q

What causes reversible pulpitis (4):

A
  • Caries into dentine.
  • Worn/ broken down teeth.
  • Defective restoration.
  • Recent dental treatment.
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16
Q

Is reversible pulpitis a dental emergency?

17
Q

Treatment of reversible pulpitis?

A
  • Caries removal + restoration/ dressing to cover dentine.
  • Review periodically via SENSITIVITY testing (may heal BUT may not heal develop irreversible pulpitis and become necrotic).
18
Q

What is irreversible pulpitis?

A

Inflammation of the pulp continues (from reversible), leading to SEVERE inflammation that will NOT resolve even if cause is removed. Pulp will slowly or quickly become necrotic.

19
Q

Irreversible pulpitis symptoms?

A

Can be asymptomatic or more often SYMPTOMATIC

20
Q

What are the symptoms felt during irreversible pulpitis (4)?

A
  • Spontaneous/ intermittent pain.
  • Pain that lasts for minutes or hours.
  • Triggered by cold/hot (extreme temp).
  • Difficult to localize early on.
21
Q

What is the typical treatment for irreversible pulpitis? (3)

A
  • Remove cause of infection + RCT.
  • If emergency carry out PULPOTOMY.
  • Extraction
22
Q

What is the interapointment dressing after the 1st stage of RCT (cleaning and shaping)

A

Non setting calcium hydroxide

23
Q

What is the dressing for emergency pulpotomy?

A

Ledermix or Odontopaste

24
Q

Symptoms of advanced symptomatic pulpitis (5)?

A
  • Excruciating acute pain.
  • Momentarily relieved by cold.
  • Often TTP as inflammation has extended periapicaly.
  • Reacts violently to heat.
  • Radiograph will show thickening of PDL.
25
Q

when is emergency pulpotomy indicated?

A
  • Done when insufficient time to completely prepare canal  Apical remnants of inflamed pulp can be acutely painful when RCT is continued.
26
Q

Same steps as normal pulpotomy BUT

A
  • Seal with odontopaste/ leddermix.
  • Apply Coltosol.
  • Temporary GIC dressing.
27
Q

In which patients are leddermix and odontopaste contraindicated?

A
  • Pregnant women/ nursing women.
  • Clindamicyn allergy.
28
Q

Do we prescribe antibiotics for acute symptomatic pulpitis?

A

NO AS THIS IS INFLAMMATION AND NOT INFECTION

29
Q

What are 2 causes of symptomatic periapical periodontitis?

A
  • Bacteria/ toxins from INFECTED + NECROTIC PULP  inflammatory response in the periapical tissues, leading to BONE RESORPTION.
  • OVERINSTRUMENTATION during RCT that pushes debris beyond the apex.
30
Q

What are 2 symptoms of symptomatic periapical periodontitis?

A
  • Pain on biting.
  • Radiolucent area around the apex.
31
Q

3 causes of tissue swelling?

A
  • Acute periapical abscess.
  • Inter appointment flare-up.
  • Post-endodontic complication.

Module 5 - Endodontics (11 decks)

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