Module 4 dental abscess, epiglottitis

Question 1

dental abscess

Answer 1

any abscess found in tissues around the tooth
- most common: acute infection of apical tissue

Question 2

dental abscess patho

Answer 2

poor dental hygiene
- necrosis of tooth pulp
-> caries, trauma, unsuccessful root canal
-> acute dental abscesses
- infection by normal flora in carious tooth
- traumatized gingival mucosa

Question 3

dental abscess clinical presentation

Answer 3

localized pain
- poor response to analgesics
heat sensitive

Question 4

dental abscess physical exam

Answer 4

edema
erythema
purulent discharge
friable/mobile tooth
partially elevated out of socket
lymphadenitis: advanced infection

Question 5

s/s of dental abscess progressed beyond local area

Answer 5

orbital cellulitis
retropharyngeal space invasion
fascial plane invasion
cavernous sinus thrombosis
- trismus (restricted jaw movement)
- airway compromise
- dysphagia

Question 6

dental abscess non-pharm management

Answer 6

I&D
dental extraction
root canal

Question 7

dental abscess Rx managment

Answer 7

abx if: sign of infection in adjacent tissues
- first line: PCN or clindamycin

Question 8

dental abscess complications

Answer 8

Minor:
- dental extraction
- root canal
Major:
- orbital cellulitis
- fascial plane infections
- osteomyelitis
- dentocutaneous fistula
- cavernous sinus thrombosis
- bacteremia with sepsis
- ludwig angina

Question 9

ludwig angina

Answer 9

infection of deep mandibular space
- trismus
- drooling
- induration of tongue and submandibular area
- tachypnea
- dyspnea
- airway compromise

Question 10

prevention of dental abscess

Answer 10

proper dental care
fluoride

Question 11

epiglottitis

Answer 11

acute inflammation of the supraglottic region of the oropharynx characterized by:
inflammation and edema of the
- epiglottis
- vallecular
- arytenoids
- aryepiglottic folds

Question 12

epiglottitis typically caused by

Answer 12

bacterial infection
-HIB

Question 13

Thermal epiglottitis

Answer 13

rare disease caused by direct thermal injury or inhalation of steam or aspiration of heated liquids
- crack cocaine has assoc.

Question 14

epiglottitis life threatening because

Answer 14

potential for laryngospasm and irrevocable loss of airway

Question 15

epiglotittis clinical manifestation

Answer 15

acute occurrence of
- severe odynophagia: pain with swallowing
- dysphagia
- fever
- SOB: tripoding/ upright
- inability to swallow secretions
- neck tenderness
- lymphadenopathy
- cough
- drooling
- stridor
- resp. distress, use of accessory muscles
- hoarseness

Question 16

Physical exam of epiglottitis

Answer 16

• pharynx should not be examined with tongue depressor
• anterior neck tenderness
• severe sore throat
• resp. distress: substernal and supraclavicular retractions
• tripod position
• dysphagia
• refusal to swallow
• tachycardia
• tachypnea
• inspiratory stridor

Question 17

indirect laryngoscopy with epiglottitis

Answer 17

erythematous, edematous epiglottis with a narrow glottic opening

Question 18

Severe resp. distress s/s

Answer 18

change in mental status
anxiety
pallor
cyanosis
hypoxia

Question 19

epiglottits management

Answer 19

Airway
- monitor airway
- sit upright
- humidified oxygen
Rx:
- NO: sedation, racemic epi, inhaled meds
- IV abx ASAP

Question 20

complications r/t epiglottitis

Answer 20

death
septicemia
meningitis
pulmonary edema
epiglottic abscess
vocal cord granuloma
pneumomediastinum