OAC / TMD Flashcards
what is an OAC/ OAF
abnormal opening between the oral cavity and maxillary sinus
when does communication become fistula
when tract epithelialises
takes 48-72 hours
risk factors for OAC
bulboous roots
last standing molars
older patients
previous OAC
close proximity to antrum on x ray
large tooth
peri op signs of an OAC
bubbling of blood
echo on suction
valsalva maoevre (caution)
direct vision and light
management of small <2mm OAC
- inform and reassure patient
- irrigate with saline
- suture closed (consider surgicel)
- give conservative management
- antibiotics
conservative management advice post OAC
no smoking
no straws
no blowing balloons
dont stifle sneeze
WSMW
management of large >2mm OAC
- inform and reassure patient
- refer for buccal advancement flap
- conservative management advice
- antibiotics
post op signs/ chronic OAF signs
fluid coming from nose when drinking
nasal quality to speech/ singing
bad taste/ odour
pain/ sinusitis symptoms
problems using straw/ smoking
common signs/ symptoms of TMD
clicking/ popping
crepitus
ear pain
headache
pain in morning
intermittent pain for months/ years
differential diagnoses for TMD
ear pathology
headache
dental pain
atypical facial pain
parotid pathology
patient education and counselling as a treatment for TMD
reassurance
soft diet
stifle yawns/ no wide opening
no gum
stop parafunctional habits (clenching, nail biting)
medications that may be used in TMD treatment
NSAIDs, tricyclic antidepressants, muscle relaxants
treatment options for TMD
- education and counselling
- splint
- medication
- surgery - rare (risk to facial nerve)
most common cause of TMD pain and what can contribute to it
myofascial pain
- direct trauma
- stress
- parafunctional habits
