Oral Surgery Flashcards
Name three oropharynx sites cancer may be detected
- Base of tongue
- Tonsils
- Soft palate
Name five oral cavity sites cancer may be detected
- Lateral border/anterior two thirds of tongue
- Floor of mouth
- Lip mucosa
- Retromolar trigone
- Buccal mucosa
- Hard palate
- Alveolus
What are the 7 red flags for oral malignancy?
- Ulcer persists for more then two weeks despite removal of any obvious causation.
- Rolled margins (raised periphery. Firm/hard), central necrosis.
- Speckled appearance (erythroleukoplakia; red and white patches)
- Cervical lymphadenopathy (enlarged ( >1cm), firm, fixed, tethered, non tender), should be picked up on during extra oral exam.
- Worsening pain (at primary site. Neuropathic, dysaesthesia, parasthesia)
- Referred pain (ear, throat, mandible, teeth)
- Weight loss. Moving from local to systemic effects. Cachexia (wasting of the body/rapid weight loss due to the metabolic demand of the disease process)
What series of actions should be taken when seeking a second opinion?
- Prior to conversation ensure that all patient details are to hand
- Ensure the conversation is held in a place that doesn’t compromise patient confidentiality.
- Summarise the significant points in the patients history
- Supply a description of the pathology according to its anatomical location, structures involved, size of lesion avoiding non specific terms.
- Outline areas of specific concern; localised infection, trismus, difficulty breathing, temperature etc
What common micro-organisms can be isolated from an acute dento-alveolar abscess?
Common bacterial isolated from an acute dentoalveolar abscess can be broadly divided into two groups;
- Streptococci eg streptococcus anginosus group
- Strict anaerobes eg prevotella intermedia
What is antimicrobial stewardship?
-A coherent set of actions which promote using antimicrobials responsibly. This is a relatively new science and is increasingly applied in a broad range of contexts linked to reducing the problem of antimicrobial resistance.
What role does pus sampling play in antimicrobial stewardship in dentistry?
The accumulation of data on susceptibility patterns helps inform the production of best guess initial treatment antibiotic prescribing by providing up to date surviellance data as patterns of antimicrobial resistance can change over time.
What is the donning sequence for basic PPE?
- Apron, tied at back
- mask
- Glasses and/or visor
- Alcohol hand rub
- Nitrile gloves
What is the doffing sequence for basic PPE?
- Gloves
- Apron torn from neck and waist, folded in on itself
- Visor
- Mask
- Alcohol hand rub
What is the donning sequence for AGP PPE?
- Hand hygiene
- Full sleeve single use gown
- FFP3 mask
- Hat (hair neatly tucked under)
- Visor
- Nitrile gloves
- Sterile gloves (over cuffs of gown)
What is the doffing sequence for AGP PPE?
- Begin after patient has left the room
- Sterile gloves
- Nitrile gloves
- Alcohol hand rub
- Gown (undone at neck and waist and folded in on itself)
- Alcohol hand rub
- Visor and hat
- FFP3 mask is removed after alcohol hand gel and after leaving the AGP room
- Alcohol hand gel
List some common extraction complications
- Fracture of tooth/root.
- Fracture of alveolar bone
- Fracture of tuberosity.
- OAC
- Damage to IAN
- Bleeding
- Dislocation of TMJ
- Damage to adjacent teeth/restorations
- Pain
- Swelling
- Bleeding
- Bruising
- Dry socket (alveolar osteitis)
- Sequestrum
- Infection
List some less common extraction complications
- Osteomyelitis
- Osteoradionecrosis
- MRONJ
- Actinomycosis
- Infective endocarditis
What advice should a patient be given regarding post extraction pain?
Expect some post op pain, this is normal. Take painkillers before LA wears off. Take 1-3 days then as and when required. If pain is getting worse after 3-4 days, contact the practice for further advice.
When should use of Ibuprofen be avoided?
- If the patient is hypersensitive to aspirin or other NSAIDs
- If the patient is asthmatic, angieodema, urticaria (hives) or rhinitis precipitated by NSAIDs.
- Taking low dose aspirin daily
- Pregnant
- Previous or active peptic ulcer
- Caution in elderly and those taking anticoagulants
