Pain management

Question 1

treatment for dentine hypersensitivity

Answer 1

potassium nitrate

Question 2

IP treatment

Answer 2

RCT
emergency pulpotomy

Question 3

what is used as the dressing for an emergency pulpotomy

Answer 3

Ledermix
Odontopaste

Question 4

what is used for vital pulp therapy as tx for IP

Answer 4

MTA or biodentine

Question 5

where is a fluctuant swelling

Answer 5

submucosal

Question 6

what is a non fluctuant swelling

Answer 6

subperiosteal

Question 7

what are signs of systemic involvement

Answer 7

high temp
fever
feeling unwell
lymphadenopathy

Question 8

acute apical abscess tx

Answer 8

removal of irritants
drainage
dress with CaOH
relieve occlusion
review in 24 hours

Question 9

when to not prescribe antibiotics

Answer 9

IP
symptomatic apical periodontitis
draining sinus tracts (chronic abscess)
post endodontic surgery to prevent flare-ups
after incision for drainage of a local swelling (without systemic involvement)

Question 10

when to prescribe antibiotics

Answer 10

diffuse swelling/ cellulitis
drainage cannot be achieved
systemic involvement

Question 11

when would you consider referral to hospital for IV antibiotics

Answer 11

ludwigs angina
cervical fasciitis

Question 12

what antibiotic is effective for dental abscesses and better absorbed than phenoxymethylpenicillin

Answer 12

amoxicillin 500mg
1 x 3 daily
5 days

Question 13

what antibiotic can be prescribed in the presence of a penicillin allergy

Answer 13

metronidazole 400mg
1 x 3 daily
5 days

Question 14

what can be used as an adjunct to amoxicillin in pts with spreading infection or pyrexia

Answer 14

metronidazole

Question 15

what must be advised to a pt taking metronidazole

Answer 15

avoid alcohol
anticoagulant effect of warfarin might be enhanced

Question 16

what microorganisms does metronidazole target

Answer 16

strict anaerobes

Question 17

3 analgesics

Answer 17

ibuprofen
diclofenac
paracetamol

Question 18

ibuprofen dose

Answer 18

400mg
1 tablet 4 x day after food

Question 19

maximum ibuprofen dose

Answer 19

2.4g

Question 20

when to avoid ibuprofen

Answer 20

hypersensitivity to aspirin or on low dose aspirin daily

Question 21

diclofenac dose

Answer 21

50mg
1 tablet x 3 day for 5 days

Question 22

paracetamol dose

Answer 22

500mg
2 tablets 4 times a day

Question 23

recommended daily paracetamol dose

Answer 23

4g

Question 24

paracetamol OD can result in

Answer 24

delayed hepatic damage

Question 25

action of LA

Answer 25

blocks sodium channels as the drug switches from acid form to base form

Question 26

pH of LA

Answer 26

low

Question 27

what LA has a lower pKa value

Answer 27

mepivacaine (Scandonest)

Question 28

effect of inflammation on blood flow

Answer 28

reduce concentration of LA by increasing the rate of systemic absorption

Question 29

effect of inflammation on nociceptors

Answer 29

effects pain detecting neurons (nociceptors)
sodium channels less sensitive to lidocaine

Question 30

cracked tooth syndrome symptoms

Answer 30

consistent symptoms of pain to biting and cold