Pulp & Periapical Disease Flashcards
what is the flow chart for caries when it extends to pulpal tissue?
what are the symptoms of a pulp hyperaemia?
- pain lasting for seconds
- pain stimulated by hot/cold or sweet
- pain resolved after stimulus removed
- caries approaching pulp but tooth can still be restored without treating pulp
what are the symptoms of acute pulpitis?
- constant severe pain
- react to thermal stimuli
- poorly localised pain
- referral of pain
- no/minimal response to analgesics
- open symptoms less severe
how can you diagnose acute pulpitis?
- history
- visual exam
- negative to TTP (not had time to spread to periapical region)
- radiographs
- removal of restorations
how do you diagnose acute periodontitis?
- easy to make
- TTP
- tooth is non-vital (unless traumatic)
- slight increase in mobility
Radiographs:
- loss of clarity of lamina dura
- radiolucent shadow
- widening of apical PDL space
what are the causes of TRAUMATIC periodontitis?
parafunction (clenching/grinding)
what is the most common pus production infection?
acute apical abscess
what organisms are involved in dental abscess’?
- polymicrobial
- anaerobes play an important part (S. aureus, P. gingivalis, prevotella species etc)
what are symptoms of an acute apical abscess?
similar to acute apical periodontitis;
- severe unremitting pain
- acute tenderness in function & permission
BUT
no swelling, redness or heat (YET!)
what are the 5 cardinal signs of inflammation?
- Heat
- Swelling
- Tender
- Redness
- Loss of function
where are some areas/spaces that an acute apical abscess could drain to?
- Submental space
- sublingual space
- submandibular space
- buccal space
- infraorbital space
- palate
what is the treatment for an acute apical abscess?
Provide Drainage:
- soft tissue excision intraorally OR extraorally
- remove source/cause (XLA, extirpation, periradicular surgery)
Antibiotic need determined by:
- severity
- absence of adequate drainage
- patient’s medical condition
what are the LOCAL factors when assessing need for antibiotics in an abscess pt?
- toxicity of swelling
- airway compromisation
- dysphagia
- trismus
- location (floor of mouth)
what are the SYSTEMIC factors when assessing need for antibiotics in an abscess pt?
- immunocompromised pts
- diabetes
- elderly
what is reversible pulpitis?
level of inflammation that tooth can return to normal IF the cause is removed
mild-moderate tooth pain when STIMULATED, no pain without stimulus, no mobility, no TTP