Pulpal therapy for primary dentition Flashcards
When use inhalation sedation or GA?
pre-cooperative
Too young
Additional needs
Multiple abscesses teeth
What is caries related dental pain caused by?
reversible pulpitis
Irreversible pulpitis
Dental abscess
symptoms of reversible pulpitis?
sharp pain
Transient pain
Stimulus
Hot and cold
Sweet
Resolves when stimulus removed
Pain not localised
Tooth not sensitive to percussion test
Management of reversible pulpitis?
if pt is compliment
Caries removal under LA and permanent restoration
If you want to ensure reversible pulpitis or are short on time… what could you do?
partial caries removal and dressing with suitable sedative dressing e.e.g zinc oxide euganol and replaced with permanent resto later
Irreversible pulpitis?
throbbing and spontaneous pain
Spontaneous/continuous
Pain to hot/cold
Disturbs sleep/play
No radiographic changes
Management of irreversible pulpitis?
co-operative - pulpal therapy
Extraction
Odontopaste and analgesics
Pre-cooperation (analgesics first)
Referral IHS/GA xtn
Dental abscess symptoms?
severe pain
Disturbing sleep
TTP and mobile (as swelling pushing tooth cervically and causing pressure on PDL)
malaise
- facial swelling
-pyrexia
Management of dental abscess?
co-operative
Pulpal therapy
Extraction
Pre-cooperative (age, understanding can use analgesics of ab)
Analgesics
Antibiotics
Referral IHS/GA extn
When should you refer dental abscess?
swelling around canine or across floor of mouth
Temp over 39 dc
Ludwig’s angina
Refer to a and e or a call to maxfax team
When to prescribe antibiotics?
Spreading cellulitis
Systemic
Pyrexia
Malaise
-amoxicillin
-metronidazole
If infection is severe, what do you do to the dose of ab?
double it
Pt allergic to amoxicillin, what to prescribe?
metronidazole
Pulp therapy pros?
avoids extraction
Pulp therapy cons?
difficult
LA, isolation, rotary systems, PMC same visit
Indications for pulpotomy?
asymptomatic or transient pain
Carious exposure
Traumatic exposure
Irreversible pulpitis Dental
Dental abscess
Contraindications for pulpotomy?
exfoliation
Unrestorable
Multiple pulp rx
Pre cooperation
Rationale for pulpectomy?
removal
Irreversible inflamed coronal and Radicular pulp
Obturation
Resorbable material
