SCR Dental Conditions Flashcards
What would you expect to find in a patient pain history of an acute periodontal abscess?
Clinical observation?
Type of pain?
Onset?
Exacerbating factors?
Localised swelling
Throbbing pain, dull ache and tenderness. Well localised
A few days onset may be recurrent.
Exacerbated by biting and pressure
What are the findings on clinical examination for an acute periodontal abscess?
Intra-oral swelling adjacent to the tooth at gingival margin level Increased mobility
Increased periodontal pocketing
Lymphadenopathy
Bleeding and pus released on probing of pocket
What are the findings on percussion for an acute periodontal abscess
Slight TTP in a lateral direction
What are potential radiographic findings of an acute periodontal abscess?
Alveolar bone loss, vertical or horizontal
Apical radiolucency in perio-endo lesion
What is the management of an acute periodontal abscess?
If FOM is raised then send to A&E
RSD with irrigation of the pocket
XLA
Antibiotics if systemic or patient is immunocompromised
What is the management of an acute periodontal abscess where the FOM is raised?
If FOM is raised then send to A&E
Give a description of a typical patient that presents with necrotising ulcerative gingivitis
Commonly young adult Smoker
Poor oral hygiene
Stressed
What would you expect to find in a patient pain history of necrotising ulcerative gingivitis?
Pain
Bleeding
Swelling from gingivae
Halitosis
What are the findings on clinical examination for a patient with necrotising ulcerative gingivitis?
Necrosis and ulceration of gingival tissues Blunted interdental papillae Loss of attachment Oral hygiene poor Increased bleeding on probing Tender gingivae Lymphadenopathy
What are potential radiographic findings of necrotising ulcerative gingivitis?
Potential bone loss
What is the management of necrotising ulcerative gingivitis?
OHI
Smoking cessation advice
Antibiotics
Chlorhexidine mouthwash
What would you expect to find in a patient pain history of dentine hypersensitivity?
Pain stimuli?
Type of pain?
Does pain linger after the removal of stimuli?
Pain with hot, cold and sweet
Short sharp pain
Pain relieved by removal of stimulus
What treatment could potentially lead to dentine hypersensitivity?
May have had recent scaling or tooth whitening
Potential ongoing periodontal treatment
What are the findings on clinical examination for a patient with dentine hypersensitivity?
Root surface exposure due to gingival recession
Failed restorations
Potential caries
Sensitive to cold air stream
What are the findings on percussion for dentine hypersensitivity?
Not TTP
What evidence from a radiograph could potentially help diagnose dentine hypersensitivity?
Caries may be present
What is the management of dentine hypersensitivity?
Advise to use desensitising toothpaste
Avoid extreme temperature & acidic food
Apply topical fluoride varnish, dentine bonding agents, or cover exposed dentine with suitable restorative material
What would you expect to find in a patient pain history of food packing?
Pain after eating fibrous food
Recent large filling
What are the findings on clinical examination for a patient with food packing?
Lost or broken contact point
Gingival inflammation
Overhang
Food debris in contact point
No resistance to floss passing through contact point
What are the findings on percussion for food packing?
Potential lateral TTP
What are potential radiographic findings of food packing?
Open contact point
What is the management of food packing?
Scaling
OHI with tepe
Consider replacing restoration or improve contact point
What would you expect to find in a patient pain history of cracked tooth syndrome?
Sound tooth gives sharp pain on biting and with hot and cold fluids
Pain on release of pressure
What are the findings on clinical examination for a patient with cracked tooth syndrome?
What may you use in your clinical examination to check for this? What would the result be?
What could there be evidence of in the mouth to suggest it caused cracked tooth syndrome?
A crack or fracture may be evident
Existing restoration present
Pain on the release of pressure as checked with tooth sleuth
Evidence of parafunction
What are the findings on percussion for cracked tooth syndrome?
Potentially TTP
What will you see when you sensibility test a tooth with cracked tooth syndrome?
Positive response with an exaggerated response
What is the management of cracked tooth syndrome if there are symptoms of reversible pulpitis?
Cement orthodontic band to prevent cusps from being wedged apart
Tooth will require cuspal coverage restoration
What is the management of cracked tooth syndrome if there is a vertical crack into root surface?
XLA
What would you expect to find in a patient pain history of reversible pulpitis?
Short sharp pain
Poorly localised pain
Mainly cold stimuli
Pain goes if stimuli removed
What are the findings on clinical examination for a patient with reversible pulpitis?
Recent or failed restoration
Tooth wear
Recession
Caries into dentine
What are the findings on percussion for reversible pulpitis?
Not TTP
What will you see when you sensibility test a tooth with reversible pulpitis?
Positive or hypersensitive
What are potential radiographic findings for reversible pulpitis?
Caries into dentine
Lamina dura seen
No periapical change
What is the management of reversible pulpitis?
Removal of caries and if pulp is nit exposed place a temporary ZOE dressing
What would you expect to find in a patient pain history of irreversible pulpitis?
Rapid onset or spontaneous pain Poorly localised pain Constant or lingering dull/sharp/stabbing pain Disturbed sleep Pain persists after stimulus is removed Exacerbated by hot
Comment on how analgesics help control both reversible and irreversible pulpitis?
Reversible can be controlled with analgesics
Irreversible cannot be controlled with analgesics
What are the findings on clinical examination for a patient with irreversible pulpitis?
Extensive caries into dentine or pulp
Recent or failed restoration
What are the findings on percussion for irreversible pulpitis?
Not TTP
What will you see when you sensibility test a tooth with irreversible pulpitis?
Negative or painful delayed response
What are potential radiographic findings for irreversible pulpitis?
Caries or large restoration near or into pulp
Widening of PDL
No periapical change
What is the management of irreversible pulpitis?
Assess restorability
If unrestorable XLA
If restorable extirpation
What would you expect to find in a patient pain history of acute apical periodontitis?
Spontaneous onset
Constant lingering pain especially on biting
Well localised pain
What are the findings on clinical examination for a patient with acute apical periodontitis?
Swelling is palpable but localised to tooth
Tooth may be carious or discoloured
May have had a previous RCT
Lymphadenopathy
What are the findings on percussion for acute apical periodontitis?
TTP
What will you see when you sensibility test a tooth with acute apical periodontitis?
Negative
What are the findings on percussion for acute apical abscess?
TTP
What will you see when you sensibility test a tooth with an acute apical abscess?
Negative
What are potential radiographic findings for an acute apical abscess?
Widening of PDL to large apical radiolucency
Root filled may be present
What are potential radiographic findings for an acute apical periodontitis?
Widening of PDL to large apical radiolucency
Root filled may be present
