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SDCEP Guidance > Management Of Acute Dental Problems > Flashcards

Management Of Acute Dental Problems Flashcards

1
Q

What could pain in the jaw be if it is not toothache

A

Referred pain from an MI

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2
Q

What else should you make sure if a patient tells you they have been self medicating for pain

A

That they have not exceeded the recommended dose for the drug

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3
Q

What should be the second question you ask yourself when treating a patient with pain

A

Is it trauma related

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4
Q

What advice should you give a parent with a child who is experiencing eruption pain

A

Optimal analgesia, soft brushing and rinsing after food

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5
Q

What advice should be given to a patient that has recently had an extraction and is experiencing pain

A

Optimal analgesia, avoid smoking and maintain good OH

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6
Q

What advice should you give a patient suffering with pain from an ortho/ RPD appliance

A

Optimal analgesia, chlorhexidine mouth rinse
Malleable wax to sharp teeth
Keep appliance out where possible

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7
Q

what should be assessed when looking at a patient with swelling

A

are they having trouble breathing
can they stick out or move their tongue
is the eye closed
is the swelling sudden

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8
Q

what is the treatment if the patient has swelling that is increasing in size slowly and is painful to touch

A

may require antibiotics

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9
Q

what should you do if the patient has swelling but isn’t in pain

A

assess typical jaw pain and signs of MI or if they have exceeded recommended dose for pain relief

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10
Q

what advice should be given to a patient presenting with bleeding who has had recent extractions

A

rinse mouth with warm water and bite on moisturised gauze and maintain constant pressure for 20 mins - if bleeding stops, avoid smoking and exercise for 24 hours

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11
Q

what should you do if a patient doesn’t stop bleeding post-extraction after pressure applied for 20 mins

A

query whether patient is on blood thinners
if not - repeat the pressure advice, if yes then call 101

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12
Q

if there is trauma including lacerations on the tongue what should be the course of action

A

emergency care - NHS 24

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13
Q

what should be the treatment plan if a patient has inhaled a tooth during trauma

A

emergency care - NHS 24

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14
Q

what should be advised for a patient with trauma but no trauma to the tooth

A

optimal analgesia and maintain goof OH

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15
Q

are primary teeth reimplanted after trauma

A

no - advise soft diet and analgesia

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16
Q

what should the course of action be if a patient has had trauma which involves the pulp

A

retain broken piece of tooth in water and expose pulp with CaOH paste

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17
Q

what should be the course of action if a patient presents with trauma that is into dentine

A

advise use of desensitising toothpaste to fractured surface while awaiting an appointment

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18
Q

what may multiple painful ulcers in the mouth be due to

A

herpes virus

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19
Q

what should you do if a patient presents with asymmetry or weakness, arm weakness and speech problems (FAST)

A

Nhs 24 - dial 999

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20
Q

if patient presents with abnormal lump that has recently increased in size what should plan of action be

A

urgent care - local rapid access

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21
Q

what should you do if a patient presents with altered sensation and they have not had dental care recently

A

urgent care

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22
Q

what should you do if a patient presents with altered sensation and they have had dental care recently

A

advise patient to contact treatment provider within 7 days

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23
Q

what should you do if a patient presents with a red/ white speckled lesion or pigmented area that has been present for more than 3 weeks

A

urgent care- rapid local access

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24
Q

what is necrotising gingivitis and necrotising periodontitis

A

severe inflammatory conditions of the gingiva caused by pathogenic bacteria more commonly in immunocompromised patients

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25
Q

what is a periodontal abscess

A

active period of periodontal breakdown that occurs whilst there is marginal closure of deep periodontal pocket occluding drainage

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26
Q

what are perio-endo abscesses

A

leads to abscess formation from a singular tooth

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27
Q

signs and symptoms of necrotising perio disease

A

pain, swelling, bleeding, halitosis, ulcerated gingival tissue, loss of attachment, malaise, fever

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28
Q

signs and symptoms of perio abscess

A

pain and tenderness of gingiva
increased tooth mobility
fever and swollen or enlarged regional lymph nodes
suppuration from gingiva

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29
Q

signs and symptoms of perio-endo abscess

A

geneeralise perio disease
localised pain
swelling with or without suppuration on probing
deep pocketing to root apex with BOP

30
Q

what is dentine hypersensitivity caused by

A

exposed dentine resulting in pain response to external stimulus

31
Q

signs and symptoms of dentine hypersensitivity

A

pain - sharp, sudden and short lived
exposed root surface as a result of gingival recession

32
Q

what is pulpitis

A

inflamed dental pulp

33
Q

what tests would indicate a reversible pulpitis

A

positive or exaggerated response to sensibility testing and tooth is not tender to percussion

34
Q

what tests would indicate an irreversible pulpitis

A

difficult to localise to single tooth, pain lasts hours and dull and throbbing, worsened by heat and alleviated by cold, pain can be spontaneous

35
Q

treatment for reversible pulpitis

A

providing a temporary dressing
restore affected tooth

36
Q

treatment for irreversible pulpitis

A

first stage endodontic therapy
extract the tooth

37
Q

what is alveolar osteitis

A

inflammation of a socket after extraction, most commonly after molar extraction

38
Q

who is more risk at alveolar osteitis

A

patients who smoke

39
Q

signs and symptoms of alveolar osteitis

A

pain, unpleasant taste or odour from area, swelling

40
Q

what is the initial management for alveolar osteitis

A

optimal analgesia
tell patient to avoid smoking and maintain good OH

41
Q

what is more invasive care for alveolar osteitis

A

irrigate with saline and apply a suitable material to the socket - avogyl

42
Q

what should be course of action if an ulcer has been present for 3 or more weeks

A

refer for urgent care at oral surgery

43
Q

what should be the treatment for an ulcer that is recurrent and self-limiting

A

tell patient to use 0.2% chlorhexidine mouthwash, optimal analgesia and a benzydamine oromucosal spray

44
Q

below which age is chlorhexidine not suitable for

A

children under 7 years

45
Q

what may emergency presentation of ill fitting or loose dentures be a sign of

A

stroke or malignancy

46
Q

what is sinusitis

A

inflamed sinuses almost always accompanied by adjacent mucosa

47
Q

what are instructions for handling an avulsed permanent tooth

A

handle tooth by the crown, reimplant tooth in socket and bite gently on tissue or place tooth in milk and get to the dentist

48
Q

what should be course of action if a patient presents with a dislocated jaw

A

send to NHS 24

49
Q

what is bell’s palsy

A

paralysis or weakness of the face, usually only on the one side

50
Q

what is the initial management of bells palsy

A

determine its not a stroke (FAST)
protect the eye with a patch

51
Q

what can be signs and symptoms of salivary gland obstruction

A

pain located to major salivary gland
swelling
history of xerostomia
dehydration
fever

52
Q

what is a candidal infection

A

acute and chronic infection in the oral cavity caused by candida species - usually candida albicans

53
Q

what is the presentation for candidal infections

A

white patches on the oral mucosa resembling milk curds - plaques can be removed to reveal a raw erythematous base which may bleed

54
Q

what is erythematous candidiasis

A

red patches on the oral mucosa

55
Q

what is paraesthesia

A

tingling

56
Q

what is a burning sensation

A

dysaesthesia

57
Q

what should you investigate firstly when a patient presents with paraesthesia or dysaesthesia

A

stroke

58
Q

what is angioedema

A

sudden swelling and affects areas of skin and mucous membranes

59
Q

what must you investigate firstly with signs of angioedema

A

that airway isnt compromised

60
Q

what is osteonecrosis

A

exposed alveolar bone

61
Q

who are at increased risk of osteonecrosis

A

patients taking bisphosphonates or have had radiotherapy to the head and neck

62
Q

what is initial treatment for patients with osteonecrosis

A

chlorhexidine mouthwash (0.2%)

63
Q

what is peri-implantitis

A

inflammation affecting the soft and hard tissues around implants, leading to loss of bone support

64
Q

what treatment should be given for patients with peri-implantitis

A

non-surgical debridement and irrigate with 0.2% chlorhexidine
surgical debridement and implant decontamination with saline or 0.2% chlorhexidine

65
Q

what is temporal arteritis

A

giant cell arthritis that involves damage to medium and large celled blood vessels of the head - specifically the superficial temporal arteries

66
Q

signs and symptoms of temporal arteritis

A

burning sensation
swelling
fever
tenderness to touch
vision difficulties
weight loss
claudication of MOM

67
Q

what is treatment for temporal arteritis

A

prescribe systemic cortico-steroids (prednisolone)
order blood tests to asses C reactive protein

68
Q

what is the dose for prednisolone for an adult

A

60 mg daily

69
Q

what is trigeminal neuralgia

A

severe facial pain in the distribution of the trigeminal nerve, usually unilateral and acute episodes short lived

70
Q

signs and symptoms of trigeminal neuralgia

A

pain - severe, stabbing, lacinating and shooting triggered by touching certain areas of the face
brief facial spasm or tic

71
Q

what is the management for trigeminal neuralgia

A

prescribe carbamazepine
optimal analgesia
long term anaesthetic block

SDCEP Guidance (17 decks)

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