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SDCEP Guidance Documents > Acute Dental Problems > Flashcards

Acute Dental Problems Flashcards

(100 cards)

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1
Q

when should the timescale be for emergency care

A

within 60 minutes and then appropriate subsequent follow up treatment

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2
Q

when should the timescale be for urgent care

A

within 24 hours unless condition worsens

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3
Q

when should the timescale be for non-urgent care

A

within 7 days unless condition worsens

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4
Q

what should the timescale be for self care

A

patient can manage symptoms by themselves

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5
Q

when are antibiotics appropriate

A

when there is evidence of spreading or systemic infection or for a patient who is immunocompromised

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6
Q

what drugs that we prescribe might interact with warfarin

A

NSAIDs
azole antifungals
antibiotics

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7
Q

what type of drugs might result in myopathy if taken with azoles, erythromycin and clindamycin

A

statins

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8
Q

what disease can be exacerbated by use of NSAIDs

A

asthma

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9
Q

when a patient presents with acute dental problem what should the basic assessment entail of

A

medical history
clinical assessment
exam of oral mucosal tissue
encourage to attend again for review

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10
Q

if you did not know where to find information on drug interactions and dental drugs where could you look

A

SCDEP drug prescribing for dentistry
BNF drug interactions

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11
Q

if a patient presents with pain in the mouth or jaw what possible non-dental differential diagnosis must you consider

A

myocardial infarction

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12
Q

if a patient presents with jaw pain and has signs of MI or overdose what do you do

A

NHS24 or 999

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13
Q

if a child presents with pain in an erupting tooth what do you do

A

advise optimal analgesia, soft brushing and rinse after food
use self care unless it worsens

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14
Q

what do you do if a patient presents with pain and analgesia cannot control the pain

A

give urgent dental care

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15
Q

if an adult has pain in an erupting tooth what do you do

A

advise chlorhexidine mouthwash, optimal analgesia
urgent dental care

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16
Q

if a patient has pain due to recent extraction what is advised

A

analgesia
avoid smoking
maintain good OH
urgent dental care

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17
Q

if a patient presents with pain due to orthodontic appliance/sharp tooth or denture what is done

A

advise analgesia
remove sharp parts
non-urgent dental care

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18
Q

if a patient has pain from an ulcer what is done

A

advise analgesia
avoid stimuli
non-urgent dental care

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19
Q

why is chlorhexidine not suitable for children under 7

A

taste and limited ability to rinse without swallowing

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20
Q

what do you do if a swelling is rapidly increasing or obstructing the airway or close to the eye

A

emergency care 999 NHS24

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21
Q

what do you do if the patient is systemically unwell

A

emergency care 999 NHS24

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22
Q

what do you do if a swelling is slowly increasing in size and is hot or firm to touch

A

consider antibiotic prescribing
give urgent dental care

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23
Q

what do you do if the patient’s swelling is not increasing in size but is in pain

A

assess if systemic reason (MI) or consider overdose of medication

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24
Q

what do you do if a patient is bleeding from a recent extraction

A

advise rinsing with salt water
bite on wet gauze
maintain pressure for 20mins

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25
what do you do if a patient is bleeding from recent extraction and is on blood thinners or is not on blood thinners but bleeding will not stop
emergency treatment
26
what do you do if a patient is bleeding but has not had an extraction/trauma
non urgent care if not persistent bleeding to assess dentally emergency care if persistent bleeding
27
what do you do if a patient has had a head injury and dental trauma
emergency care
28
in what situations with trauma would a patient be sent to emergency care in hospital
head injuries cannot open and close jaws large lacerations suspected inhalation of tooth
29
in trauma what situation is it best to be seen as soon as possible
avulsion of adult tooth
30
when would patients with ulcers be seen in emergency care
when they are dehydrated and showing signs of severe dehydration
31
if a patient with an ulcer for the first time is systemically unwell with multiple ulcers or is taking medication/have underlying medical condition what do we do
advise analgesia send for urgent medical care
32
if a patient appears with sign of stroke what do you do
999
33
if the patient has altered sensation not due to dental treatment what do you do
give urgent care
34
if a patient has altered sensation probably due to recent dental treatment what do you do
advise to contact within 7 days if worsens
35
if a patient has abnormal appearance with white/red speckled lesions present for more than 3 weeks what do you do
refer to local rapid access pathway
36
what are the key signs and symptoms of acute apical abscess
pain swelling of gingiva, face or neck fever lethargy
37
what is the initial management of acute apical abscess
determine if airway compromised - 999 if it is or analgesia and urgent dental care if not
38
what is the subsequent care of acute apical abscess
incise and drain drain through canal and irrigate advise analgesia (NSAIDs) extract if appropriate
39
what is an acute apical abscess
acute inflammation of soft tissues surrounding the tip of the root of a tooth often caused by decay or pulp necrosis
40
what is acute pericoronitis
infection under operculum
41
what are the signs and symptoms of pericoronitis
pain swelling discomfort on swallowing trismus unpleasant taste/smell fever nausea fatigue
42
what is the initial management of pericoronitis
determine if airway compromised recommend analgesia rinse with 0.2% chlorhexidine advise to seek urgent dental care
43
what is the subsequent care for acute pericoronitis
debridement under operculum irrigate with chlorhexidine extract tooth if chronic adjust occlusion if traumatising operculum
44
what are the main acute periodontal conditions
necrotising gingivitis necrotising periodontitis periodontal abscess perio-endo lesions
45
what is a periodontal abscess
breakdown of periodontal tissues while there is closure of periodontal pocket not allowing drainage seen in patients with untreated periodontitis
46
what are the signs and symptoms of necrotising periodontal disease
pain swelling bleeding halitosis ulcerated gingival tissue loss of attachment malaise fever
47
what are the signs and symptoms of periodontal abscess
pain and tenderness increased mobility fever swelling on gingiva suppuration from gingiva
48
what is the care for necrotising periodontal disease
scaling prescribe chlorhexidine OHI metronidazole possibly
49
what is the care for periodontal abscess
scaling irrigating pocket extraction
50
what is the initial management of dentine hypersensitivity
advise to avoid acidic foods and drinks, use desensitising toothpaste seek non-urgent dental care
51
what is the subsequent care of dentine hypersensitivity
eliminate other causes of pain apply desensitising toothpaste, consider fluoride varnish or dentine bonding agents
52
what is the care of reversible pulpitis
provide temporary dressing restore affected tooth
53
what is the care of irreversible pulpitis
provide first stage endodontic therapy extract tooth
54
what is the care of dry socket
irrigate with saline pack with alvogyl advise against smoking
55
what is the management of post-extraction haemorrhage
rinse and pressure on damp gauze haemostatic dressing - surgicell sutures
56
when an ulcer has been present for more than 3 weeks what do you do
refer to urgent care for cancer assessment
57
when an ulcer has been present for less than 3 weeks what do you
chlorhexidine mouthwash consider medication causes/conditions consider trauma
58
what is the initial management of fractured teeth
if inhaled 999 if open cavity buy temp dressing at pharmacy recommend analgesia urgent care if pain not relieved
59
what is the subsequent care for fractured teeth
smooth rough edges provide palliative dressing pulp therapy extract if unrestorable
60
what is the care for fractured indirect restorations
recement restoration with temp make replacement provide new crown for a primary tooth
61
what is the initial management for trauma from fixed appliances
remove loose components apply wax onto sharp bites advise to seek care from orthodontist
62
what is the initial management for sinusitis
recommend analgesia determine if bacterial - consider antibiotics if it is if not bacterial then steam inhalation and see GP
63
if a patient presents with jaw fracture or lacerations inside the mouth what do you do
send to hospital advise good OH and chlorhexidine
64
if a patient has TMJ pain what is initial management
recommend analgesia consider diazepam advise local heat packs/ice packs have soft diet seek non-urgent dental care
65
what is the subsequent management for TMJ pain
make splint monitor symptoms refer for specialist opinion if symptoms do not improve
66
what is the initial management of bells palsy
rule out stroke protect eye with patch advise to seek urgent medical care
67
what is the subsequent care of bells palsy
prednisolone (25mg 2x per day for 10 days) refer to GMP
68
what do you do if you suspect salivary gland infection
analgesia seek urgent medical care
69
what do you do if you suspect mumps
analgesia stay at home refer for urgent medical care
70
what do you do if there is an obstruction of a major gland without infection
analgesia drink fluids seek urgent dental care
71
what is the initial management of oral thrush
consider if they use steroid inhaler systemic fluconazole or miconazole gel
72
what is the subsequent care of oral thrush
monitor symptoms if does not respond send to GMP or specialist
73
what is the care of prolonged anaesthesia/altered sensation
treat if known cause refer to specialist or monitor symptoms
74
what is angioedema
sudden swelling affecting areas of skin and mucous membranes
75
what is the initial management of angioedema
determine airway compromisation
76
what is the subsequent care of angioedema
follow up medical care to identify cause of angioedema and establish underlying medical condition
77
what can angioedema be caused by
allergic like response
78
what is osteonecrosis
exposed avascular bone
79
what is the initial management of osteonecrosis
recommend analgesia advise patient to rinse with 0.2% chlorhexidine advise to seek care
80
what is the subsequent care of osteonecrosis
minimise need for extractions and avoid MOS refer to oral surgeon
81
what is peri-implantitis
inflammation affecting soft and hard tissues around implants leading to loss of bone support
82
what is the initial management of peri-implantitis
recommend analgesia recommend good OH advise to seek dental care
83
what is the subsequent treatment of peri-implantitis
assess patients progress including radiographic assessment give appropriate OHI consider debridement and irrigate with chlorhexidine
84
what is temporal arteritis
inflammation and damage to medium and large blood vessels of the head, typically affecting the superficial temporal arteries
85
what is the initial management of temporal arteritis
if visual disturbance refer for emergency medical care because high dose corticosteroid prescription without delay is likely to be required
86
what is trigeminal neuralgia
severe facial pain in the distribution of the trigeminal nerve
87
what is the initial management of trigeminal neuralgia
prescribe carbamazepine seek medical care
88
what is the subsequent care of trigeminal neuralgia
monitor symptoms and response to medication at follow up appointments refer to specialist
89
what is the prescription for paracetamol for mild to moderate odontogenic or post-operative pain
paracetamol 500mg send 40 tablets take 2 tablets 4 times daily
90
what is the prescription for ibuprofen
ibuprofen tablets 400mg send 20 tablets 1 tablet four times daily, preferably after food
91
what is the carbamazepine prescription for trigeminal neuralgia
carbamazepine tablets 100mg send 20 tablets 1 tablet twice daily
92
what is the prescription for benzydamine mouthwash for oral ulceration
benzydamine mouthwash 0.15% send 300ml rinse using 15ml every 1.5 hours as required
93
what is the benzydamine oromucosal spray prescription for oral ulceration
benzydamine oromucosal spray 0.15% send 30ml 4 sprays onto affected area every 1.5hrs
94
what is the lidocaine ointment prescription for oral ulceration
lidocaine ointment 5% send 15g rub sparingly and gently on affected areas
95
what drugs can cause black hairy tongue
penicillin tetracyclines
96
what drugs can cause gingival overgrowth
phenytoin ciclosporin nifedipine
97
what drugs can cause osteonecrosis of the jaw
bisphosphonates
98
what drugs can cause oral thrush
broad spectrum antibiotics corticosteroids immunosuppressants
99
what drugs can cause tooth discolouration
chlorhexidine fluoride iron tetracyclines
100

SDCEP Guidance Documents (11 decks)

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