Management of the Paediatric Dental Emergency Flashcards

1
Q

Infective emergency types

A
Viral
Bacterial
Fungal
Prion
Parasitic
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2
Q

Vaccinations

A
Polio
Diphtheria 
MenB, C, PCV
MMR - 90% effective 
PCV
HPV
MenACWY
Td/polio booster
TB in some ethnic populations
Pneumococcal vaccine and flu 
Shingles 
Chickenpox
Hep B
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3
Q

Viral - herpes

A

Herpes simplex (primary)
Varicella-zoster - chickenpox/shingles
- stimulus can activate it

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4
Q

Viral - MMR

A

Measles
Kopek’s spots
Mumps
Rubella

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5
Q

Viral
Cocksackie virus
Epstein-Barr virus

A

Herpangina
Hand foot and mouth

EBV - glandular fever

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6
Q

Mechanism of viral infection

A

get infected by virus - acute phase may not occur so unaware
1/3 virus not redacted - stimulated by stress, trauma, uv light
virus lives in trigeminal ganglion
cold sore shows it is active

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7
Q

Measles

A

Classic macular wide rash

Kopek’s spots - white spots inside mouth

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8
Q

Mumps

A

Infection in salivary glands
Swellings lead to ears sticking out
Affects other exocrine glands

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9
Q

Rubella

A

Unwell
Rash
Milder than measles
Teratogenic

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10
Q

Herpangina

A

Malaise

IO ulcers towards posterior, palate and pharynx

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11
Q

Herpes

A

Ulcers all over mouth and on gingivae

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12
Q

Hand foot and mouth

A

Widespread rashes

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13
Q

Bacterial - impetigo

A

Infective rash which can cover face. Weeping sores/spots

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14
Q

Bacterial - scarlet fever

A

Reared face and sore throat
Maybe caused by streptococcus mutans
May be becoming less pathogenic

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15
Q

Bacterial - cat scratch disease

A

Facial wound

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16
Q

ANUG

A

Trench mouth
Bacterial - spirochetes
Treated with metronidazole and chlorohexidine

17
Q

Actinomyosis

A

Yellow exudate

18
Q

Meningitis

A

Rash that doesn’t go away with pressure

19
Q

Dental abscess

A

5% of 5 year olds have one

20
Q

Spread of abscess

A
Fascial plains - cellulitis from neutrophils is leaking --> oedema into tissues 
Sub lingual 
sub mandibular 
pharyngeal 
venous - bacterial 
ocular
21
Q

Examination

A

History of c/o
Symptoms, duration, pain score, sleep, fluids
MH
DH
SH
E/o - symmetry. swelling, lymph nodes, temperature, rashes
I/O
- soft tissues - swellings - towards eye - lateral incisor
- ulcers
- form
- colour
- hard tissues - carious teeth, colour and bone

22
Q

Swelling/ulcer

A
Site 
Size 
surface 
Texture
Colour
23
Q

Special investigations

A

Radiographs
Vitality tests
Bloods

24
Q

e.g1 Primary herpes

Symptoms

Duration

Treatment

A
Fever
Headache 
Malaise
Mild dysphagia 
Lymphadenopathy 
Oral ulceration - 100s
Marginal gingivitis - bright red 

14 days
Recurrent herpes labialis
Admission for dehydration and fever

Fluids
Rest 
analgesics 
antipyretics
chlorhexidine
avoid cross infection 
antivirals - only for those admitted
25
Q

Dental abscess

Tooth is non vital if abscessed

A
Drainage
Antibiotics if spreading infection 
Antibiotics if system upset
analgesic 
antipyretic
follow up
26
Q

Admission for?

A
Infection spread risk 
Trismus 
Pyrexia
Malaise 
Dehydration 
Dysphagia
27
Q

Difficulties of local analgesia

A

Co-operation
Decreased effectiveness
risk of spreading infection
In acidic environment, less likely to work as solution cannot dissociate
Injecting into area of infection can build pressure and send infection into blood stream
e.ginfected D - inject into mesial and distal

28
Q

Trauma

Head injury?

A

Account for missing tooth