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Therapeutic Guidelines > Medical conditions > Flashcards

Medical conditions Flashcards

1
Q

5 preventative ways to manage dental caries?

A
  1. Plaque reduction
  2. Diet modification
  3. Plaque modification
  4. Tooth surface modification
  5. Increase saliva flow
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2
Q

What are the recommended fluoride dosages?

A
  • <18 months = brush teeth with no toothpaste
  • 18 months to 6yo = use 400-500ppm (pea-sized amount)
  • > 6yo = use 1000ppm
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3
Q

What are the two types of periodontitis and their subcategories?

A
  1. Plaque-induced gingivitis
    - Chronic (most common)
    - ANUG
  2. Periodontitis
    - Chronic slow-progressing (most common)
    - Aggressive
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4
Q

Characteristics of ANUG?

A
  • Severe pain
  • Punched out I/P
  • Ulcers
  • Strong odour
  • Systemic symptoms (fever)
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5
Q

Treatment of gingivitis?

A
  • Remove calculus and overhangs
  • OH
  • Chlorhexidine
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6
Q

After treatment, when is complete resolution of gingivitis expected?

A

1 week

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7
Q

ANUG treatment?

A
  1. Acute
    - Removal of plaque and necrotic tissue
    - irrigation with chlorhex or hydrogen peroxide 3%
    - smoking cessation counselling
  2. Take home treatment
    - Chlorhex until pain resolved
    - antibiotics (nitroimidazole + chlorhex bd-tid until pain resolved)
    - analgesics
    - review in 48-72 hours
  3. Preventative management
    - scaling
    - OH
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8
Q

Usual dose of Phenoxymethylpenicillin?

A

500mg qid for 5 days

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9
Q

Usual dose of Amoxycillin?

A

500mg tid for 5 days

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10
Q

Usual substitute for penicillin allergy and usual dose of this medication?

A

Clindamycin, 300mg tid for 5 days

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11
Q

What comprises the periodontium?

A

PDL, gingivae, cementum, alveolar bone

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12
Q

Two major risk factors for periodontitis?

A

Smoking and uncontrolled diabetes

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13
Q

Differences in clinical features of slow vs. aggressive perio?

A

Slowly-progressing:
- Pocket formation +/- gingival recession

Aggressive:

  • Rapid attachment+bone loss
  • familial aggregation
  • plaque deposits inconsistent with perio destruction
  • RARE in children (suspect T1DM, leukemia)
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14
Q

Treatment of aggressive perio?

A
  • scaling +/- surgical (flap)
  • Smoothing any overhang
  • OHI
    NOTE: antibiotics RARELY required and can only penetrate biofilm in combination with scaling)
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15
Q

Periodontal abscesses are mainly seen in patients with what conditions? (two)

A
  • existing periodontal disease

- uncontrolled diabetes

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16
Q

According to TG, are antibiotics indicated for dental abscesses?
If so, what are first and second line abx?

A

Only if infection has spread beyond jaw or systemic Sx present
1st line: phenoxymethylpenicillin or amoxycillin or clindamycin
- Review pt within 48-72 hrs
2nd line:
any of the above PLUS metronidazole or amox+clav

17
Q

Usual dose of metronidazole?

A

400mg bd for 5 days

18
Q

Usual dose of amox+clav?

A

875mg+125mg bd for 5 days

19
Q

Where can canine fossa infections spread to?

A

intracranially via orbital veins

20
Q

Where can buccal space infections spread to?

A

to the neck causing deep infections

21
Q

What is ludwig’s angina?

A

Severe bilateral cellulitis involving all neck spaces

22
Q

What is the danger of trismus with dental abscesses?

A

There may be breathing or swallowing difficulties -> require IV abx at hospital

23
Q

What are the signs of dentoalveolar surgical infection and how should it be managed?

A

Signs:

  • No improvement in pain/swelling
  • Pus
  • Fever

Management:

  • Drainage of pus
  • Hourly mouthwash
  • Antibiotics (for systemic Sx or immunocompromised)
24
Q

How long is too long for dry socket to heal and what are 3 differential diagnoses?

A 
>3 weeks
DDx:
- Osteomyelitis
- Bisphosphonate-related osteonecrosis of the jaw
- Alveolar SCC
25
Q

Treatment for Salivary gland infection?

A

refer for IV abx and surgical drainage

Therapeutic Guidelines (5 decks)

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