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Dental emergencies (Types of damage (Tooth avulsion (Diagnosis (History …

- - - - Type 1-2
        Not an emergency - go to dentist
        Sensitive toothpaste over area to reduce pain
      - Pulp involvement
        Refer to on-call dentist
      - Root fracture
        Refer to on-call dentist to stabilise
  - - - History
        HPC: mechanism of injury
        PMH: prior missing teeth
      - Examination
        Dental: missing teeth, are all accounted for?
        timeframe since injury
        Head/C-spine: associated injuries
      - Investigations
        Head X-ray: impacted teeth
        CXR: aspirated teeth
    - - Conservative
        Refer ASAP to on-call dentist
        Store teeth in milk until op
        Clean and replace with firm pressure
      - Medical
        Tetanus prophylaxis
        Prophylactic abx e.g. erythromycin
      - Surgical
        Indication: avulsed secondary teeth
        MOA: surgical stabilisation
  - - - Pathophysiology
        May occur after extraction of a tooth
        Worse if coagulopathy
      - Management
        Bite on rolled up gauze 10m
        If continues, horizontal mattress suture under LA
        If continues, direct pressure and refer to on-call dentist
    - - Pathophysiology
        Typically a few days after tooth extraction
        Bone becomes exposed in empty socket
      - Management
        Irrigate with warm saline
        Analgesia, abx
        Refer to dentist
  - - - History
        HPC: SOCRATES, other signs
      - Examination
        Dental: visible cavity/abscess
      - Investigations
        Bedside: obs
        Bloods: FBC, CRP, U+E
    - - Medical
        Analgesia
        Abx PO (local infection), IV (systemic)
      - Surgical
        Indication: swelling, trismus, dysphagia, sepsis
        MOA: I+D
      - Conservative
        Refer to dentist (no systemic signs/severe symptoms)
        ASAP to maxfax (swelling, trismus, dysphagia, sepsis)