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Other oral health risk assessment

Traumatized permanent teeth
Reversible pulpitis
• Tooth is not mobile/displaced but tender on biting • Transient pain with hot, cold or sweet stimuli Irreversible pulpitis
• Tooth is loose with some displacement • Tx = Repositioning, splinting, +/-root canal • Spontaneous, prolonged, poorly localized pain Periapical periodontitis
• Tx = Repositioning, splinting, +/-root canal • Cavity causes pulp necrosis & periapical inflammation Examination
• More complications than for other luxations • Spontaneous, prolonged, localized pain, tooth • Irrigate to remove blood, clots, and debris Periapical abcess
- Hold tooth by crown only, DO NOT touch root • Localized purulent form of periapical peridontitis • Spontaneous, prolonged, localized pain, tooth • Tx = I and D if ‘pointing’; no antibiotics unless - Check Tetanus status; booster if necessary - Rx Penicillin (Erythromycin if allergic) - See dentist immediately for radiograph, Cellulitis
Periapical periodontitis involves soft tissue • If can’t re-implant on scene, transport in saline, Tx = Rx Pencillin: Adults 500mg tid; Children 50mg/kg per day divided (Erythromycin if Traumatized primary teeth
• Do not assume missing teeth are lost at scene Pericoronitis
• Consider x-ray to determine if missing teeth are: • Luxated teeth that are very loose or interfering with • Food and bacteria under gum of erupting molar • Tx = irrigation; removal of gum flap; or extraction • Luxated teeth that are not too loose are monitored - intruded into sinus or other structures • Intruded teeth are variable and often grow back out; * While waiting for definitive treatment, treat pain should be evaluated and monitored by a dentist adequately, and counsel to avoid aggravating Fractured Teeth
Alveolar Bone Fractures
• Often associated with gingival laceration POCKET CARD
Palpate alveolar ridge for step-offs (can often see teeth are at different heights in mouth) Hugh Silk MD, Alan Douglass MD, Joanna Douglass BDS
• Segmental alveolar fractures move when assessing A product of the STFM Group on Oral Health • Tx = Oral surgeon referral within 1 hour. Reduction The information on this card should not substitute for consultation with an oral health expert. Chin trauma
Tx = Dental referral non-urgently to smooth rough Tooth fracture (including posterior teeth) Oral piercings
• Tx = Dental referral with 12 hours for restoration to Treat pain with narcotics, NSAIDs and acetaminophen. INJURY PREVENTION: MOUTH GUARDS
Pulp will be visible (either bleeding or pale pink) • Mouth guards should be worn for all sports with For describing teeth when charting or talking to risk of high impact accidents which include: • Tx = Immediate dental referral for root canal treatment, restoration and long term monitoring or • Tooth may or may not be mobile depending on (Note: falls, violence, and MVAs are also high risk • Other traumatic tooth injuries may be present • Tx = Immediate dental referral for splinting, root - Boil and Bite: better fit, best fabricated with *If fragments available, keep hydrated in saline or milk - Custom: most expensive; made by dentist; best fit/protection and most likely to be worn.


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An Iranian family with congenital myasthenic syndrome caused by a novel acetylcholine receptor mutation (CHRNE K171X) P Soltanzadeh, J S Müller, A Ghorbani, A Abicht, H Lochmüller and A Soltanzadeh J. Neurol. Neurosurg. Psychiatry doi:10.1136/jnnp.2004.059436 Updated information and services can be found at: References This article cites 5 articles, 3 of which can be accessed free a

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