Question

In: Anatomy and Physiology

a 35 year medically fit non-smoking patient presents complaining of a buccal intraoral swelling associated with...

a 35 year medically fit non-smoking patient presents complaining of a buccal intraoral swelling associated with his lower right posterior teeth. In addition, the patient complains of bleeding gums and wishes to improve the appearance of the gingiva around tooth FDI 23 that clinically has associated class II gingival recession.

Initial clinical examination indicates an intraoral swelling with a draining sinus between teeth FDI 45 and 46, grade I mobility of 46, generalized clinical loss of attachment of 3-4mm and generalized pocketing of 5-6mm with bleeding on probing around all teeth.

Questions:
1-discuss the treatment options available for the management of this patient

2-discuss the pros and cons for the non-surgical and surgical management

Solutions

Expert Solution

  • For an acute dental abscess that causes substantial pain or swelling, the doctor may incise and drain the abscess and/or try therapy with antibiotics.
  • Abscesses that are eminently life-threatening may require hospital admission.
  • Pain medication is commonly prescribed until the symptoms can be controlled.
  • These initial measures are often necessary to temporarily relieve the signs and symptoms of an acute abscess; however, further treatment directed at eliminating the primary source of the infection is necessary to prevent recurrence. The location of this primary source determines the "definitive" treatment options, which may include root canal treatment, periodontal treatment, or extraction of the tooth.

Incision: The abscess needs to be cut out and the pus, which contains bacteria, drained away. The doctor will administer a local anesthetic.

Treating a periapical abscess: Root canal treatment will be used to remove the abscess. A drill is used to bore a hole into the dead tooth so that the pus can come out. Any damaged tissue will be removed from the pulp. A root filling is then inserted into the space to prevent subsequent infections.

Treating a periodontal abscess: The abscess will be drained and the periodontal pocket cleaned. The surfaces of the root of the tooth will then be smoothed out by scaling and planing below the gum line. This helps the tooth heal and prevents further infections from occurring.

Surgery

People with a periapical abscess and a recurring infection may need to have diseased tissue surgically removed. This will be done by an oral surgeon. Those with a periodontal abscess and a recurring infection may have to have their gum tissue reshaped and the periodontal pocket removed. This procedure will be performed by an oral surgeon. If a dental abscess comes back, even after surgery, the tooth may be taken out.

Surgical management of a dental abscess can include root canal or tooth extraction. If there is a periapical dental abscess, it may require incision and drainage. Incision and drainage can be performed in the emergency department or the clinic but must be followed up by a dentist.

Pros. Incision and drainage or spontaneous rupture of the abscess quickly accelerates resolution of the infection.

Cons. Painful procedure, require OT admission.

Sydney Mullin answered 10 months ago
Next > < Previous

Related Solutions

a 35 year medically fit non-smoking patient presents complaining of a buccal intraoral swelling associated with...
a 35 year medically fit non-smoking patient presents complaining of a buccal intraoral swelling associated with his lower right posterior teeth. In addition, the patient complains of bleeding gums and wishes to improve the appearance of the gingiva around tooth FDI 23 that clinically has associated class II gingival recession. Initial clinical examination indicates an intraoral swelling with a draining sinus between teeth FDI 45 and 46, grade I mobility of 46, generalized clinical loss of attachment of 3-4mm and...
A 35 year medically fit non-smoking patient presents complaining of a buccal intraoral swelling associated with...
A 35 year medically fit non-smoking patient presents complaining of a buccal intraoral swelling associated with his lower right posterior teeth. In addition, the patient complains of bleeding gums and wishes to improve the appearance of the gingivae around tooth FDI 23 that clinically has associated Class II gingival recession. Initial clinical examination indicates an intraoral swelling with a draining sinus between teeth FDI 45 and 46, grade 1 mobility of 46, generalized clinical loss of attachment of 3-4mm and...
a 35 year medically fit non-smoking patient presents complaining of a buccal intraoral swelling associated with...
a 35 year medically fit non-smoking patient presents complaining of a buccal intraoral swelling associated with his lower right posterior teeth. In addition, the patient complains of bleeding gums and wishes to improve the appearance of the gingiva around tooth FDI 23 that clinically has associated class II gingival recession.   Initial clinical examination indicates an intraoral swelling with a draining sinus between teeth FDI 45 and 46, grade I mobility of 46, generalized clinical loss of attachment of 3-4mm and...
A 67-year-old female patient presents to the emergency room you work at complaining of shortness of...
A 67-year-old female patient presents to the emergency room you work at complaining of shortness of breath and pain on the right side of her chest. Upon auscultation of the lung field during the physical exam, you note flatness and diminished breath sounds over the right lung. Her temperature is 101.3°F. What are the possible causes of her symptoms? (What is your differential diagnosis?) What tests might order to determine the specific cause of this patient’s symptoms? Why? This patient’s...
The patient is a 45-year-old man who presents to the clinic complaining of intermittent fevers, joint...
The patient is a 45-year-old man who presents to the clinic complaining of intermittent fevers, joint pain, myalgias, and generalized fatigue. He noticed a rash several days ago that seemed to appear and disappear on different parts of his abdomen. He noticed the lesion below this morning and decided to come in for evaluation. He denies recent international travel and the only difference in his usual routine was clearing some underbrush from his back yard about a week ago. Past...
Your patient is a 52-year-old male with a history of smoking and alcohol abuse. He presents...
Your patient is a 52-year-old male with a history of smoking and alcohol abuse. He presents to the ED with complaints of "my skin looks yellow, my stomach hurts, and I feel nauseous". He is taken to CT and a tumor near the pancreas is observed. It appears to be blocking the common bile duct. Develop a plan of care for the patient. Use the attached concept map Possible Medications (Minimum of 2 medications needed) Clinical Manifestations Subjective: Objective: Possible...
A patient presents complaining of weakness and mild pain at the right (R) elbow on the...
A patient presents complaining of weakness and mild pain at the right (R) elbow on the lateral side. The pain is limiting functional activity, in particular activities that involve gripping and turning. a) Considering the types of skills and the specific tests for elbow structures, outline how you would go about differentiating the contribution of the elbow joints and the relevant muscles to causing this impairment, indicating which tests you could use and what information you would gain from performing...
Patient presents to the clinic with a four-month history of generalized joint pain, stiffness, and swelling,...
Patient presents to the clinic with a four-month history of generalized joint pain, stiffness, and swelling, especially in her hands. She states that these symptoms have made it difficult to grasp objects and has made caring for her 6 and 4-year-old children problematic. Physical exam remarkable for bilateral ulnar deviation of her hands as well as soft, boggy proximal interphalangeal joints. The metatarsals of both of her feet also exhibited swelling and warmth. .why patients with rheumatoid arthritis exhibit these...
A 48-year-old female patient has breast carcinoma and presents to the hospital outpatient unit complaining of low energy.
A 48-year-old female patient has breast carcinoma and presents to the hospital outpatient unit complaining of low energy. The physician orders hemoglobin and hemocrit counts, which were performed.After evaluation, it is determined the patient has anemia in neoplastic disease. The physician orders 3 units of packed red blood cells, which are transfused on the unit.Which coding is best for the blood products? (See the HCPCS options below.)HCPCS CodeDescriptorP9010Whole blood for transfusion, per unitP9021Red blood cells for transfusion, per unitP9060Fresh frozen...
patient is 9 years old and female presents with her mother complaining of a dry cough...
patient is 9 years old and female presents with her mother complaining of a dry cough that “wakes up everyone in the house” each night for the last 2 weeks. Denies prior hx of the same. For the case you have chosen: Discuss what questions you would ask the patient, what physical exam elements you would include, and what further testing you would want to have performed. In SOAP format, list: Pertinent positive and negative information Differential and working diagnosis...
ADVERTISEMENT
Subjects
ADVERTISEMENT
Latest Questions
ADVERTISEMENT