Facial Pain

Miscellaneous

• Ludwig’s angina primarily affects the submandibular space, leading to severe swelling and potential airway obstruction. Prompt diagnosis and treatment are crucial to prevent serious complications. [Q4278]
• Myofascial pain is often caused by tight bands within the muscles, leading to significant discomfort and functional limitations. Effective management involves both medical and physical therapies. [Q4948]
• Infection of the temporal muscle can spread to the neck, causing further complications such as neck stiffness and systemic infection. Early intervention is necessary to control the spread. [Q5845]

Impacted Teeth

Assessment

• Preoperative assessment is the most critical factor in the surgical removal of impacted teeth, ensuring proper planning and risk management. This step helps prevent complications during and after surgery. [Q235]
• The incidence of paraesthesia following the removal of an impacted lower third molar is around 10%. Proper surgical technique and careful handling of neural structures are essential to minimize this risk. [Q3001]

Extraction

• Directing the extraction lingually takes advantage of the thinner bone on the lingual side, making the extraction easier. This technique reduces the force needed and minimizes the risk of fracturing the bone. [Q314]

Infection

• Infection of a partially erupted third molar is least likely to spread to the parotid space, as this space is anatomically less connected to the impacted tooth. Understanding the pathways of infection spread is vital for effective treatment. [Q4153]

Neurology

• Referral to a specialist is appropriate if a third molar is close to the nerve to avoid nerve damage. This ensures that the patient receives the most skilled care for their condition. [Q4003]
• Damage to the lingual nerve can result in numbness and loss of taste on the affected side of the tongue. Prompt identification and management of nerve damage are crucial for patient recovery. [Q6088]

Pain

• Cold application helps reduce swelling and pain immediately after the surgical removal of an impacted third molar. This simple measure can significantly improve patient comfort in the immediate postoperative period. [Q437]
• Maximum swelling typically occurs 24-48 hours after third molar surgery. Managing patient expectations and providing appropriate postoperative care instructions are essential. [Q575]

Techniques

• Marsupialization followed by extraction is a common approach for treating dentigerous cysts. This technique allows for gradual decompression of the cyst before complete removal. [Q3707]
• Yes, but with caution, high-speed rotary burs are often used to reduce time in third molar impaction cases. Careful use of these tools minimizes tissue damage and enhances surgical efficiency. [Q4129]

Infection Control in Surgery

Abscess

• A drain is typically necessary to maintain an open incision in a large abscess. This allows for continuous drainage and reduces the risk of further infection. [Q3058]

Anesthesia

• Yes, local anesthetic sprays are used for surface anesthesia in children. These sprays provide effective pain control with minimal discomfort during application. [Q4220]
• Supraperiosteal injection is used for maxillary canine anesthesia. This technique provides localized anesthesia with minimal discomfort for the patient. [Q4614]
• General anesthesia requires the presence of an anesthesiologist for safety and legality, ensuring proper administration and monitoring. This collaboration ensures the highest standard of care during surgical procedures. [Q5029]
• Used anaesthetic cartridges should be disposed of in sharps bins. This method ensures safe disposal and reduces the risk of injury or contamination. [Q5352]

Antibiotics

• Ampicillin cover is appropriate for patients on warfarin to manage the risk of endocarditis and bleeding. Coordinating anticoagulant management with dental procedures is critical for patient safety. [Q577]
• Patients with a history of rheumatic fever should receive 2g of amoxicillin pre-operatively as prophylaxis. This helps prevent infective endocarditis during dental procedures. [Q601]
• Treatment of osteoradionecrosis typically involves conservative treatment, including antibiotics and resection of the affected jaw segment. This approach aims to control infection and remove necrotic tissue. [Q727]
• Prophylactic antibiotics are recommended primarily for high-risk patients to prevent osteomyelitis. Routine use in low-risk patients is generally not advised to avoid antibiotic resistance. [Q4200]

Antiseptics

• Yes, a 5% iodine solution is commonly used for field disinfection. This concentration effectively reduces microbial load on surgical sites. [Q4186]
• The best concentration for chlorhexidine gel as an irrigant or dressing is 0.01. This concentration provides effective antimicrobial activity while being safe for tissues. [Q5551]

Bleeding

• If bleeding continues for more than 3 days after extraction, checking for a bleeding disorder is essential. Identifying underlying coagulopathies ensures appropriate management and intervention. [Q3999]
• Yes, INR measures the extrinsic pathway, and APTT measures the intrinsic pathway of the coagulation cascade. Understanding these tests helps in assessing and managing bleeding risks. [Q4167]
• A coagulation profile is essential to assess the bleeding risk before exodontia. This evaluation helps prevent excessive bleeding during and after the procedure. [Q4892]

Diabetes

• Patients should maintain their normal diet and insulin regimen. This helps in managing blood glucose levels and reducing surgical risks for diabetic patients. [Q576]
• Yes, with proper management, insulin-dependent diabetic patients can undergo outpatient GA. Preoperative planning and intraoperative monitoring are crucial for safe anesthesia. [Q4172]

Infection

• Prophylactic antibiotics can significantly reduce the risk of postoperative infections after wisdom tooth extraction. This practice is especially important for immunocompromised patients. [Q34]

Legal

• An unaccompanied patient, especially if a minor or not fully competent, should have a legal guardian present for consent and support. This ensures informed consent and proper postoperative care. [Q3906]
• Yes, the practitioner should always have another trained person present during sedation to assist in emergencies. This team approach enhances patient safety during sedation procedures. [Q4105]

Material

• Catgut sutures are banned in the UK due to their inconsistent resorption and potential for causing inflammation. Modern alternatives provide more predictable outcomes and lower risks. [Q6052]
• Nylon sutures are commonly used for skin or lip trauma because they are non-resorbable and provide good tensile strength. These sutures offer reliable wound closure and minimal tissue reaction. [Q6053]

Medication

• Using sedation and providing reassurance are effective ways to manage a nervous patient undergoing extraction. This approach helps reduce anxiety and improves the overall experience. [Q3908]
• Local anesthesia is typically used for simple restorative procedures to ensure patient comfort. This method effectively manages pain during minor dental treatments. [Q3909]
• Flumazenil is used to reverse the effects of midazolam sedation in emergencies. Prompt administration can quickly restore consciousness and breathing in sedated patients. [Q4090]

Neurology

• Anterior superior alveolar nerve is anesthetized for flap elevation in the lateral incisor. Effective anesthesia ensures patient comfort and procedural success. [Q5997]

Other

• Hyperbaric oxygen treatment helps in healing and reducing the risk of osteoradionecrosis following dental extractions in irradiated patients. This therapy enhances tissue oxygenation and recovery. [Q943]
• 8mg of dexamethasone is commonly recommended to reduce facial swelling after impacted teeth removal. This dosage effectively controls inflammation and improves postoperative comfort. [Q3022]
• All these factors (altered bone density, osteoradionecrosis, delayed healing, increased risk of infection) should be considered in such patients. Comprehensive preoperative assessment is crucial for safe surgical outcomes. [Q3104]
• A minimum platelet count of 50,000 per microliter is generally required for tooth extraction. This threshold helps ensure adequate hemostasis during and after the procedure. [Q4230]
• Leaving a tooth open for drainage can lead to caries or flare-ups due to food packing. Proper management involves appropriate temporary restorations to prevent these complications. [Q4231]
• Individuals with negative HBsAg are not considered chronic healthy carriers. Accurate diagnosis and patient history are essential for appropriate infection control measures. [Q4418]
• Immunosuppression is the primary etiological factor for the development of oral candidiasis. Management involves addressing the underlying immune deficiency and antifungal therapy. [Q4771]
• Barrier envelopes and packaging should not be discarded as normal waste. Proper disposal methods help prevent environmental contamination and maintain hygiene standards. [Q4920]
• Gauze does not effectively protect the airway. Proper positioning and airway management techniques are essential during IV sedation. [Q5177]
• If a foreign body is swallowed into the airways, it is crucial to call for medical help first before using X-rays to locate it. Immediate action can prevent serious respiratory complications. [Q5178]
• Used cotton pads are considered clinical waste and should not be disposed of in domestic black bags. Proper disposal practices ensure safety and compliance with health regulations. [Q5353]
• Permanent restorations should not be placed in an infected area as it may seal in the infection. Appropriate treatment of the infection is necessary before definitive restorations. [Q5793]
• Clindamycin is effective for anaerobic infections in dental abscesses. Its use helps in controlling the infection and promoting healing of the surgical site. [Q5922]

Sedation

• Using sedation can help manage a patient with a severe gag reflex during dental procedures. This technique improves patient comfort and procedural success. [Q3905]

Techniques

• Adherence of tissues on the surgical electrode usually means the current intensity is too low. Adjusting the current ensures effective cutting and minimizes tissue damage. [Q819]