HEAD, EYE, EAR, NOSE, AND THROATEMERGENCIESSYMPTOMS/EXAM
■ Pain and swelling
■ Trismus
TREATMENT
■ Saline irrigation to remove food from under the gingival flap
■ Antibiotics: PCN, erythromycin, or clindamycin
■ I+D if abscess is present
■ Referral to dentist must occur within 24 to 48 hours.
■ In the case of third molar pericoronitis, tooth removal is the common,
definitive treatment.
Periodontal Abscess
ETIOLOGY
■ Debris and bacteria entrapped along the gingiva or between the teeth
causing local swelling and infection
■ Most common cause of tooth loss = gum disease.
SYMPTOMS/EXAM
■ Dental and gingival pain
■ Gingival swelling
TREATMENT
■ Warm saline irrigation
■ Antibiotics
■ I+D if abscess is present
Periapical Abscess
ETIOLOGY
■ Inflammation, infection, and necrosis of the apical (distal) portion of the
tooth
■ Usually secondary to dental caries
SYMPTOMS/EXAM
■ Pain, especially when tapping on (percussing) tooth
■ Facial swelling common
TREATMENT
■ Analgesics
■ Antibiotics
■ Dental referral
COMPLICATIONS
Can erode through bone into other spaces (see Figure 14.23)
Alveolar Osteitis
ETIOLOGY
■ Postextraction (usually of the molars) pain due to loss of healing clot →
inflammation and local osteomyelitis.