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HEAD, EYE, EAR, NOSE, AND THROAT

EMERGENCIES

CLASSII

Fracture through dentin and enamel

TREATMENT

Smooth edge with file and apply calcium hydroxide covering over exposed

dentin with dental follow-up.

CLASSIII

Fracture through pulp, dentin, and enamel

TREATMENT

Dental consult for pulpotomy, pulpectomy, to prevent infection

COMPLICATION

Always consider aspiration or ingestion of fractured pieces.

Acute Necrotizing Ulcerative Gingivitis

Caused by overgrowth of normal oral bacteria (usually fusobacteria or oral

spirochetes) or a periodontal infection that invades nonnecrotic tissue). The

name trench mouth comes from the high incidence of this disease in World

War I trench-bound soldiers. It is thought to result from stress and poor

hygiene and is not contagious. (See Figure 14.25.)

SYMPTOMS/EXAM

■ Rapid onset

■ Risk factors: Trauma, poor hygiene, smoking, immunodeficiencies, young

adults

FIGURE 14.25. Acute necrotizing ulcerative gingivitis. (See also color insert.)

(Courtesy of David P. Kretzschmar, DDS, MS as reproduced, with permission, from Knoop KJ,

Stack LB, Storrow AB. Atlas of Emergency Medicine, 2nd ed. New York: McGraw-Hill, 2002:174.)