5-14
Objective: Signs
Erythema, swelling with fluctuance, breakthrough and purulent drainage; fever, malaise and anorexia are
common.
Assessment:
Rapid progression of an oncologic process must be included in the differential diagnosis.
Plan:
- Extract tooth after the acute symptoms subside. Positively identify the involved tooth.
- Drain abscess surgically even with spontaneous drainage. Otherwise the infection will recur, especially
during periods of lowered resistance. - Administer antibiotics for several days (See Dental Antibiotics section.)
- Evacuate for consultant care.
e. LUXATED (DISLOCATED) TOOTH - a tooth moved from normal position.
Subjective: Symptoms
History of trauma or biting into hard object.
Objective: Signs
Visibly malpositioned tooth.
Assessment:
Look for other injury if related to trauma.
Plan:
Administer local anesthetic (See Procedure section.). Manually reposition tooth into normal occlusal scheme.
Stabilize tooth with gentle pressure during splinting procedure. Splint to adjacent teeth with wire, heavy
monofilament fishing line or an IRM/cotton fiber splint or glass ionomer splint (see Tooth/Crown Fractures).
f. AVULSED TOOTH - tooth completely removed from socket.
Subjective: Symptoms
History of trauma or severe dental caries; may present with tooth in hand.
Objective: Signs
Visible space or empty socket.
Assessment:
Look for other injury if related to trauma.
Plan:
- If tooth has been saved, transport avulsed tooth in any clean liquid medium (saline, milk, and saliva). Do
not let tooth dry out. Gently rinse tooth with 0.9% normal saline. Do not scrape off any debris or attempt
to scale the tooth. - Administer local anesthetic. (See Procedure section.)
- Replace tooth into its socket.
- If blood clot prevents tooth placement, rinse socket with saline to remove blood clot.
- Splint the tooth to adjacent teeth with dental wires, heavy monofilament , IRM/cotton fiber splint or a glass
ionomer splint (see Tooth/Crown Fractures). - Provide pain relief. Use acetaminophen or ibuprofen for mild pain. Use acetaminophen with codeine
for more severe pain. CAUTION: Do not use aspirin products if excessive bleeding is noted. (See
Procedure section.).