Dental abscess - Revision history

Rossdonaldson1: /* Clinical Features */

2021-12-02T23:46:41Z

Clinical Features

← Older revision		Revision as of 23:46, 2 December 2021
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	[[File:Chronic apical periodontitis (with arrows).jpg\|thumb\|Maxillary right second premolar after extraction. The two single-headed arrows point to line separating the crown (in this case, heavily decayed) and the roots. The double headed arrow (bottom right) shows the extent of the abscess that surrounds the apex of the palatal root.\|]]		[[File:Chronic apical periodontitis (with arrows).jpg\|thumb\|Maxillary right second premolar after extraction. The two single-headed arrows point to line separating the crown (in this case, heavily decayed) and the roots. The double headed arrow (bottom right) shows the extent of the abscess that surrounds the apex of the palatal root.\|]]
	[[File:Abces dentaire.jpg\|thumb\|Abscess originating from a tooth that has spread to the buccal space. Above: deformation of the cheek on the second day. Below: deformation on the third day.]]		[[File:Abces dentaire.jpg\|thumb\|Abscess originating from a tooth that has spread to the buccal space. Above: deformation of the cheek on the second day. Below: deformation on the third day.]]
	[[File:Abces parulique.jpg\|thumb\|A decayed, broken down tooth, which has undergone pulpal necrosis. A periapical abscess ~~(i.e. around the apex of the tooth root)~~ has then formed and pus is draining into the mouth via an intraoral sinus (gumboil)]]		[[File:Abces parulique.jpg\|thumb\|A decayed, broken down tooth, which has undergone pulpal necrosis. A periapical abscess has then formed and pus is draining into the mouth via an intraoral sinus (gumboil).]]
	[[File:GingivalAbscess.jpg\|thumb\|Periodontal abscess between the lower left canine and first premolar.]]		[[File:GingivalAbscess.jpg\|thumb\|Periodontal abscess between the lower left canine and first premolar.]]
	*Acute [[dental pain\|pain]], swelling, and mild tooth elevation		*Acute [[dental pain\|pain]], swelling, and mild tooth elevation

Rossdonaldson1: /* Disposition */

2021-12-02T23:44:31Z

Disposition

← Older revision		Revision as of 23:44, 2 December 2021
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	==Disposition==		==Disposition==
	*Outpatient management		*Outpatient management
			**Follow up with a dentist

	==See Also==		==See Also==

Rossdonaldson1: /* Evaluation */

2021-12-02T23:43:33Z

Evaluation

← Older revision		Revision as of 23:43, 2 December 2021
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	==Evaluation==		==Evaluation==
	[[File:Abcés dentaire TDM 1.jpg\|thumb\|CT scan showing a large left tooth abscess with significant inflammation of fatty tissue under the skin.]]		[[File:Abcés dentaire TDM 1.jpg\|thumb\|CT scan showing a large left tooth abscess with significant inflammation of fatty tissue under the skin.]]
	*~~Clinical evaluation~~		===Workup===
	*~~Radiographs~~		*Consider CT if concern for a larger or deeper abscess

			===Diagnosis===
			*Typically clinical
			*Differentiation between periapical and periodontal abscess is not of key importance in the ED, as the initial treatment is the same

	==Management==		==Management==

Rossdonaldson1 at 23:36, 2 December 2021

2021-12-02T23:36:06Z

@@ Line 22: / Line 22: @@
 [[File:Abces dentaire.jpg|thumb|Abscess originating from a tooth that has spread to the buccal space. Above: deformation of the cheek on the second day. Below: deformation on the third day.]]
 [[File:Abces parulique.jpg|thumb|A decayed, broken down tooth, which has undergone pulpal necrosis. A periapical abscess (i.e. around the apex of the tooth root) has then formed and pus is draining into the mouth via an intraoral sinus (gumboil)]]
 *Acute [[dental pain|pain]], swelling, and mild tooth elevation
 *Exquisite sensitivity to percussion or chewing on the involved tooth
@@ Line 37: / Line 38: @@
 ==Management==
 *[[Analgesia]] with NSAIDs, [[opioids]] and/or [[local anesthetics]]
-*Dental follow-up within 48 hrs.
+*Dental follow-up within 48 hrs
 *Emergent oral surgeon follow-up if complicated (Ludwig's angina, Lemierre's syndrome)
@@ Line 45: / Line 46: @@
 ===[[I&D]]===
 *Can be performed in ED depending on provider comfort or by a dental consultant
 ====Procedure====
 *11 or 12 blade stab incision
@@ Line 62: / Line 64: @@
 [[Category:ENT]]
 [[Category:ID]]

Rossdonaldson1 at 23:13, 2 December 2021

2021-12-02T23:13:48Z

← Older revision		Revision as of 23:13, 2 December 2021
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	*Larger abscesses require [[I&D]]		*Larger abscesses require [[I&D]]
	*Chlorhexidine 0.1% mouth rinses BID for short-term use		*Chlorhexidine 0.1% mouth rinses BID for short-term use

	~~==Disposition==~~
	*Out-patient treatment

	~~==See also==~~
	~~[[Dental problems]]~~

	~~==References==~~

	~~[[Category:ENT]]~~
	~~[[Category:ID]]~~

Rossdonaldson1 at 23:13, 2 December 2021

2021-12-02T23:13:07Z

@@ Line 59: / Line 59: @@
 ==References==
 <references/>
 [[Category:ENT]]
 [[Category:ID]]

Rossdonaldson1: Rossdonaldson1 moved page Periapical abscess to Dental abscess

2021-12-02T23:12:15Z

Rossdonaldson1 moved page Periapical abscess to Dental abscess

← Older revision	Revision as of 23:12, 2 December 2021
(No difference)

Rossdonaldson1 at 23:11, 2 December 2021

2021-12-02T23:11:28Z

← Older revision		Revision as of 23:11, 2 December 2021
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	*11 or 12 blade stab incision		*11 or 12 blade stab incision
	*Hemostat blunt dissection +/- packing		*Hemostat blunt dissection +/- packing

			==Disposition==
			*Outpatient management

	==See Also==		==See Also==
	*[[Dental Problems]]		*[[Dental Problems]]

			==External Links==

	==References==		==References==
	<references/>		<references/>
	*ER Atlas



	[[Category:ENT]]		[[Category:ENT]]
	[[Category:ID]]		[[Category:ID]]

Rossdonaldson1 at 23:10, 2 December 2021

2021-12-02T23:10:26Z

← Older revision		Revision as of 23:10, 2 December 2021
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	==Background==		==Background==
	*Associated with dental caries or nonviable teeth
	*Significant erosion of the pulp with bacterial overgrowth

	~~{{Dental numbers}}~~
	[[File:Periodontium.png\|thumb\|Anatomy of the periodontium. The crown of the tooth is covered by enamel (A). Dentin (B). The root of the tooth is covered by cementum. C, alveolar bone. D, subepithelial connective tissue. E, oral epithelium. F, free gingival margin. G, gingival sulcus. H, principal gingival fibers. I, alveolar crest fibers of the periodontal ligament (PDL). J, horizontal fibers of the PDL. K, oblique fibers of the PDL.]]

	===Periapical vs Periodontal Abscess===		===Periapical vs Periodontal Abscess===
	{\| {{table}}		{\| {{table}}
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	\| Epidemiology\|\|More common\|\|Less common		\| Epidemiology\|\|More common\|\|Less common
	\|-		\|-
	\| Area\|\|Associated with a ~~nonvital~~ dead tooth (i.e. pulpitis)\|\|Associated with a vital (living) tooth		\| Area\|\|Associated with a nonviable dead tooth (e.g. [[pulpitis]])\|\|Associated with a vital (living) tooth
	\|-		\|-
	\| Cause\|\|Tooth infection\|\|Gum infection		\| Cause\|\|Tooth infection\|\|Gum infection
	\|}		\|}

			{{Dental numbers}}
			[[File:Periodontium.png\|thumb\|Anatomy of the periodontium. The crown of the tooth is covered by enamel (A). Dentin (B). The root of the tooth is covered by cementum. C, alveolar bone. D, subepithelial connective tissue. E, oral epithelium. F, free gingival margin. G, gingival sulcus. H, principal gingival fibers. I, alveolar crest fibers of the periodontal ligament (PDL). J, horizontal fibers of the PDL. K, oblique fibers of the PDL.]]

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Periapical vs Periodontal Abscess */

2021-12-02T23:04:09Z

Periapical vs Periodontal Abscess

← Older revision		Revision as of 23:04, 2 December 2021
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	\| align="center" style="background:#f0f0f0;"\|'''Periodontal'''		\| align="center" style="background:#f0f0f0;"\|'''Periodontal'''
	\|-		\|-
	\| Other Names\|\|Tooth abscess, dentoalveolar abscess, apical abscess, endodontic abscess, and lesion of endodontic origin\|\|Gingival, pericoronal *lateral (periodontal) abscess		\| Other Names\|\|Tooth abscess, dentoalveolar abscess, apical abscess, endodontic abscess, and lesion of endodontic origin\|\|Gingival, pericoronal, lateral (periodontal) abscess
	\|-		\|-
	\| Epidemiology\|\|More common\|\|Less common		\| Epidemiology\|\|More common\|\|Less common