Dental Emergencies E-Book

Mark Greenwood

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 336

Veröffentlichungsjahr: 2012

Beschreibung

Dental emergencies are common and require rapid response. Order today and keep readily accessible in your dental practice!

Filled with clinical examples and step-by-step procedures, Dental Emergencies covers the full range of both common and complex traumatic injuries, pain, and oral lesions.

From clinical examination and assessment of potential complications to key considerations in pain management, acute oral medical and surgical conditions, restorative emergencies, treating special needs patients, and beyond, you get a comprehensive reference that:

• distills essential information on dental emergencies
• offers succinct, practical instruction for immediate treatment
• highlights conditions for referral
• and much more!

Leseprobe

Contents

Cover

Title Page

Copyright

List of Contributors

Preface

Acknowledgements

Chapter 1: Introduction, Infection Control and Prescribing

Introduction to the dental emergency clinic

Infection and infection control

Prescribing

Conclusions

Chapter 2: History Taking and Clinical Examination of Patients on a Dental Emergency Clinic

Introduction

History taking

Patient examination

Special tests

Record keeping

Consent

Conclusions

Chapter 3: Radiology and the Dental Emergency Clinic

Introduction

Patients in pain

Trauma radiology

Looking at radiographs

Conclusions

Chapter 4: Acute Oral Medical and Surgical Conditions

Introduction

Oro-facial swelling

Blistering disorders of the oral mucosa

Oral ulceration

Disturbed oro-facial sensory or motor function

Haemorrhage

Other acute conditions

Bony pathology

Summary

Chapter 5: Restorative Dental Emergencies

Introduction

General principles

Pain management

Infections and soft tissue problems

Crack, fracture and mobility of teeth and dental restorations

Fractured and loose implants

Fractures and swallowing of removable prostheses

Conclusions

Chapter 6: Acute Presentations of Chronic Oro-Facial Pain Conditions

Introduction

Oro-facial pain history

Examination of patients with oro-facial pain

Special investigations for oro-facial pain

Presentation, investigations and initial management of acute non-odontogenic oro-facial pain

Chapter 7: Traumatic Injuries to the Teeth and Oral Soft Tissues

Assessment of the traumatised patient

Management of traumatic dental injuries

Injuries to the hard dental tissues and the pulp

Injuries to the hard dental tissues, the pulp and the alveolar process

Injuries to the periodontal tissues

Dento-alveolar fractures

Conclusions

Chapter 8: Pain Relief in the Dental Emergency Clinic

Introduction

General mechanism of pain

Distribution of pain fibres in the mouth and jaws

Sources of pain in the mouth and jaws

Control of pain

Psychology of pain

Medication

The ladder of analgesia

Avoiding problems in prescribing analgesics

Chapter 9: Management of the Special Needs Patient

Introduction

Commonly seen conditions

Assessment

Medical history in the patient with special needs

Informed consent

Examination

Factors to consider in treatment

Conclusion

Chapter 10: Making a Referral

Introduction

When to refer

How to refer

Where to refer

The referral letter

Urgency

Cancer referrals

Copies of the referral letter

Summary

Chapter 11: Medical Emergencies in the Dental Emergency Clinic – Principles of Management

Introduction

Contents of the emergency drug box

The ‘ABCDE’ approach to an emergency patient

Airway (A)

Use of defibrillation

Principles of management after the initial treatment of a medical emergency

Conclusions

Chapter 12: Examples of Specific Medical Emergency Situations

Introduction

Vasovagal syncope (simple faint)

Hyperventilation

Asthma

Cardiac chest pain

Epileptic seizures

Diabetic emergencies

Allergies/hypersensitivity reactions

Adrenal insufficiency

Stroke

Local anaesthetic emergencies

Problems with haemostasis

Conclusions

Appendix 1: Normal Reference Ranges

Appendix 2: Changes in Vital Signs in Patients with Infection

Appendix 3: Warfarin Protocol

Principles

Should the INR be measured before a dental procedure?

Are there any drug interactions that are relevant to this patient group?

Oral surgery patients

Restorative patients

Checklist for patients taking warfarin who require dental treatment

Appendix 4: Aspects Relating to Local Anaesthetics

Appendix 5: NICE Guidelines for the Removal of Wisdom Teeth

Appendix 6: Protocol for Surgical Dental Treatment of Patients Taking Bisphosphonates

Introduction and background

Management of patients taking bisphosphonates

Appendix 7: Common ‘Recreational’ Drugs

Introduction

Index

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Library of Congress Cataloging-in-Publication Data

Dental emergencies / edited by Mark Greenwood. p. ; cm. Includes bibliographical references and index. ISBN 978-0-470-67396-6 (pbk. : alk. paper) I. Greenwood, M. (Mark) [DNLM: 1. Dental Care--methods. 2. Emergencies. 3. Emergency Treatment--methods. WU 105] 617.6′026-dc23 2011042659

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

List of Contributors

U. Chaudhry, BDS, MFDSRCS, DHypSpecialist Registrar in Paediatric Dentistry, Manchester Dental Hospital and Royal Manchester Children's Hospital, Manchester

I.P. Corbett, BDS, BSc, PhD, FDS (OS), RCSLecturer in Oral and Maxillofacial Surgery, Newcastle University, Newcastle

J. Durham, BDS, PhD, FDS (OS), RCS, FHEAWalport Lecturer in Oral and Maxillofacial Surgery, Newcastle University, Newcastle

J. Greenley, BDS, MFDSRCSSenior Dental Officer, Newcastle Dental Hospital, Newcastle

M. Greenwood, MDS, PhD, FDS, FRCS, FRCS (OMFS), FHEAConsultant and Honorary Clinical Professor, Newcastle University, Newcastle

C.B. Hayward, BDS, Dip Cons SedAssociate Specialist, Dental Emergency Clinic, Newcastle Dental Hospital, Newcastle

I.C. Mackie, BDS, MSc, PhD, FDSRCPSProfessor and Consultant in Paediatric Dentistry, Manchester Dental School, Manchester

R.I. Macleod, BDS, PhD, FDSRCS, DDR, RCRConsultant in Dental and Maxillofacial Radiology, Newcastle Dental Hospital, Newcastle

U. J. Moore, PhD, FDSRCSSenior Lecturer in Oral Surgery, School of Dental Sciences, Newcastle University, Newcastle

A. Moufti, DDS, Dip OMFS, PhD, MFDSRCSLecturer in Restorative Dentistry, University of Damascus, Syria

T. Nugent, BDS, MFDSRCSSenior Dental Officer, Community Dental Service, Newcastle

P.J. Thomson, BDS, MSc, PhD, FFD, FDS, FRCSProfessor in Oral and Maxillofacial Surgery, Newcastle University, Newcastle

Preface

The dental emergency clinic is an important area for any dental service. Such departments are usually staffed by clinicians with a variety of backgrounds and levels of experience. This book does not attempt to be exhaustive but is a guide to help clinicians with the management of the wide variety of patients that may present. An attempt is made, where appropriate, to place patient management in an academic context.

Acknowledgements

Thanks are due to the clinicians and nurses who work on the dental emergency clinic at Newcastle Dental Hospital. We would also like to acknowledge the help given by Mrs Beryl Leggatt in the typing of the manuscript.

Where figures or photographs have been taken from other sources, due acknowledgement is given. Thanks are also due to Dr Anna Beattie and Dr Helen Stancliffe for some of the photographs seen in Chapter 11.

Chapter 1

Introduction, Infection Control and Prescribing

M. Greenwood

Introduction to the dental emergency clinic

The dental emergency clinic (DEC) is an important part of the service provided to patients. It is a demanding environment in which to work for main two reasons. First, many patients who attend such departments have a general tendency to avoid dental treatment and view attending such a department as a last resort. Second, from the point of view of the clinicians who work in such clinics, the clinical spectrum is wide, and although there is no remit to provide a specialist service, the boundaries of knowledge and experience for clinicians in certain areas are approaching this. Clinical staff working in these departments need a wide skill mix.

This textbook aims to summarise important areas of knowledge with which practitioners working in the DEC should be familiar. Modern clinical working often requires adherence to protocols, and a summary of some of the more important current management protocols, together with supporting evidence, is provided in the appendices.

For maximum efficiency in any department that deals with emergencies, a system of triage is immensely valuable. Triage is essentially the process of determining the priority of patients’ treatment on the basis of severity of their condition. Triage should result in determining the order and priority of a patient's emergency treatment and occasionally their onward transport. In the DEC, emergency situations include those where the airway may be compromised due to infection or trauma. Such patients must be assessed promptly and referred quickly for onward management. Other patients, who may have sustained trauma, need to be assessed expeditiously, particularly from the point of view of airway and vital signs, and also possible head injury and concomitant injuries, which in some cases may take priority over the facial or dental injuries. More detail in relation to the assessment of trauma patients is given in Chapter 7.