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Dental emergencies L
Dental emergencies Ludhiana Most oral emergencies relate to pain, bleeding, or orofacial trauma and should be attended by a dental practitioner. However, in the absence of access to dental care, a medical practitioner may be called on to help. Jaw fractures require the attention of oral or maxillofacial surgeons.​surgeons. Table 1 Dental indications for urgent admission to hospital Trauma Middle third facial fractures Mandibular fractures unless simple or undisplaced Zygomatic fractures where there is danger of ocular damage Inflammatory lesions and infections Cervical or facial fascial space infection Oral infections in which patient's condition is “toxic” or severely immunocompromised Tuberculosis (some) Severe viral infections Severe vesiculobullous disorders (pemphigus, Stevens-Johnson syndrome, toxic epidermal necrolysis) Blood loss Severe or persistent hemorrhage (particularly in a patient with a bleeding tendency) Others Diabetes mellitus under poor control DENTAL PAIN Pulpal pain is spontaneous, strong, often throbbing, exacerbated by temperature, and outlasts the evoking stimulus. Localization is poor, and pain tends to radiate to the ipsilateral ear, temple, or cheek. The pain may abate spontaneously, but the patient should still be referred for dental advice because the pulp has probably necrosed, and acute periapical periodontitis (dental abscess) will probably follow (figure 1). Endodontics (root canal treatment) or tooth extraction is required. Figure 1 Figure 1 Orofacial swelling in a patient with an acute dental abscess Periapical periodontitis pain is spontaneous, severe, persists for hours, is well localized, and is exacerbated by biting. The adjacent gum is often tender to palpation. An abscess may form (gumboil), sometimes with facial swelling, fever, and illness (figure 2). Fascial space infections are fortunately rare because they threaten the airway: patients should be referred to a specialist (see box). In the absence of immediate dental attention, it is best to incise a fluctuant abscess and to give antimicrobial agents (such as amoxicillin) and analgesic medication. The acute situation usually then resolves, but the abscess will recur because the necrotic pulp will become reinfected unless the tooth is endodontically treated or extracted. A chronic abscess, however, may be asymptomatic apart from a discharging sinus. Rarely, this may open on to the skin (figure 3). Figure 2 Figure 2 Chronic dental abscess at a typical site, in this case, related to the broken molar Figure 3 Figure 3 Dental sinus opening on to skin BLEEDING Most oral bleeding results from gingivitis (see Toolbox, wjm April 2001) or trauma, but if it is prolonged, the patient should have an evaluation for a bleeding tendency. Trauma After a tooth is extracted, the socket bleeds normally for a few minutes but then clots. Because clots are easily disturbed, patients should be advised not to rinse their mouth, disturb the clot, chew hard, take hot drinks or alcohol, or exercise for the next 24 hours. If the socket continues to bleed, a gauze pad should be laid across the socket and the patient bite on it for 15 to 30 minutes. If it continues to bleed, a hemostatic agent (such as Surgicel) should be placed in the socket. If the bleeding continues, the socket should be sutured and consideration given to a bleeding tendency. SURGICAL COMPLICATIONS Postextraction pain Some pain and swelling after tooth extraction are common but ease after a few hours. Acetaminophen usually provides adequate analgesia. Pain from complex procedures may last longer and should be controlled with regularly administered analgesic agents. If pain persists or increases, the patient should return to the dentist to exclude a pathologic disorder (such as dry socket or jaw fracture). Infection Localized osteitis (dry socket) occasionally follows an extraction, typically a lower molar extraction. After 2 to 4 days, there is usually increasing pain, halitosis, unpleasant taste, an empty socket, and tenderness. The clinician should exclude retained roots, foreign body, jaw fracture, osteomyelitis, or other pathologic condition, especially if there is fever, intense pain, or neurologic signs such as labial anesthesia. The infection is treated by irrigation with warm (50°C) saline solution or aqueous chlorhexidine, after which the socket is dressed (several concoctions are available), and the patient given analgesic medication and an antimicrobial agent (metronidazole). Actinomycosis is a rare late complication of extraction or jaw fracture and usually presents as a chronic purplish swelling (figure 4). A 3-week course of penicillin is often indicated. Figure 4 Figure 4 Purplish swelling characteristic of actinomycosis Antral complications If the patient has loss of a tooth or root into the antrum, an antimicrobial agent and a nasal decongestant are given and the object located by radiography. A further operation is required. Patients in whom an oroantral fistula (figure 5) develops should be cautioned not to blow their nose. An antimicrobial agent and nasal decongestants are helpful. If a fistula is detected early, primary closure is possible, but others may need flap closure by a specialist. Figure 5 Figure 5 Oroantral fistula after extraction of an upper molar. The antral floor is often in close proximity to the roots of maxillary molars and premolars FRACTURED TEETH Injuries to the primary teeth may be of little consequence with regard to emergency care, but even seemingly mild injuries can damage the permanent successors. As many as 30% of children have damaged permanent teeth by the age of 15 years. Enamel fracture of permanent teeth needs no emergency care, but dental attention should be sought later. More severe injuries affecting the dentine should be treated as urgent because there might be pulpal infection. Emergency care consists of placing a suitable dentine lining material onto the fractured dentine, so prompt treatment by a dentist within the same working day or at least by the following morning is required. Fractured roots require dental advice. AVULSED TEETH Avulsed permanent anterior teeth (figure 6) can be replanted successfully in a child, particularly if the root apex is not completely formed (children younger than 16 years). Avulsed primary teeth should not be replanted. The younger the child and the sooner the replantation, the better the success; teeth replanted within 15 minutes stand a 98% chance of being retained after further dental attention. Figure 6 Figure 6 Oral and dental trauma after a skateboarding accident Immediate replantation gives the best results. Hold the tooth by the crown (do not handle root as that could damage the periodontal ligament). If the tooth is contaminated, rinse it with a sterile saline solution, and if the socket contains a clot, remove it with saline irrigation. Replant the tooth the right way round (ensuring that the labial [convex] surface is facing forward) and manually compress the socket. Splint the tooth; “finger crimping” a foil milk bottle top is a temporary measure, and an alternative is tissue adhesive. The child should see a dentist within 72 hours. If immediate replantation is not possible, the tooth should be placed in an isotonic fluid (cool fresh pasteurized or long-life milk, saline solution, or contact lens fluid). Otherwise, if the child is cooperative, the tooth should be placed in the buccal sulcus and dental care obtained within 30 minutes. Unsuitable and slightly damaging fluids are water (because of isotonic damage as a result of prolonged exposure), disinfectants, bleach, and fruit juice. The use of a doxycycline immersion before reimplantation by the dentist may be helpful in preventing later external root resorption.​resorption. Dr. PRABHJOT SINGH SAAGU -DR SAAGU TOOTH ART- 14-SCF, BLOCK-I SARABHA NAGAR LUDHIANA M-9876044222 -best dentist Ludhiana Best dental clinic Ludhiana Top dentist ludhiana Top dental clinic Ludhiana
  • 2018-11-30T14:54:05

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Latest dental treatment in Ludhiana The field of dentistry is constantly evolving and changing to best suit patient needs. 123Dentist is always on the lookout for new and emerging technology to make our patients’ experience as comfortable as possible. Here is just a few of the different technologies that 123Dentist practices use to ensure we provide world-class service to all our patients: 1. VELscope—VELscope is a special type of light that a dentist will shine in a patient’s mouth to detect any abnormalities. This new form of technology is effectively used to detect early forms of cancer or disease during an oral cancer screening. 2. Digital X-Rays—Digital X-rays are faster and contain less radiation than traditional X-rays. When a patient has a digital X-ray done, the image appears on the computer in a matter of seconds. Your dentist can then zoom into the image to better assess and educate the patient regarding their oral health. Digital X-rays are also less harmful for patients as they contain up to 90% less radiation compared to traditional X-rays. 3. Invisalign—Invisalign are clear, practically invisible braces that can gently straighten your teeth. They provide an effective and comfortable way to straighten your smile without the inconvenience of wearing heavy, metal braces. Invisalign braces are easy to take out for cleaning and don’t require a restriction on what type of foods to eat. They get the job done in less time with less hassle. 4. Laser Dentistry—Lasers are used to improve efficiency and eliminate discomfort in a number dental procedures, including filling cavities, reducing tooth sensitivity, getting rid of tumors, and whitening. Laser dentistry is fast, painless, and can effectively eliminate any form of bacteria during the procedure to avoid any further complications or problems. 5. Dental Implants—Dental implants are screw-replacements for the root portion of missing teeth. Implants are used to restore healthy smiles when patients have missing teeth. Implants are effective because they can replace missing teeth, while still giving the patient the feel and look of a natural tooth. 6. HealOzone—HealOzone is a fast, easy and painless way to eliminate tooth decay. HealOzone is effective because it contains ozone (O3), which is a common, natural gas that effectively kills bacteria and fungus. HealOzone is a great tool to detect and get rid of any early signs of tooth decay before it progresses to a more advanced stage. 7. DIAGNOdent— DIAGNOdent is a new, state of the art device that dentists use to detect cavities that are hiding in places regular x-rays can’t find. It ensures that your mouth has been thoroughly checked for early signs of cavities to avoid you having to spend more in the future if the cavities progress and expand. 8. Intraoral Camera—The intraoral camera is a tool that dentists use to gain precise and well-defined pictures of hard to see places within a patient’s mouth. The camera also allows dentist to show these images to patients while assessing and educating the patient’s needs. This new form of technology allows dentist to conduct a thorough checkup of your mouth and better assess their patient’s oral care needs. 9. Zoom! Whitening—Zoom! Whitening is a new, state of the art whitening treatment that gives our patients fast and easy results. In just one appointment, Zoom! Whitening can make a significant change in a person’s smile and can make their teeth up to eight shades whiter. 10. Nitrous Oxide and (Intravenous) IV Sedation—Nitrous oxide, also known as laughing gas, can calm a patient down to a point that they are relaxed but can still interact with their dentist. On the other hand, IV sedation puts a patient to sleep completely so that they are unaware of what happened during their dental session. This is usually recommended for patients who are fearful of going to the dentist or for procedures that are painful such as wisdom teeth extraction. Visit a 123Dentist location today! By using new and advancing technology in our dental practices, we can make your visit as comfortable and efficient as possible! Dr. PRABHJOT SINGH SAAGU -DR SAAGU TOOTH ART- 14-SCF, BLOCK-I SARABHA NAGAR LUDHIANA M-9876044222 -latest technology in dentistry Ludhiana Good dentist Ludhiana Fillings RCT Crown Laser Dental laser Gum disease Sensitive teeth treatment Ludhiana Sensitivity in teeth Pale teeth treatment Ludhiana Yellow teeth treatment Ludhiana Bleeding gums treatment Ludhiana Bad breath treatment Ludhiana Mouth ulcer treatment Swelling on face treatment Best dentist Ludhiana Bleaching of teeth Ludhiana Best Dental clinic ludhiana Dentist in Ludhiana Mouth dryness treatment Top dentist Ludhiana Too dental clinic Ludhiana Dental Implants ludhiana Best Dental Implants ludhiana
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