emergency impacts patient staff dentist patient presentation pain pain and swelling trauma...
DESCRIPTION
Patient Presentation Pain Pain and swelling Trauma (later lecture)TRANSCRIPT
![Page 1: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/1.jpg)
![Page 2: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/2.jpg)
Emergency Impacts
Patient Staff Dentist
![Page 3: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/3.jpg)
Patient Presentation
Pain Pain and swelling Trauma (later lecture)
![Page 4: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/4.jpg)
3 D’s ofSuccessful Management
Diagnosis Definitive dental treatment Drugs
![Page 5: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/5.jpg)
Diagnosis
![Page 6: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/6.jpg)
Diagnosis Determine the CC Take an accurate
medical history Complete a
thorough exam, with all necessary tests
Perform a radiographic exam
Analyze and synthesize results
Establish a treatment plan
![Page 7: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/7.jpg)
Treatment Planto
REMOVEthe
ETIOLOGY
![Page 8: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/8.jpg)
When do patients present foremergency endodontic care? No prior RCT / initial infection After RCT initiated After obturation
![Page 9: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/9.jpg)
Initial Presentation
PAIN!
Primary infection
![Page 10: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/10.jpg)
After Initiation ofEndodontic Therapy
![Page 11: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/11.jpg)
After Initiation ofEndodontic Therapy FLARE-UP!
![Page 12: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/12.jpg)
After InitiationofEndodontic Treatment Before obturation
![Page 13: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/13.jpg)
After Obturation
Recent obturation
Non-healing endodontic therapy
![Page 14: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/14.jpg)
Determine aPulpal
andPeriradicular
Diagnosis
![Page 15: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/15.jpg)
Pulpal Diagnosis Normal pulp Reversible pulpitis Irreversible pulpitis Necrotic pulp Pulpless/ previously treated
![Page 16: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/16.jpg)
Periradicular Diagnosis Normal periradicular tissues Acute periradicular periodontitis Acute periradicular abscess
![Page 17: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/17.jpg)
Periradicular Diagnosis Chronic periradicular periodontitis
Symptomatic Asymptomatic
Chronic periradicular abscess (suppurative periradicular periodontitis)
![Page 18: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/18.jpg)
Periradicular DiagnosisFocal sclerosing
osteomyelitis(condensing osteitis):
LEO
![Page 19: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/19.jpg)
Etiology After listening to the patient, begin to
determine the etiology of the chief complaint:
Contents of the root canal? Dentist controlled factors? Host factors?
![Page 20: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/20.jpg)
Contents of theRoot Canal Pulp tissue Bacteria Bacterial by-
products Endodontic therapy
materials
![Page 21: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/21.jpg)
DentistControlled Factors Over-instrumentation Inadequate debridement Missed canal Hyper-occlusion* Debris extrusion Procedural complications*
![Page 22: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/22.jpg)
HyperocclusionRosenberg PA, Babick PJ, Schertzer L,
Leung A. The effect of occlusalreduction on pain after endodontic
instrumentation. J Endodon1998;24:492.
![Page 23: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/23.jpg)
Hyperocclusion Researchers have
foundthat patients most likelyto benefit from occlusalreduction are thosewhose teeth initiallypresent with symptoms. Indiscriminant
reductionof the occlusal surface isnot indicated
PRE-OP PAIN PULP VITALITY PERCUSSION
SENSITIVITY ABSENCE OF A
PERIRADICULAR RADIOLUCENCY
COMBINATION OF THESE SYMPTOMS
![Page 24: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/24.jpg)
Procedural Complications Perforation Separated instrument Zip Strip NaOCl accident Air emphysema Wrong tooth
![Page 25: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/25.jpg)
DentistControlled Factors Dentist’s
personality
![Page 26: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/26.jpg)
Host Factors Allergies Age Sex Emotional state
![Page 27: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/27.jpg)
Host Factors
Complex etiology
Microbiologic Immunologic Inflammatory
![Page 28: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/28.jpg)
Bacteria! Bacterial
byproducts/ endotoxin
![Page 29: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/29.jpg)
Host Defense is Multi-factorial
![Page 30: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/30.jpg)
Three D’sofSuccessful Management
Diagnosis Definitive dental treatment Drugs
![Page 31: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/31.jpg)
EmergencyTreatment
Non-surgical Surgical Combined
![Page 32: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/32.jpg)
Non-surgicalEmergency Treatment
Pulpotomy Partial pulpectomy Complete pulpectomy Debridement of the root canal
system*
![Page 33: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/33.jpg)
SurgicalEmergency Treatment
Incision for drainage
Trephination/apical fenestration
![Page 34: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/34.jpg)
Rationale for I & D Decreases number of bacteria Reduces tissue pressure
Alleviates pain/trismus Improves circulation
Prevents spread of infection Alters oxidation-reduction potential Accelerates healing
![Page 35: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/35.jpg)
Management Inadequate debridement Debris extrusion Over-instrumentation Missed canal Fluctuant swelling Severe pain, no swelling
![Page 36: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/36.jpg)
Treatment For severe pain without visible
swelling… Trephination!
![Page 37: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/37.jpg)
QUESTIONS
![Page 38: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/38.jpg)
“Should I leave the tooth OPEN or CLOSED?”
![Page 39: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/39.jpg)
“Should I place anInter-appointment
Medicament?”Ca(OH)2
![Page 40: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/40.jpg)
“Should I prescribeANTIBIOTICS?”
![Page 41: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/41.jpg)
Three D’sofSuccessful Management
Diagnosis Definitive Dental Treatment Drugs
![Page 42: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/42.jpg)
Remember, there is aComplex Etiology
Microbiologic Immunologic Inflammatory
![Page 43: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/43.jpg)
And, not all can be easilytreated...
Debris extrusion Over-instrumentation Over-filling Over-extension
![Page 44: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/44.jpg)
Breakingthe
![Page 45: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/45.jpg)
Use a Flexible AnalgesicStrategy
![Page 46: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/46.jpg)
Drugs Pre - op / loading dose Long acting anesthesia Prescription
![Page 47: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/47.jpg)
Codeine Prototype opioid for orally available
combination drugs Studies found that 60 mg of codeine
(2T-3) produces significantly more analgesia than placebo but less analgesia than 650 mg aspirin, or 600 mg acetaminophen
Troullis E, Freeman R, Dionne R. The scientific basis for analgesic use in dentistry.
Anesth Prog 1986 33:123.
![Page 48: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/48.jpg)
Codeine
Patients taking 30 mg of codeine report only as much analgesia as placebo
Troullis E, Freeman R, Dionne R. The scientific basis for analgesic use indentistry. Anesth Prog 1986 33:123.
![Page 49: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/49.jpg)
Ibuprofen andAcetaminophen* 57 patients Local anesthesia, pulpectomy, post- op analgesic
Placebo 600 mg ibuprofen 600 mg ibuprofen & 1000 mg acetaminophen
*Menhinick KA, Gutman JL, Regan JD, Taylor SE and Buschang PH. The efficacy of pain control following nonsurgical root canal treatmnent using ibuprofen or a combination of ibuprofen and acetaminophen in a randomized, double-blind, placebo-controlled study. Int Endod J 2004;37:531-41.
![Page 50: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/50.jpg)
Ibuprofen andAcetaminophen* Visual analogue scale & baseline 4-point category pain scale
1 hr, 4 hr, 6 hr, 8 hr General linear model analyses Significant differences
Placebo and combination Ibuprofen and combination
No significant difference Placebo and ibuprofen
![Page 51: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/51.jpg)
Ibuprofen andAcetaminophen*
“The results demonstrate thatthe combination of ibuprofenand acetaminophen may be
more effective than ibuprofenalone for the management of
postoperative endodonticpain.”
![Page 52: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/52.jpg)
Analgesic Doses Codeine 60mg Oxycodone 5-6 Hydrocodone 10 Dihydrocodone 60 Propoxyphene HCl (Darvon) 102 Meperidine (Demerol) 90 Tramadol (Ultram) 50
![Page 53: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/53.jpg)
Flexible Analgesic Plan
![Page 54: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/54.jpg)
Flexible Analgesic Plan
![Page 55: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/55.jpg)
Selected NSAID DrugInteractions Anticoagulants Increased prothrombin time or
bleeding time ACE Inhibitors Reduced antihypertensive
effectiveness Beta Blockers Reduced antihypertensive effects Cyclosporine Increased risk of nephrotoxicity Lithium Increased serum levels of lithium Sympathomimetics Increased blood pressure Thiazide Reduced antihypertensive
effectiveness
![Page 56: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/56.jpg)
Indications forAntibiotic Therapy Systemic involvement Compromised host
resistance Fascial space involvement Inadequate surgical
drainage
![Page 57: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/57.jpg)
Guidelines forAntibiotic Therapy
Select antibiotic with anaerobicspectrum
Use a larger dose for a shorterperiod of time (“hard and fast”
rule)
![Page 58: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/58.jpg)
Selecting theAppropriate Antibiotic Gram stain results available:
antibiotic-sensitivity charts C & S results available:
antibiotic-sensitivity charts No gram stain or C & S results:
PCN is antibiotic of choice
![Page 59: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/59.jpg)
Penicillin V Still, the drug of choice for infections of
endodontic origin Loading dose: 1-2 g then 500 mg qid x
7-10 days
![Page 60: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/60.jpg)
Metronidozole(Flagyl) Used in conjunction with
Penicillin V 500 mg of Penicillin V with
250 mg Metronidozole, qid x 7-10 days
![Page 61: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/61.jpg)
Clindamycin Loading dose: 300 mg 150-300 mg qid x 10 days
![Page 62: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/62.jpg)
Closely Follow All InfectedPatients
![Page 63: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/63.jpg)
Components of aSuccessful Management Appropriate attitude of dentist Proper patient management Accurate diagnosis Profound anesthesia Prompt and effective
treatment
![Page 64: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/64.jpg)
Patient Instructions By the Clock NOT PRN
![Page 65: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/65.jpg)
E Evaluate the case M Make diagnosis E Evacuate swelling R Rubber dam and local anasthetic G Gain access and remove caries E Eliminate pulpal content and irrigate N No canal instrumentation if time
limited C Canal dressing and coronal seal. Y You have to give post-op instructions:
AnalgesicsAntibiotics
![Page 66: Emergency Impacts Patient Staff Dentist Patient Presentation Pain Pain and swelling Trauma (later lecture)](https://reader036.vdocuments.us/reader036/viewer/2022062600/5a4d1b8f7f8b9ab0599c0680/html5/thumbnails/66.jpg)