Dental Emergencies – Post Test

Which one of the following statements is correct regarding the management of dental emergencies in the UK?

You are working in the minors area of the ED and you examine the mouth of a 6-year-old boy. Which one of the following combinations of deciduous and permanent teeth are you most likely to see?

Which one of the following statements is correct regarding the anatomy and pathophysiology of a dental abscess?

A 64-year-old male smoker presents with ongoing mandibular pain which became worse when he went outside for a morning walk. On examination his observations are within normal limits, he has a BMI of 36 and generalised poor oral hygiene though no obvious abscess.

Select the most appropriate investigation that should be performed on initial assessment of this patient.

A 26-year-old man presents to the ED complaining of one day of unilateral posterior mandible pain. He states that the pain is similar to when he had an impacted wisdom tooth on the other side one year ago. He denies any trauma and is normally fit and well and doesn’t take any medication. His observations are all normal and examination of the oral cavity reveals no erythema, swelling or any other signs of intraoral pathology.

Which one of the following options represents your best course of action in this case?

You are working in the ED on a night shift when the triage nurse informs you that a man who presented earlier with toothache and a fever, now looks unwell. He is sitting in the waiting room, appears tachypnoeic and is complaining that he is unable to swallow.

Which one of the following statements represents the optimal course of action you should take?

A 36-year-old woman with rheumatoid arthritis and currently on maintenance prednisolone presents with right sided lower mandible pain and swelling. She has been taking ibuprofen and amoxicillin, prescribed by her GP, for the last two days. On examination her observations are; pulse 120/minute, blood pressure 115/72, respiratory rate 20/minute, temperature 38.2°C. There is an obvious swelling at the base of her right second molar.

Which one of the following statements is the optimal disposal plan for this patient?

A previously well 38-year-old woman, presents to the ED one evening with a 7-day history of a dental abscess. She is still complaining of pain and there is obvious swelling to the lower left cheek over the first molar which has not changed appreciably in the last week. She has just finished a five day course of amoxicillin 500mg TDS from her dentist. A set of observations are done which are all normal except for a temperature 37.9°C.

Which one of the following treatments is most appropriate in this patient?

A 39-year-old man is brought to the ED by ambulance at 05:00h with severe pain in his mouth and obvious bilateral submandibular erythema and swelling. The paramedic advises you that the patient has a temperature of 38.8°C and is struggling to breathe as his tongue is protruding from his mouth. You make a rapid diagnosis of Ludwig’s angina.

Which one of these statements is true regarding this diagnosis?

The next patient you see is a 48-year-old alcoholic man complaining of a worsening sore mouth for the past two weeks. He hasn’t seen his GP and is not registered with a dentist. On examination his observations are normal apart from a temperature of 37.7°C. You find generalised erythema and swelling of the gingiva with a grey membrane covering the upper part of the gum. You make a diagnosis of acute necrotising ulcerative gingivitis.

Which one of the following statements is correct regarding this diagnosis?