Student.Handout.HEENT (2)

65 oral pain and discomfort photo adopted from

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65 Oral Pain and Discomfort Photo adopted from: http://www.1dental.com/blog/2011/05/25/recovery-tooth-extraction/
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66 Causes of Oral Pain Tooth hypersensitivity Teething discomfort Aphthous stomatitis (canker sore) Herpes Simplex Labialis Xerostomia
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67 Pain that Warrants a Referral Oral Trauma Toothache (bacterial invasion into the pulp) Consider if patient has poor oral hygiene Gingival recession / bleeding gums Mouth soreness with ill-fitting dentures Suspected infection or abscess Presence of a fever or swelling
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68 Tooth Hypersensitivity Experienced by 30% of adults Sharp pain resulting from exposed dentin Loss of enamel or lesion Gingival recession Worsened by a stimulus Chemical Thermal Physical Photo adopted from: http://www.studiodentaire.com/en/glossary/dentin.php
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69 Hypersensitivity Risk Factors Physical trauma Grinding teeth (bruxism), recent oral procedure, excessive brushing, medium to hard bristle toothbrush Exposure to acid Dental erosion Poor oral hygiene Gastroesophageal reflux disease, bulimia nervosa Frequent citrus juices and fruits, carbonated drinks, wines, ciders Chemical irritation Whitening kits
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70 Hypersensitivity Pharmacologic Therapy Dentifrices containing potassium salts Potassium nitrate 5% Children ≥ 12 years old and adults Common OTC brands Colgate ® , Crest ® , Sensodyne ® , Orajel ® Dual-effective with fluoride Photo adopted from: http://www.drugstore.com/
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71 Hypersensitivity Counseling Points Use > 1 inch strip of toothpaste Brush ≥ twice daily for at least 1 full minute with a soft bristle toothbrush Do not rinse mouth after brushing Maximal relief takes 2 to 4 weeks, if pain continues refer patient to a specialist 25% of patients will develop chronic tooth sensitivity and will need long-term treatment
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72 Teething Discomfort Caused by eruption of deciduous teeth in infants Can cause pain, sleep disturbance, and irritability Eruption cysts Mild pain Irritation Excessive drooling Swollen red gums Photo adopted from: http://whendobabiesstartteething.net/ Nonpharmacologic treatment: Teething Rings
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73 Teething Analgesic Products Topical Benzocaine 7.5% Baby Anbesol Gel ® Baby Orajel Teething Pain Medicine ® – Gel, liquid, or swabs Benzocaine 10% Baby Orajel Teething Nighttime Formula ® Systemic Acetaminophen Ibuprofen Photo adopted from: http://www.drugstore.com/
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74 Teething Counseling Points Topical analgesic products For the temporary relief of sore gums Gel products are the easiest to apply Choose alcohol-free products For use in children > 4 months of age Do NOT use benzocaine 20% in infants If symptoms do not improve in 3 to 5 days or if pain is accompanied by non-teething related symptoms refer patient to a physician
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75 Recurrent Aphthous Stomatitis (RAS) “Canker Sore”, “Aphthous Ulcer” 50% of cases will recur within 3 months Photo adopted from: http://canker-sorehomeremedy.com/canker-sore-home-remedy-what-causes-canker-sores/
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76 RAS Clinical Presentation Epithelial ulceration on tongue, floor of the
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65 Oral Pain and Discomfort Photo adopted from

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