This document contains summaries of common medical conditions and their management provided by Dr. Firas Kassab. It discusses appropriate treatment regimens for conditions such as allergic reactions, asthma, angina, cardiac arrest, seizures, fainting, hypoglycemia, anxiety, infections, dental infections, sinusitis, and oral thrush. For each condition, it provides signs and symptoms, management steps, and recommended medications and their dosages.
This document discusses the role of medications in dentistry. It covers drugs used to treat dental emergencies such as syncope, seizures, asthma, angina and allergic reactions. It also discusses antibiotic prophylaxis for certain cardiac conditions and drugs commonly prescribed on an outpatient basis for issues like dentoalveolar abscesses, odontogenic infections, and conditions like ANUG, pseudomembranous candidiasis and herpetic gingivostomatitis. Finally, it notes some drugs that should be avoided during pregnancy like thalidomide, methotrexate and tetracycline due to potential harms.
The document discusses drugs commonly used in dentistry to treat various medical emergencies and conditions, including antibiotics, analgesics, and drugs for anaphylaxis, asthma, angina, cardiac arrest, myocardial infarction, epilepsy, fainting, anxiety, infections, dental procedures, sinusitis, pseudomembranous candidiasis, and denture stomatitis. It provides recommended drugs, dosages, and administration instructions for adults and children. The most commonly used antibiotics are amoxicillin, metronidazole, erythromycin, and penicillin derivatives like augmentin.
This document discusses drug prescription and classification in dentistry. It begins by classifying common medications like analgesics, antibiotics, antifungals and antihypertensives. It then discusses indications for medications to treat pain, infections and chronic diseases. The document outlines the components of a prescription, provides examples, and defines common abbreviations. It proceeds to describe several specific drugs like paracetamol, NSAIDs, opioids, antibiotics and cephalosporins. It notes indications, dosages, interactions and side effects for these medications.
this presentation helps you describing drugs for patients attending dental clinic regarding their medical problems and drugs they use for their illness.
Dental management of Patients taking oral anti-coagulants and AspirinJignesh Patel
This document discusses the management of patients on anticoagulant therapy who require dental treatment. It provides guidelines on assessing coagulation status using INR, determining bleeding risk of dental procedures, and managing hemostasis. For procedures with low bleeding risk and INR in the therapeutic range of 2-4, dentistry can proceed with local hemostatic measures. Higher risk procedures require consultation and adjusting anticoagulation therapy to reduce bleeding complications. Post-operative care involves rest, avoiding suction and trauma to the socket to promote clotting.
This document discusses basic life support (BLS) procedures and emergency drugs used in dentistry. It provides an overview of BLS procedures including assessing victims, performing chest compressions and rescue breathing. It also outlines the key drugs that may be used in dental emergencies, including epinephrine, antihistamines, atropine, nitroglycerin and bronchodilators. The document emphasizes that dentists should be prepared to provide initial emergency care and stabilize patients until full medical treatment can be given.
This document discusses various drugs used in dental clinics. It describes analgesics, antibiotics, anaesthetics, antiseptics and other categories of drugs. It provides examples of commonly used drugs like lidocaine, paracetamol, amoxicillin, chlorhexidine. It also covers uses of vasoconstrictors to increase the duration of local anaesthetics, and different types of local anaesthesia techniques like topical and regional nerve block anaesthesia. Medical gas cylinders and their identification colours are also mentioned.
This document discusses the role of medications in dentistry. It covers drugs used to treat dental emergencies such as syncope, seizures, asthma, angina and allergic reactions. It also discusses antibiotic prophylaxis for certain cardiac conditions and drugs commonly prescribed on an outpatient basis for issues like dentoalveolar abscesses, odontogenic infections, and conditions like ANUG, pseudomembranous candidiasis and herpetic gingivostomatitis. Finally, it notes some drugs that should be avoided during pregnancy like thalidomide, methotrexate and tetracycline due to potential harms.
The document discusses drugs commonly used in dentistry to treat various medical emergencies and conditions, including antibiotics, analgesics, and drugs for anaphylaxis, asthma, angina, cardiac arrest, myocardial infarction, epilepsy, fainting, anxiety, infections, dental procedures, sinusitis, pseudomembranous candidiasis, and denture stomatitis. It provides recommended drugs, dosages, and administration instructions for adults and children. The most commonly used antibiotics are amoxicillin, metronidazole, erythromycin, and penicillin derivatives like augmentin.
This document discusses drug prescription and classification in dentistry. It begins by classifying common medications like analgesics, antibiotics, antifungals and antihypertensives. It then discusses indications for medications to treat pain, infections and chronic diseases. The document outlines the components of a prescription, provides examples, and defines common abbreviations. It proceeds to describe several specific drugs like paracetamol, NSAIDs, opioids, antibiotics and cephalosporins. It notes indications, dosages, interactions and side effects for these medications.
this presentation helps you describing drugs for patients attending dental clinic regarding their medical problems and drugs they use for their illness.
Dental management of Patients taking oral anti-coagulants and AspirinJignesh Patel
This document discusses the management of patients on anticoagulant therapy who require dental treatment. It provides guidelines on assessing coagulation status using INR, determining bleeding risk of dental procedures, and managing hemostasis. For procedures with low bleeding risk and INR in the therapeutic range of 2-4, dentistry can proceed with local hemostatic measures. Higher risk procedures require consultation and adjusting anticoagulation therapy to reduce bleeding complications. Post-operative care involves rest, avoiding suction and trauma to the socket to promote clotting.
This document discusses basic life support (BLS) procedures and emergency drugs used in dentistry. It provides an overview of BLS procedures including assessing victims, performing chest compressions and rescue breathing. It also outlines the key drugs that may be used in dental emergencies, including epinephrine, antihistamines, atropine, nitroglycerin and bronchodilators. The document emphasizes that dentists should be prepared to provide initial emergency care and stabilize patients until full medical treatment can be given.
This document discusses various drugs used in dental clinics. It describes analgesics, antibiotics, anaesthetics, antiseptics and other categories of drugs. It provides examples of commonly used drugs like lidocaine, paracetamol, amoxicillin, chlorhexidine. It also covers uses of vasoconstrictors to increase the duration of local anaesthetics, and different types of local anaesthesia techniques like topical and regional nerve block anaesthesia. Medical gas cylinders and their identification colours are also mentioned.
1) The document discusses important considerations for prescribing medications to patients who are pregnant or breastfeeding. It provides guidelines on medication categories based on safety in pregnancy and minimizing infant exposure through breast milk.
2) Key points include only using medications if benefits outweigh risks, avoiding first trimester use, and prescribing minimum effective doses. It also addresses advising patients on timing medication intake around breastfeeding.
3) Clinical factors like potential teratogenic effects, alternative treatments, and monitoring infants for adverse reactions are discussed.
This document provides information on medical emergencies that can occur in dental practice settings. It discusses the importance of recognizing at-risk patients and conducting thorough medical histories. It also outlines the primary survey process for assessing airway, breathing, circulation, disability, and exposure during a medical emergency. Finally, it provides details on responding to specific emergency situations like syncope, angina, myocardial infarction, seizures, hypoglycemia, asthma, foreign body obstruction, anaphylaxis, hyperventilation, and adrenal insufficiency.
Fluoride compounds are commonly used in preventive dentistry to reduce tooth decay. Sodium fluoride, stannous fluoride, and acidulated phosphate fluoride are three compounds discussed. Sodium fluoride is applied using the Knutson technique in a series of 4 appointments to deposit fluoride onto the teeth. Stannous fluoride is prepared as an 8% or 10% solution and applied using the Muhler technique every 6 months. Acidulated phosphate fluoride is prepared as an aqueous solution or gel and applied using a tray for 4 minutes every 6-12 months. Fluoride works to strengthen enamel, remineralize early caries, and interfere with bacteria to help prevent tooth decay when used appropriately.
The document provides an overview of medical emergencies that can occur in dental practice. It begins with an introduction defining medical emergency and classifications of emergencies. It then discusses the dental office emergency team and basic actions for any emergency. Common emergencies like syncope, postural hypotension, acute adrenal insufficiency, hyperventilation, asthma, diabetes, epilepsy and anaphylaxis are explained. Emergency equipment, drugs, and camp management are reviewed. Recent Indian studies on emergency preparedness and knowledge are summarized. The document aims to increase awareness of medical emergencies and their appropriate management in dental settings.
Dental floss comes in various types such as nylon or silk, some coated with fluoride, and flavored or unflavored. Flossing involves using a piece of floss about 18 inches long by winding it around fingers and rubbing it between teeth and under the gumline to remove plaque and food particles. Proper technique is to apply gentle pressure and change to a clean section of floss regularly. Flossing improves oral hygiene by cleaning interdental spaces and beneath the gumline, preventing cavities, gingivitis, and bad breath.
The document discusses emergency management in dental offices. It outlines various types of dental and medical emergencies that may occur, such as injuries, infections, fainting, seizures and allergic reactions. It emphasizes the importance of prompt diagnosis, pain relief, referral when needed, and having trained staff and emergency equipment. The ABCDE approach of assessing airways, breathing, circulation, disability and exposure is recommended for dealing with medical emergencies until emergency services arrive.
Topical Fluorides- Professionally applied & Self appliedDrSusmita Shah
An overview of Topical Fluorides. Includes mechanism of action of topical application of fluorides- professionally and self applied. Recommendations of use of Fluorides in pediatric dentistry.
Antibiotics used in dentistry
Terminologies
History
Classification of antibiotics
Principles of antibiotics use
Commonly used antibiotics
Drug interaction
Drug combination
Antibiotic resistance
Summary
Oral Surgery in Patients on Anticoagulant TherapyVarun Mittal
Management of patients on Anticoagulant Therapy in Surgical Practice with special emphasis on Oral Surgical Procedures; along with Guidelines drawn from various Text Books and Journals
This document discusses strokes, including statistics on strokes in the US, risk factors, types of strokes, signs and symptoms, diagnosis, treatment, and dental management of patients who have had a stroke. Over 700,000 strokes occur in the US each year, making it a leading cause of disability. There are two main types of strokes - ischemic (caused by clots) and hemorrhagic (caused by bleeding). Common risk factors include hypertension, smoking, diabetes, atrial fibrillation, and high cholesterol. Signs of a stroke include sudden numbness, confusion, vision problems, or trouble walking. Prompt treatment is crucial. Dental treatment for stroke patients aims to control risk factors and minimize stress.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
This document provides an overview of managing medical emergencies in the dental office. It discusses preventing emergencies through patient evaluation and preparation. It then covers classifications of emergencies and managing specific issues like syncope, respiratory distress, allergic reactions, seizures, hypoglycemia, chest pain, and more. Emergency equipment and drugs are outlined. ABCs of evaluating and treating emergencies are also reviewed, including CPR procedures.
This document provides guidance on dental management of medically compromised children, focusing on those with bleeding disorders like hemophilia. It discusses evaluating coagulation factor levels, using local anesthetics safely, replacing deficient factors, and administering antifibrinolytic drugs to prevent bleeding complications. Minor procedures may require only local measures, while more extensive work like oral surgery demands factor replacement, antifibrinolytics, and close monitoring to safely manage bleeding risks. Prevention through oral hygiene and regular cleanings can reduce need for invasive dental work in these high-risk patients.
This document provides an overview of topical fluorides. It defines topical fluorides as fluoride treatments applied directly to tooth surfaces. Topical fluorides are classified as professionally applied or self-applied. Professionally applied fluorides discussed include sodium fluoride solution, stannous fluoride solution and gel, and acidulated phosphate fluoride gel. Sodium fluoride and stannous fluoride solutions are painted on teeth and allowed to dry, forming protective layers. Stannous fluoride may have additional antibacterial properties. Topical fluorides strengthen tooth enamel and make it more resistant to decay.
SDF is a solution containing silver diamine fluoride that is used to treat dental caries. It has several advantages as a treatment for caries, including being painless and effective at stopping the progression of lesions. Potential disadvantages include tooth staining. SDF is generally applied using a simple technique and has indications for use in patients with early childhood caries, disabilities, or those who are not cooperative for traditional restorative treatments. The staining can be addressed using other restorative materials immediately following SDF application.
Glass Ionomer cement & it's advancement.Sk Aziz Ikbal
Glass ionomer cement was introduced in 1972 as a tooth-colored filling material that bonds chemically to tooth structure and releases fluoride. There have since been several advancements to glass ionomer cement, including metal-modified versions to increase strength, resin-modified varieties to enhance setting properties and reduce sensitivity, and polyacid-modified composite resins that combine the benefits of glass ionomer with the durability of composites. These various types of glass ionomer cements each have advantages and uses in dental restoration.
Stainless steel crowns in pediatric dentistry pptdrvinodini
This document provides an overview of stainless steel crowns (SSCs), including their history, composition, indications, contraindications, placement procedure, and modifications. SSCs were first described in 1950 as a semi-permanent restoration option for primary and young permanent teeth. They are made of stainless steel or nickel-chromium alloys. SSCs are indicated for restoring teeth with extensive decay, fractures, pulpotomies, or as a space maintainer. Placement involves tooth preparation, selection and fitting of the crown, contouring, crimping, cementation, and finishing. Modifications include altering crown size or adding material to accommodate deep caries or spacing issues. Studies have found SSCs to have low microleakage and
Thyroid dysfunction and its management in dental officeShankar Hemam
This document discusses thyroid dysfunction, including hyperthyroidism and hypothyroidism. It covers the pathophysiology, predisposing factors, clinical manifestations, prevention, and management. Regarding prevention in dental care, patients with thyroid conditions may require medical consultation and modified treatment to avoid exacerbating their condition through the use of certain medications like sedatives, vasopressors, or CNS depressants. Precautions are especially important for hypothyroid and severe hyperthyroid patients.
This document provides an overview of dental adhesion and dentin bonding. It discusses the basic concepts and requirements of adhesion, applications of adhesive restorative techniques, enamel and dentin adhesion mechanisms, and challenges in dentin bonding. It also summarizes the generations of dentin bonding agents from the beginning in the 1950s to current techniques, noting limitations and improvements over time in bonding strength and stability of the bond. The goal has been to develop adhesive systems that can effectively bond to tooth structure, withstand stresses from polymerization, and resist degradation in the oral cavity.
Class IV composite restorations involve lesions on the proximal surfaces of anterior teeth that extend to the incisal angle. There are two main types of preparations - beveled and modified. A beveled preparation has longer facial and shorter lingual bevels to blend the restoration with the tooth, along with additional retention features if needed. A modified preparation removes just the lesion with minimal tooth structure and relies on bonding for retention. Proper shade selection before preparation is important for esthetics, and can be challenging for large Class IV restorations.
COMMON MEDICATIONS USED IN INTENSIVE CARE UNIT.pptxNurjannahKamar
This document contains information about Nurjannah binti Kamar, employee number C003782. It lists 20 different drugs along with their generic names, trade names, drug classes, administration routes, dosages, frequencies, indications, and contraindications. For each drug, it also summarizes common and serious potential adverse effects. The document provides a detailed reference for information about these 20 pharmaceutical drugs.
1) Scorpion stings are a medical emergency in tropical countries, with the Indian red scorpion being the most poisonous species in India.
2) Scorpion venom contains toxins that cause an "autonomic storm" by stimulating the sympathetic nervous system, leading to symptoms like tachycardia, hypertension, and convulsions.
3) Treatment involves pain relief, fluids, prazosin to manage the autonomic storm, antivenom for severe cases, and supportive care for any complications like pulmonary edema.
1) The document discusses important considerations for prescribing medications to patients who are pregnant or breastfeeding. It provides guidelines on medication categories based on safety in pregnancy and minimizing infant exposure through breast milk.
2) Key points include only using medications if benefits outweigh risks, avoiding first trimester use, and prescribing minimum effective doses. It also addresses advising patients on timing medication intake around breastfeeding.
3) Clinical factors like potential teratogenic effects, alternative treatments, and monitoring infants for adverse reactions are discussed.
This document provides information on medical emergencies that can occur in dental practice settings. It discusses the importance of recognizing at-risk patients and conducting thorough medical histories. It also outlines the primary survey process for assessing airway, breathing, circulation, disability, and exposure during a medical emergency. Finally, it provides details on responding to specific emergency situations like syncope, angina, myocardial infarction, seizures, hypoglycemia, asthma, foreign body obstruction, anaphylaxis, hyperventilation, and adrenal insufficiency.
Fluoride compounds are commonly used in preventive dentistry to reduce tooth decay. Sodium fluoride, stannous fluoride, and acidulated phosphate fluoride are three compounds discussed. Sodium fluoride is applied using the Knutson technique in a series of 4 appointments to deposit fluoride onto the teeth. Stannous fluoride is prepared as an 8% or 10% solution and applied using the Muhler technique every 6 months. Acidulated phosphate fluoride is prepared as an aqueous solution or gel and applied using a tray for 4 minutes every 6-12 months. Fluoride works to strengthen enamel, remineralize early caries, and interfere with bacteria to help prevent tooth decay when used appropriately.
The document provides an overview of medical emergencies that can occur in dental practice. It begins with an introduction defining medical emergency and classifications of emergencies. It then discusses the dental office emergency team and basic actions for any emergency. Common emergencies like syncope, postural hypotension, acute adrenal insufficiency, hyperventilation, asthma, diabetes, epilepsy and anaphylaxis are explained. Emergency equipment, drugs, and camp management are reviewed. Recent Indian studies on emergency preparedness and knowledge are summarized. The document aims to increase awareness of medical emergencies and their appropriate management in dental settings.
Dental floss comes in various types such as nylon or silk, some coated with fluoride, and flavored or unflavored. Flossing involves using a piece of floss about 18 inches long by winding it around fingers and rubbing it between teeth and under the gumline to remove plaque and food particles. Proper technique is to apply gentle pressure and change to a clean section of floss regularly. Flossing improves oral hygiene by cleaning interdental spaces and beneath the gumline, preventing cavities, gingivitis, and bad breath.
The document discusses emergency management in dental offices. It outlines various types of dental and medical emergencies that may occur, such as injuries, infections, fainting, seizures and allergic reactions. It emphasizes the importance of prompt diagnosis, pain relief, referral when needed, and having trained staff and emergency equipment. The ABCDE approach of assessing airways, breathing, circulation, disability and exposure is recommended for dealing with medical emergencies until emergency services arrive.
Topical Fluorides- Professionally applied & Self appliedDrSusmita Shah
An overview of Topical Fluorides. Includes mechanism of action of topical application of fluorides- professionally and self applied. Recommendations of use of Fluorides in pediatric dentistry.
Antibiotics used in dentistry
Terminologies
History
Classification of antibiotics
Principles of antibiotics use
Commonly used antibiotics
Drug interaction
Drug combination
Antibiotic resistance
Summary
Oral Surgery in Patients on Anticoagulant TherapyVarun Mittal
Management of patients on Anticoagulant Therapy in Surgical Practice with special emphasis on Oral Surgical Procedures; along with Guidelines drawn from various Text Books and Journals
This document discusses strokes, including statistics on strokes in the US, risk factors, types of strokes, signs and symptoms, diagnosis, treatment, and dental management of patients who have had a stroke. Over 700,000 strokes occur in the US each year, making it a leading cause of disability. There are two main types of strokes - ischemic (caused by clots) and hemorrhagic (caused by bleeding). Common risk factors include hypertension, smoking, diabetes, atrial fibrillation, and high cholesterol. Signs of a stroke include sudden numbness, confusion, vision problems, or trouble walking. Prompt treatment is crucial. Dental treatment for stroke patients aims to control risk factors and minimize stress.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
This document provides an overview of managing medical emergencies in the dental office. It discusses preventing emergencies through patient evaluation and preparation. It then covers classifications of emergencies and managing specific issues like syncope, respiratory distress, allergic reactions, seizures, hypoglycemia, chest pain, and more. Emergency equipment and drugs are outlined. ABCs of evaluating and treating emergencies are also reviewed, including CPR procedures.
This document provides guidance on dental management of medically compromised children, focusing on those with bleeding disorders like hemophilia. It discusses evaluating coagulation factor levels, using local anesthetics safely, replacing deficient factors, and administering antifibrinolytic drugs to prevent bleeding complications. Minor procedures may require only local measures, while more extensive work like oral surgery demands factor replacement, antifibrinolytics, and close monitoring to safely manage bleeding risks. Prevention through oral hygiene and regular cleanings can reduce need for invasive dental work in these high-risk patients.
This document provides an overview of topical fluorides. It defines topical fluorides as fluoride treatments applied directly to tooth surfaces. Topical fluorides are classified as professionally applied or self-applied. Professionally applied fluorides discussed include sodium fluoride solution, stannous fluoride solution and gel, and acidulated phosphate fluoride gel. Sodium fluoride and stannous fluoride solutions are painted on teeth and allowed to dry, forming protective layers. Stannous fluoride may have additional antibacterial properties. Topical fluorides strengthen tooth enamel and make it more resistant to decay.
SDF is a solution containing silver diamine fluoride that is used to treat dental caries. It has several advantages as a treatment for caries, including being painless and effective at stopping the progression of lesions. Potential disadvantages include tooth staining. SDF is generally applied using a simple technique and has indications for use in patients with early childhood caries, disabilities, or those who are not cooperative for traditional restorative treatments. The staining can be addressed using other restorative materials immediately following SDF application.
Glass Ionomer cement & it's advancement.Sk Aziz Ikbal
Glass ionomer cement was introduced in 1972 as a tooth-colored filling material that bonds chemically to tooth structure and releases fluoride. There have since been several advancements to glass ionomer cement, including metal-modified versions to increase strength, resin-modified varieties to enhance setting properties and reduce sensitivity, and polyacid-modified composite resins that combine the benefits of glass ionomer with the durability of composites. These various types of glass ionomer cements each have advantages and uses in dental restoration.
Stainless steel crowns in pediatric dentistry pptdrvinodini
This document provides an overview of stainless steel crowns (SSCs), including their history, composition, indications, contraindications, placement procedure, and modifications. SSCs were first described in 1950 as a semi-permanent restoration option for primary and young permanent teeth. They are made of stainless steel or nickel-chromium alloys. SSCs are indicated for restoring teeth with extensive decay, fractures, pulpotomies, or as a space maintainer. Placement involves tooth preparation, selection and fitting of the crown, contouring, crimping, cementation, and finishing. Modifications include altering crown size or adding material to accommodate deep caries or spacing issues. Studies have found SSCs to have low microleakage and
Thyroid dysfunction and its management in dental officeShankar Hemam
This document discusses thyroid dysfunction, including hyperthyroidism and hypothyroidism. It covers the pathophysiology, predisposing factors, clinical manifestations, prevention, and management. Regarding prevention in dental care, patients with thyroid conditions may require medical consultation and modified treatment to avoid exacerbating their condition through the use of certain medications like sedatives, vasopressors, or CNS depressants. Precautions are especially important for hypothyroid and severe hyperthyroid patients.
This document provides an overview of dental adhesion and dentin bonding. It discusses the basic concepts and requirements of adhesion, applications of adhesive restorative techniques, enamel and dentin adhesion mechanisms, and challenges in dentin bonding. It also summarizes the generations of dentin bonding agents from the beginning in the 1950s to current techniques, noting limitations and improvements over time in bonding strength and stability of the bond. The goal has been to develop adhesive systems that can effectively bond to tooth structure, withstand stresses from polymerization, and resist degradation in the oral cavity.
Class IV composite restorations involve lesions on the proximal surfaces of anterior teeth that extend to the incisal angle. There are two main types of preparations - beveled and modified. A beveled preparation has longer facial and shorter lingual bevels to blend the restoration with the tooth, along with additional retention features if needed. A modified preparation removes just the lesion with minimal tooth structure and relies on bonding for retention. Proper shade selection before preparation is important for esthetics, and can be challenging for large Class IV restorations.
COMMON MEDICATIONS USED IN INTENSIVE CARE UNIT.pptxNurjannahKamar
This document contains information about Nurjannah binti Kamar, employee number C003782. It lists 20 different drugs along with their generic names, trade names, drug classes, administration routes, dosages, frequencies, indications, and contraindications. For each drug, it also summarizes common and serious potential adverse effects. The document provides a detailed reference for information about these 20 pharmaceutical drugs.
1) Scorpion stings are a medical emergency in tropical countries, with the Indian red scorpion being the most poisonous species in India.
2) Scorpion venom contains toxins that cause an "autonomic storm" by stimulating the sympathetic nervous system, leading to symptoms like tachycardia, hypertension, and convulsions.
3) Treatment involves pain relief, fluids, prazosin to manage the autonomic storm, antivenom for severe cases, and supportive care for any complications like pulmonary edema.
Anaphylaxis is a severe, life-threatening allergic reaction characterized by rapidly developing symptoms that affect the airway, breathing, and circulation. It is usually caused by exposure to an allergen that triggers an immune response involving immunoglobulin E (IgE) antibodies. Common triggers include stings, nuts, foods, medications, and latex. Treatment involves rapidly assessing the airway, breathing, circulation, disability, and exposure, administering epinephrine, supplemental oxygen, intravenous fluids, antihistamines, and corticosteroids, and monitoring the patient closely. Prompt recognition and treatment of anaphylaxis is critical in preventing fatalities.
Medical emergencies in a dental clinicShermil Sayd
Medical emergencies can occur in a dental office. The staff must be prepared to handle situations like syncope, hyperventilation, allergic reactions, airway obstruction, asthma, and hypertensive or hypotensive emergencies. It is important to take thorough medical histories, have emergency equipment and medications available, and monitor patients closely during procedures to recognize and quickly treat any issues. Prevention methods include reducing stress, avoiding allergens, and stabilizing patients' medical conditions before elective treatment.
Hypertension is defined as having a systolic blood pressure over 140 mmHg or a diastolic blood pressure over 90 mmHg. It is classified based on these thresholds into normal, prehypertension, stage 1 hypertension, and stage 2 hypertension. The dental office plays a key role in detecting hypertension as patients may be asymptomatic in early stages. Local anesthetics with epinephrine can be used carefully for hypertensive patients, using the smallest dose and administering it slowly. For severe hypertensive emergencies in the dental office, management includes positioning the patient supine, assessing vital signs, administering oxygen, and consulting a physician if needed.
Asthma is a chronic inflammatory disease of the airways that causes variable and recurring symptoms of wheezing, coughing, chest tightness and shortness of breath. It is not "all in the mind" or something you can catch from others, and it cannot be cured by moving locations or growing out of it. Proper management of asthma includes avoiding triggers, monitoring symptoms and lung function, and establishing medication plans. Treatment involves the use of bronchodilators, anti-inflammatories, and lifestyle changes like dietary modifications and yoga.
This document discusses the management of chemotherapy-induced nausea and vomiting (CINV). It defines different types of CINV including acute, delayed, and anticipatory. The pathophysiology involves serotonin, substance P, and dopamine pathways in the brain and gut. Risk factors include the emetogenic potential of chemotherapy agents as well as patient factors. Common antiemetic agents discussed are 5-HT3 receptor antagonists such as palonosetron, dolasetron, ondansetron, and granisetron which are effective for acute CINV. Guidelines for their use and dosing are provided.
Medical emergencies in the dental practiceRuhi Kashmiri
Medical emergencies do, can and will occur in any dental practice, oral health professionals need to know how to diagnose and manage any such situation when required.
Cyclophosphamide is a synthetic antineoplastic drug that is converted in the liver to active forms with chemotherapeutic activity. It is an alkylating agent that alters DNA structure and interferes with cell growth. Cyclophosphamide is used to treat various cancers such as lymphoma, multiple myeloma, leukemia, and retinoblastoma. It has potential adverse effects including nausea, vomiting, alopecia, hemorrhagic cystitis, and bone marrow suppression. Nursing care involves frequent monitoring of blood counts and symptoms as well as educating patients about contraception and potential side effects.
Angina pectoris is characterized by chest pain or heaviness due to atherosclerosis in the coronary arteries. There are different types including classic angina brought on by exertion, unstable angina with unpredictable symptoms at rest, and Prinzmetal angina due to coronary artery spasm. Treatment involves vasodilators like nitrates, calcium channel blockers, beta blockers, and other drugs to increase blood flow and decrease workload on the heart. Nursing care focuses on medication administration and monitoring for side effects, providing comfort measures, educating on risk factor reduction, and evaluating treatment effectiveness.
This document discusses various drugs used to treat cardiovascular conditions like heart failure and hypertension. It covers different classes of drugs like cardiotonics, antianginals, and antihypertensives. Cardiotonics like digoxin and milrinone work by increasing calcium levels in heart muscle to boost contraction and output. Antianginal drugs like nitrates, beta-blockers, and calcium channel blockers aim to restore the heart's oxygen supply-demand balance. Antihypertensive drug classes discussed are diuretics, adrenergic inhibitors, angiotensin inhibitors, and direct vasodilators. Specific drugs, their mechanisms, indications, dosages and nursing considerations are provided for each class.
Antibiotics in oral and maxillofacial surgery Firas Kassab
The document discusses antibiotics and their mechanisms and uses. It provides information on the history of antibiotics including discoveries by Pasteur, Fleming, Chain and Florey. It classifies antibiotics as bactericidal or bacteriostatic and lists examples of each. The mechanisms of different classes of antibiotics are described such as inhibiting cell wall synthesis or protein synthesis. Guidelines for antibiotic selection and factors like host defenses, toxicity, and cost are covered. Information on specific antibiotics for different infections is provided.
Medical emergencies in oral and maxillofacial surgerypptHafeezAzeez1
Medical emergencies can occur during oral and maxillofacial surgery procedures. The document outlines how to prevent and manage some common medical emergencies through medical risk assessment of patients, having emergency drugs and equipment available, understanding how to perform a primary survey during an emergency, and being competent in emergency management skills. It also provides algorithms for managing some example emergencies like vasovagal syncope, angina, myocardial infarction, and hypoglycemia.
This document provides information on assessing and managing patients with heart failure, including breathing, sleep, diet, medications, activity, and confusion. It also reviews the inotropes milrinone and dobutamine, including their indications, contraindications, adverse effects, interactions, and dosing. Proper administration of inotropes requires a central catheter and guidelines recommend not flushing furosemide into lines containing milrinone or dobutamine due to the risk of precipitates.
This document outlines medical emergencies that may occur in a dental practice and how to properly prepare and respond. It emphasizes the importance of having emergency equipment, oxygen, resuscitation training, and drugs like epinephrine, nitroglycerin, albuterol, and glucose. Specific conditions covered include anaphylaxis, asthma, choking/aspiration, hypoglycemia, and hyperventilation. For each, it describes signs and symptoms and recommended emergency treatment procedures until further help arrives.
Therapeutic drug monitoring of cardiovascular agentsranjith lucky
This document discusses therapeutic drug monitoring of cardiovascular agents. It provides details about amiodarone and digoxin, including their clinical uses, mechanisms of action, dosing, toxicity, and monitoring. For amiodarone, it describes factors affecting drug concentrations, toxic effects, and patient tips. For digoxin it outlines dosing in various populations, factors influencing concentrations, side effects, and monitoring therapy.
Palliative class presentation slid3.pptxssuser504dda
1. Symptom control in palliative care requires a systematic approach including thorough assessment of each symptom, diagnosis of the underlying cause, explanation to the patient, individualized treatment, and continuous monitoring.
2. Common gastrointestinal symptoms like nausea, vomiting, diarrhea, and constipation are addressed through both pharmacological and non-pharmacological management depending on the specific cause.
3. Breathlessness, wound care, and malignant spinal cord compression are also managed based on identifying and treating their underlying causes while providing pain relief and other supportive care measures.
The document discusses the benefits of meditation for reducing stress and anxiety. Regular meditation practice can help calm the mind and body by lowering heart rate and blood pressure. Making meditation a part of a daily routine, even if just 10-15 minutes per day, can have mental and physical health benefits over time by helping people feel more relaxed and focused.
- In 1952, Professor Per-Ingvar Branemark accidentally discovered that titanium forms a direct connection with living bone called osseointegration.
- Osseointegration is the direct structural and functional connection between living bone and the surface of a load-bearing artificial implant.
- Heat generated during dental implant drilling can damage bone if the temperature exceeds 47°C for over 1 minute, so drilling techniques aim to minimize heat exposure.
The document provides information on the anatomy and surgical procedures related to maxillary sinus augmentation. It discusses the maxillary sinus anatomy, blood supply, drainage pathways, and membrane characteristics. It then describes various sinus lift surgical techniques categorized based on residual bone height (SA-1 to SA-4). For each category, it details the surgical steps, grafting materials used, healing timelines and risks. It also outlines post-operative care instructions and possible complications along with their management.
This document discusses various aspects of dental implant surgery, including patient preparation, implant site preparation, and one-stage versus two-stage implant procedures. For two-stage procedures, it describes the first stage of submerged implant placement and healing, followed by a second stage surgery to expose the implant. It provides details on flap design, osteotomy preparation using drills, implant placement, closure techniques, and post-operative care. The document emphasizes the importance of achieving primary closure without tension and maintaining keratinized tissue for healthy soft tissue healing.
This document discusses implant surfaces and osseointegration. It begins with definitions of osseointegration as the direct attachment of bone to implant surfaces. Implant surfaces have evolved from smooth machined surfaces to modified surfaces to promote faster bone formation and stronger bone-implant integration. Surface modifications include blasting, etching, coatings and other treatments to increase surface roughness at the micron scale. These altered surfaces provide benefits like increased surface area for bone attachment and cellular response that supports bone growth. Evaluation methods of osseointegration include biomechanical tests and histological analysis of bone-implant interfaces.
This document discusses implant surgery protocols and requirements. It covers operative requirements like equipment needed, surgical techniques for implant installation including flap design and bone preparation, post-operative care instructions, and surgery for abutment connection. Specific details are provided on surgical steps like drilling protocols, implant placement and angulation considerations, and closure of flaps.
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6. Signs and symptoms include:
• Generalised itching (urticaria),
particularly of hands and feet
• Rhinitis, conjunctivitis
• Abdominal pain, vomiting,
diarrhoea, and a sense of
impending doom
• Flushing, but pallor might also
occur
• Marked upper airway
(laryngeal) oedema and
bronchospasm, causing stridor
and wheezing
Dr. Firas Kassab
7. Call for an ambulance.
Secure the patient’s airway and help to restore their blood
pressure by laying the patient flat and raising their feet.
Administer adrenaline, 0.5 ml (1:1000), i.m. injection repeated
after 5 minutes if needed
Administer 100% oxygen – flow rate:10 litres/minute.
Dr. Firas Kassab
8. For milder forms of allergy:
Administer 1 chlorphenamine tablet,4 mg.(cadistin)
For children:
Chlorphenamine Tablet, 4 mg or Oral Solution, 2 mg/5 ml
Chlorphenamine can cause drowsiness. Advise patients not to drive.
Dr. Firas Kassab
9. acute severe asthma
• Inability to complete sentences
in one breath
• Respiratory rate >25 per
minute
• Tachycardia (heart rate >110
per minute)
Life threatening asthma
• Cyanosis or respiratory rate
<8 per minute
• Bradycardia (heart rate <50
per minute)
• Exhaustion, confusion,
decreased conscious level
Dr. Firas Kassab
10. • Salbutamol 4 puffs (if patients own puff available)
• Salbutamol 5 mg +ipratropium bromide 5OOumg nebulised
• Oxygen 10 l/min
• Hydrocortisone 100 mg iv
• Ventilation if needed
Dr. Firas Kassab
11. Signs and symptoms include:
• Chest pain
• Shortness of breath
• Fast and slow heart rates
• Increased respiratory rate
• Low blood pressure
• Poor peripheral perfusion
management
• Administer glyceryl trinitrate
(GTN) dispersible tab
• Administer 100% oxygen –
flow rate 10 litres/minute.
• If the patient suffers more-
severe attacks of chest pain
or if there are sudden
alterations in the patient’s
heart rate, call for an
ambulance.
Dr. Firas Kassab
12. Signs and symptoms include:
• Loss of consciousness
• Loss of pulse and blood
pressure
• Absence of breathing
management
• Call for an ambulance.
• Adrenaline 1 mg and repeated
after 3 – 5 mins
• 2 nd dose of adr +atropine 1 mg
iv
+
• Initiate CPR, using 100% oxygen
for ventilation – flow rate: 10
litres/minute.
Dr. Firas Kassab
13. Signs and symptoms include:
• Progressive onset of severe, crushing
pain in the centre and across the
front of chest; the pain might
radiate to the shoulders and down
the arms (more commonly the left),
into the neck and jaw or through to
the back
• Skin becomes pale and clammy
• Nausea and vomiting are common
• Pulse might be weak and blood
pressure might fall
• Shortness of breath
• Call for an ambulance and allow the
patient to rest in a comfortable
position.
• Administer 100% oxygen – flow
rate:10 litres/minute.
• Administer GTN 1 tab sublingually
• Administer aspirin, 300-mg
dispersible tablet, orally.
• Morphine 5 mg im
For children:
• Do not use in children because,
rarely, it can cause Reye’s syndrome
Dr. Firas Kassab
14. Signs and symptoms include:
• Brief warning or ‘aura’
• Sudden loss of consciousness, the patient
becomes rigid, falls, might give a cry
and becomes cyanosed (tonic phase)
• After a few seconds, there are jerking
movements of the limbs; the tongue
might be bitten (clonic phase)
• There might be frothing from the mouth
and urinary incontinence
• The seizure typically lasts a few minutes;
the patient might then become floppy
but remain unconscious
• After a variable time the patient regains
consciousness but might remain confused
Management
• Do not try to restrain convulsive
movements.
• Ensure the patient is not at risk
from injury.
• Administer 100% O2– flow
rate10 litres/minute.
• If the epileptic fit is repeated or
prolonged (5 minutes or longer),
continue administering oxygen
and:
• Administ er diazepam 10 mg im
Dr. Firas Kassab
15. Signs and symptoms include:
• Patient feels faint, dizzy,
light-headed
• Slow pulse rate
• Low blood pressure
• Pallor and sweating
• Nausea and vomiting
• Loss of consciousness
Management
• Lay the patient flat and, if
the patient is not breathless,
raise the patient’s feet.
Loosen any tight clothing
around the neck.
• Administer 100% oxygen –
flow rate:10 litres/minute
until consciousness is
regained.
• Ammonia tabs crushed and
sniffed to the patients
Dr. Firas Kassab
16. •If the patient remains conscious and cooperative
administer oral glucose (10–20 g), repeated, if necessary, after 10–15 mins
•If the patient is unconscious
administer glucagon, 1 mg, i.m. injection
For children:
•Glucagon, i.m. injection
•2–18 year body-weight <25 kg ……..0.5 mg
•2–18 years body-weight >25 kg……..1 mg
•administer oral glucose (10–20 g) when the patient regains consciousness
•If the patient does not respond or any difficulty is experienced, call for an
ambulance.
Dr. Firas Kassab
17. appropriate regimen to produce mild sedation
to aid anxiety management is:
• Diazepam Tablets, 5 mg, 1 tablet on night before
procedure and 1 tablet 2 hours before procedure
• Advise all patients that they should not to drive.
Dr. Firas Kassab
18. • Localized Infection, Non-allergy Patients:
penicillin and amoxicillin continue to be the first drugs of
choice due to their safety and effectiveness against oral
infections. ions. The usual dosage is 500mg tid. .
• for the localized, non-allergy patient, the drug of
choice is amoxicillin 500 mg tid If the patient does not
improve after 3 days then consider "piggy-backing" the
remainder of the amoxicillin with metronidazole400mg,
bid. The metronidazole is effective against resistant
anaerobic bacteria and works well when taken with
amoxicillin.
Dr. Firas Kassab
19. • Spreading Infection, Non-allergy Patients: the first drug of
choice is
Augmentin/clavum
Ampicillin +cloxacillin(megapain)
• Spreading Infection, Allergy to Penicillin Patients: the drugs of
choice are (clarithromycin) and(azithromycin) which are second
generation erythromycin drugs and are effective against oral
pathogens and are also broad spectrum like Augmentin. The best
choice in this category is azithromycin
• Clindamycin can also be used
Dr. Firas Kassab
20. High risk category
• Dental extractions
• Periodontal procedures including surgery,
scaling, rootplaning and probing
• Dental implant placement, reimplantation of
teeth
• Endodontic instrumentation or surgery
beyond the tooth apex
• Subgingival placement of antibiotic fibers
or strips
• Initial placement of orthodontic bands but
not brackets
• Intraligamentary local anesthetic injections
• Prophylactic cleaning of teeth or
implants with andanticipated bleeding
PROCEDURES NOT RECOMMENDED FOR PROPHYLAXIS
• Restorative dental procedures with or
withoutretraction cord
• Local anesthetic injections (except for
intraligamentary)
• Intracanal endodontic procedures,
• post placement andbuildup
• Placement of rubber dams
• Postoperative suture removal
• Placement of removable orthodontic or
prosthodonticappliances
• Taking oral impressions
• Fluoride treatments
• Taking oral radiographs
• Orthodontic appliance adjustment
• Shedding of primary teeth
Dr. Firas Kassab
21. High risk
• Prosthetic cardiac valves
• Previous
bacterialendocarditis
• Complex,cyanoticcongenitalh
eart disease
• Surgicallyconstructed
systemicpulmonary shunts
Moderate risk
• Most other congenital cardiac
malformations not otherwise
indicated
• Acquired valvulardysfunction
• Hypertrophiccardiomyopathy
• Mitralvalveprolapsewithregurgit
ation and/or thickened valve
leaflets
Dr. Firas Kassab
22. Standard
Prophylaxis
Amoxicillin
Adults, 2.0 grams;
Children
50
milligrams/kilogra
m
orally one hour
before
procedure
Cannot Use
Oral
Medications
Ampicillin
Adults, 2.0 g
IMor IV
children, 50
mg/kgIMor
IV within 30
minutes
before
procedure
Clindamycin
Adults, 600 mg;
children,
20 mg/kg orally one
hour
before procedure
Cephalexin
Adults, 2.0 g;
children,
50 mg/kg orally one
hour
before procedure
Azi/clarithromycin
Adults, 500 mg;
children,
15 mg/kg orally one
hour
before procedure
Allergic to Penicillin
Clindamycin
Adults, 600 mg;
children,
15 mg/kg IV one
hour
before
procedure
Cefazolin
Adults, 1.0 g;
children,
25 mg/kg IM or
IV within
30 minutes
before
procedure
Allergic to
Penicillin and
Unable
to Take Oral
Medications
Dr. Firas Kassab
23. Management
Local Measures – to be used in
the first instance
• If pus is present in dental
abscesses, drain by
extraction of the tooth or
through the root canals.
• If pus is present in any soft
tissue, attempt to drain by
incision.
Antiboitics used
If drug treatment is required, an
appropriate 5-day regimen is a
choice of:
Amoxicillin Capsules, 500 mg tds
X 5 days
Amoxiclav
Megapain
Dr. Firas Kassab
24. • Metronidazole Tablets,
400 mg tds X 5 days
For children:
• Metronidazole Tablets,
200 mg, orOral
Suspension, 200 mg/5
ml
• advise patient to avoid
alcohol (metronidazole
has a disulfiram-like
reaction with alcohol).
• The anticoagulant effect
of warfarin might be
enhanced by
metronidazole.
Dr. Firas Kassab
25. • Erythromycin is an
alternative to the
penicillins:Erythromycin
(erythrocin) Tablets, 500mg
bd X5 days
• Also clindamycin(clincin)
300 mg tid
For children:
• Erythromycin Tablets, 250
mg, or
• Oral Suspension, 125 mg/5
mldaily
• Clindamycin is not
recommended for the routine
treatment of oral infections
because it is no more effective
against anaerobes than the
penicillins and can cause the
serious adverse effect of
antibiotic-associated colitis
more frequently than other
antibiotics.
• The empirical use of
antibiotics, such as
clindamycin, cephalosporins,
co-amoxiclav or other broad-
spectrum antibiotics, over
amoxicillin, metronidazole and
erythromycin for most dental
patients can also be done
Dr. Firas Kassab
26. The primary treatment of odontogenic infections has been surgical
Antibiotics are a necessary adjunctive therapy
in many infections to hasten complete
the antibiotic must be effective against
Streptococcus and anaerobes
Dr. Firas Kassab
27. • A. Very effective
• 1. Peniccilin
• Tab clavum /augmentin
• megapain
• 2. Clindamycin
• 3. Metronidazole (alone or in
combination with penicillin)
• B. Effective
• 1.Erythromycin/azithromyn
• 2. cefexime
• Parenreral
• Clavum iv od
• Cefazolin iv bd
• Ceftriaxone iv bd +
• Metronidazole iv tid
Dr. Firas Kassab
28. • In the penicillin-allergic
patient, clindamycin is
the second drug of
choice. In the penicillin-
allergic patient,
clindamycin is the second
drug of choice.
• The first-generation cephalosporins
have the same effect on the microbial
population causing odontogenic
infections that penicillindoes.
• The second-generation drug cefoxitin is
more active against the anaerobic
bacteria but loses some of the anti-
streptococcal activity of the first-
generation drugs.
• The third-generationcephalosporins
are generally effective against
anaerobes but also have increased
effectivenessagainst streptococci
• Thus the second- and third-generation
drugs are not highly desirable
Dr. Firas Kassab
29. management
local Measures – to be used in
the first instance
in anug undidemeer LA-do
debridement
3 % h2o2 mouthwash 2 hourly
for 5 -7 days then switch to
Chx mouthwash 0.2% bd for
15 days
Medications
• If drug treatment is required, an
appropriate 3-day regimen is:
• Metronidazole Tablets, 400mg tid
• For children:
• MetronidazoleTab 400mg, or
Oral Suspension, 200 mg/5 ml
Or
• Amoxicillin Capsules, 500mg, or
Oral Suspension 125 mg/5 ml
• Have a day gap re schedule for the
treatment outcome
Dr. Firas Kassab
30. Sinusitis
• Local Measures – to be
used in the first instance
• Advise the patient to
use steam inhalation.
Do not recommend the
use of boiling water for
steam inhalation in
children.
• If drug treatment is required, an
appropriate regimen is:
• Ephedrine Nasal Drops, 0.5 % 1 drop into
each nostril up to three times daily when
required
Advise patient to use for a maximum of 7
days. In adults and children, the dose of
ephedrine nasal drops can be increased to
2 drops 3 or 4 times daily, if required.
If an antibiotic is required, an appropriate 7-
day regimen is a choice of:
Amoxicillin Capsules, 500mg tds
Doxycycline Capsules, 100 mg. 2 capsules on
the first day, followed by 1 capsule daily
Dr. Firas Kassab
31. Local Measures – to be used in the
first instance
• Advise patients who use a
corticosteroid inhaler to rinse their
mouth with water or brush their teeth
immediately after using the inhaler.
• If drug treatment is required, an
appropriate 7-day regimen is a choice
of:
• Fluconazole Capsules, 50mg(fluzone)
• lf fluconazole and miconazole are
contraindicated, an appropriate
regimen is a choice of:
• Amphotericin b 10mg (fungisome). 1
lozenge dissolved slowly in the mouth
after food four times daily for 10
days
Advise patient to continue use for 48
hours after lesions have healed.
• Nystatin Oral Suspension,100,000
units/ml. 1 ml after food four times
daily for 7 days
Dr. Firas Kassab
32. Denture Stomatitis
Advise the patient to:
• clean their dentures thoroughly (by
soaking in chlorhexidine mouthwash or
sodium hypochlorite for 15 minutes twice
daily; note that hypochlorite should only
be used for acrylic dentures) and brush
their palate daily to treat the condition;
• leave their dentures out as often as possible
during the treatment period;
• not wear their dentures at night
If dentures themselves are identified as
contributing to the problem, ensure the
dentures are adjusted or new dentures
are made to avoid the problem recurring.
• If drug treatment is
required, an appropriate
7-day regimen is a choice
of:
• Fluconazole Capsules,
150 mg per weekly
• Miconazole Oromucosal
Gel24 mg/ml (daktarin)
If fluconazole andmiconazole
are contraindicated, an
appropriate regimen is a
choice :Amphotericin
Lozenges, 10 mg
• Nystatin Oral Suspension,
100,000 units/ml
Dr. Firas Kassab
33. • Miconazole Cream, 2%
Advise patient to continue
use for 10 days after lesions
have healed.
Nystatin Ointment(mycostatin)
(100,000 units per g) Apply to
angles of mouth four times
daily
Sodium Fusidate Ointment,
2% qid X 10 days
• An appropriate regimen for
unresponsive cases is a
choice of:
Hydrocortisone (1%) and
Miconazole (2%) Cream bid
X 7 days
Dr. Firas Kassab
34. Aciclovir Tablets, 400 mg X 5 times
/day X
For children:
Aciclovir Tablets, 200 mg, or
Oral Suspension 200 mg/5 ml
.
Aciclovir Cream, 5% Apply to
lesion every 4 hours for 5 days
Aciclovir cream can be applied
for up to 10 days, if required
Penciclovir Cream, 1%
Apply to lesions every 2 hours
during waking for 4 days
Dr. Firas Kassab
35. Dr. Firas Kassab
• In patients with herpes zoster
(shingles), systemic antiviral
agents reduce pain, and
reduce the incidence of post-
herpetic neuralgia and viral
shedding
• Aciclovir is the drug of choice.
However, valaciclovir and
famciclovir are suitable
alternatives
• Aciclovir Tab 800 mg X5/day
X7 days.
36. • For mild to moderate
odontogenic or post-
operative pain, an
appropriate 5-day regimen
is:
Paracetamol Tablets, 500 mg
X4/day daily
• For children:
Oral Suspension 120 mg/5 ml
or 250 mg/5 ml
• For mild to moderate odontogenic,
post-operative or inflammatory
pain, an appropriate 5-day
regimen is:
Ibuprofen Tablets, 400 mg x4 /day
• For children:
• Ibuprofen Oral Suspension,100
mg/5 ml
Dr. Firas Kassab
37. • For mild to moderate
odontogenic or
inflammatory pain,
an appropriate 5-
day regimen
is:ipobrufin
+pcm(flexon)
• Or ketorolac 10 mg
tid
• For moderate to severe
inflammatory or post-
operative pain, an
appropriate 5-day
regimen is:
• Codep(codine +pcm) tid
• Diclofenac Tablets, 75 mg
three times daily
• Tramadol 50 mg tid
Dr. Firas Kassab
38. • If a patient with
trigeminal neuralgia
presents in primary
care, control quickly by
treatment with
carbamazepine(tegret
al)
• Carbamazepine
Tablets, 200 mg bd
x10 days(tegretal) can
be increased to 600
mg bd
• Baclofen 5 mg tid for 3
days and increased up to
10 mg tid for 3 days
• Phenytoin 300 -600 mg
bd
• Gabapentin and
oxycarbamazepine can
also be prescribed
• LA injections at pain sites
Dr. Firas Kassab
39. Pharmacotherapy
•Ibuprofen400mgtd+diazepam
10 mg bd
•Naproxen 500 mg bd or
celecoxib 100 mg bd
•Amytryptaline 10 mg od(triad)
•Chlorzoxazone 500 mg
tid(lorzone)
• tizanidine 2 mg tds
•Chymoral forte qid
•Pepsa 10 mg tid x 5 days
50 % of patients get relieved by this
treatment
Psychological counselling
Trigger point injections
0.5 -1 ml of LA injection
covering the conical area
around the trigger zone(0.5 ml
of procaine or 1 ml of
lignocaine)
Botulism toxin patch or injection(botox)
Capsaicin patch
0.025%-0.075% used
It it’s a substance p depleter so
there is decreased nerve
sensitisation
Used 4 times a day for atleast 2
weeks
Dr. Firas Kassab
40. Causes of mouth ulcers.
● Local causes:
– trauma
– burns
● Drugs
● Recurrent aphthous stomatitis
● Malignant ulcers
● Systemic disease:
–blood disorders
– gastrointestinal disorders
–mucocutaneous disease
– connective tissue disease
– vasculitides
–infective diseases
● Others
• Lichen planus
• Kenakort topical
• Tacrolimus 0.003% topical
• Careage –multivitamin
• lycostar-antioxidant
• If large lichen ulcer …prescribe 20
mg tds x 5 days later tapered to 20
mg bd and then 10 mg bd and 5 mg
bd and 5 mg od x 5 days
prednisolone
Dr. Firas Kassab
41. • Local Measures – to be used in
the first instance
• Antimicrobial Mouthwashes
Chlorhexidine Mouthwash, 0.2%
1 minute with10 ml twice daily
• Hydrogen Peroxide Mouthwash,
6% Rinse mouth for 2 minutes
with 15 ml diluted in half a glass
of warm water three times daily
• Tetracycline mouthwash (now
using doxycycline) is effective in
some patients with recurrent
aphthous stomatitis.
Local Analgesics
• Lidocaine 5% ointment can be
applied to the ulcer
Benzydamine Mouthwash, 0.15% 2
hourly as required
Advise patient that benzydamine
mouthwash can be diluted with an
equal volume of water if stinging
occurs.
• Advise patient to spit out mouthwash
after rinsing.
• The mouthwash is usually given for not
more than 7 days.
Dr. Firas Kassab
42. • Betamethasone Soluble Tab,500
umg 1 tablet dissolved in 20 ml
water as a
Triamcinolone ointment_ Apply a
thin layer to dried mucosa four
times daily
Systemic corticosteroids in cases of
immune mediated
mucocutaneous ulcerations
Dr. Firas Kassab
43. Management of traumatic ulcers
•Remove aetiological factors and prescribe
a chlorhexidine 0.2% mouthwash.
•Maintenance of good oral hygiene and
the use of benzydamine
(absorb)(tantum)or hot saline mouthbaths
may help
•Most ulcers of local cause heal
spontaneously in about 1 week if the
cause is removed and suchsupportive care
given.
Dr. Firas Kassab
44. Information to be given to the patients
• These are common
• The cause is not known
• Children may inherit ulcers from
parents
• Aphthous ulcers are not thought to be
infectious
• Some deficiencies or diseases may
predispose toulcers
• No long-term consequences are known
• Blood tests and biopsy may be
required
• Ulcers can be controlled but rarely
cured
Management of aphthae
• Any underlying predisposing factors
should betreated where possible, and
the aphthaecontrolled with:
• chlorhexidine 0.2% aqueous
mouthwash, or
• topical corticosteroids such as
hydrocortisonehemisuccinate 2.5 mg
pellets, or
• 0.1% triamcinolone acetonide in
Orabase usedfour times daily or
• 0.3% tricaine gel oe kenacort
• in adults, tetracycline rinses 4 -5 /day
Dr. Firas Kassab
45. Treat systemic or local
disease if present
Local Measures – to be used
in the first instance
• Advise the patient to take
frequent sips of water
• Prilocarpine (salagen) 5
mg tid
• Saliva-stimulating Tablets
(SSTs)Eg .prescription of sst
like neutrasal and caphosol
Dr. Firas Kassab
46. • Removal of habits is the most important factor
• Treatment is usually done with
• Hyaluronidase mixed with hydrocortisone and lignocaine and injected
intralesionally
• Vit A and B and E tabs(careage)
• Lycostar-antioxidant(vit A ,C ,E, zinc ,selinium ,lycopene)
Dr. Firas Kassab
48. • Textbook of pharmacolgy:K D .Tripathi
• Emergencies in dental office:Malamed
• Textbook of oral medicine:Burkit
• CIMS-drugs and dosage
• Journal of drugs used in dentistry:scottish
Dr. Firas Kassab