free software download hotspot shield latest version Dental management of patients with medical conditions -- Medical emergencies in dental practice therapeutic guidelines oral and dental version 2 free download Management of dental problems for medical practitioners -- Appendices. Log in Please enter a valid email address. Nonhomogenous leukoplakias including speckled leukopl akias present as white patches on a red background and have a higher risk of malignant change- reported to be 7 times that of homogenous leukopl akias. Schematic diagram of localised odontogenic infections Box See more.">
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Dentists should be aware of the potential value and implications of salivary tests in clinical practice, and further translational and clinical studies regarding the use of saliva for diagnostic purposes are required.
The primary objectives of the Australian Dental Association ABN 95 are to encourage the improvement of the oral and general health of the public, promote the ethics, art and science of dentistry and support members to provide safe, high quality professional oral care. Membership Number. Log in Don't remember me. The intraoral persistence of calcium and phosphate ions is limited as they combine rapidly into insoluble and children 18 months to less than 6 years- toothpaste containing nonbioavailable forms.
This form of bioavailable calcium phosphate can help slow C'O , fluoride ppm 1 mglg twice daily. Parents should be advised of the risk of dental fluorosis. Examples of topical applications and how they Further reading can be used to reduce caries in patients at high Austra lia n Researc h Ce ntre for Population Ora l Hea lth. The use of fluori des in risk of caries Au st ra lia: gui delines. Aust De nt J ;51 2 : Application Example of how application can be used Fej e rskov 0 , Kidd E, editors.
Oxford: Blackwell M u nksgaard ; 2 0 Esse nt ials of dent al cari es : the d isease and its management. Adults can use the gel daily at home by brushing on the teeth, or apply it usi ng customised t rays.
While the use of gels is sti ll relatively common, they have largely been replaced by concentrated fluoride varnishes in denta l surgeries. Concentrated fluoride toothpastes and other remineralising pastes are preferred for home use. After rinsing, the mouthwash should be spat out and not swallowed.
After rinsing, the mouthwash should be spat out and not swa llowed. After rinsing, the mouthwash should be QJ c spat out and not swallowed. J CPP-ACP sugar-free gum Can be used 4 times daily, preferably after meals and after ;: cleaning teeth with a toothpaste containing fl uoride.
Adults can apply the cream nightly to teeth after tooth-cleaning and not rinse out. Periodontal disease is usually chronic inflammation of the gingivae and the supporting structures of the teeth-the periodontal ligament, the cementum and the alveolar bone.
There are two major forms of chronic periodontal disease- plaque-induced gingivitis see below and periodontitis see p. Periodontitis has two major variations- chronic and aggressive. Periodontal disease is caused by dental plaque-a complex biofilm of mixed bacteria and their by-products that builds up on the teeth.
Plaque can calcifY to become calculus. In the early stage of periodontal disease, bacteria in plaque cause inflammation of the gingivae- gingivitis. Gingivitis can usually be treated successfully by removal of the plaque and calculus followed by thorough and regular oral hygiene practices. In some patients, untreated gingivitis progresses to a more advanced stage of periodontal disease called periodontitis, which may result in loss of the bone and the tissues that support the teeth.
As gingival inflammation progresses, periodontal pockets are formed and the gingivae may recede. As a result of damage to the supporting structures, the teeth can become loose and may eventually require extraction.
For locations of infections around the tooth, see Figure 2, p. Acute forms of periodontal disease can occw- if bacteria from the biofilm invade the tissues. These include acute ulcerative gingivitis see p. It is defined as inflammation restricted to the gingival tissues, which become red and swollen, and bleed easily. There is no destruction of the periodontal ligament or alveolar bone. Gingivitis is rarely painful and, with the correct dental treatment, is reversible.
Secondary featu res biofilm plaque in the gingival crevices and adjacent to the gingival include amounts of microbial deposits inconsistent with the severity margins. Bacterial antigenic products from the biofilm diffuse into the of periodontal destruction, elevated proportions of Aggregatibacter adjacent gingival tissue causing a nonspecific inflammatory response.
Management Periodontitis is rarely seen in children. Children require urgent specialist review because periodontitis in children is almost invariably Gingivitis should be managed by a dentist or dental hygienist under the associated with systemic disease eg leukaemia, type 1 diabetes, cyclic prescription of a dentist. The aim oftreatment is to remove plaque and neutropenia.
Complete resolution of the inflammation can be The management of periodontitis expected within 1 week. Dental treatment should be combined with Antibiotic therapy is rarely requires debridement to break up the patient education about oral hygiene. Systemic without concomitant Antibiotics are not indicated in the management of gingivitis. The short- antibiotics are rarely required, and debridement. It is often associated from deeper pockets, together with planing of the roots.
This is with halitosis see p. In advanced cases, the teeth may often done under local anaesthetic and is usually accompanied by become loose and may also drift, allowing spaces to develop between polishing, reshaping, or replacement of defective fillings the teeth.
Cll en Usually the disease presents in a chronic slowly progressing form Unresponsive periodontitis or periodontitis in an immunocompromised :c with brief acute episodes. However, a relatively aggressive form patient requires specialist management. It is characterised chlorhexidine 0. It can be associated with or chlorhexidine 0. I minute, 8- to hourly until pain has abated.
Acute ulcerative gingivitis is most common ly seen in young adult The addition of an oxygenating mouthwas h may be considered. It is rarely, if ever, seen in children. In children, acute herpetic Metronidazole is often given as an 8-hourly regimen; however, in these gingivostomatitis see p.
Immediate management involves: In immunocompromised, unresponsive or very severe cases, prompt gentle removal of as much plaque and necrotic debris as possible specialist referral is indicated. For patients hypersensitive to penicillin see p. The patient should be reviewed in 48 to 72 hours For patients hypersensitive to penicillin who are unable to swallow for oral hygiene instruction and periodontal examination.
Treatment clindamycin capsu les, see 'Lincosamides' p. Antibiotic therapy alone, without Cl prevent recurrence. This should be In patients with HIV infection, acute ulcerative gingivitis can spread to Q debridement and improvement provided once the acute stage has in oral hygiene, invariably leads involve the underlying bone necrotising ulcerative periodontitis and "C!
The For antibiotic therapy, use: discomfort associated with the swelling is usually not enough to keep 1 metronidazole mg orally, I2-hourly for 5 days the patient awake at night. Pain is often difficult to localise. The flora associated with periodontal abscesses is more mixed than with most OR ifpatient adherence is a concern other periodontal infections.
Un der local anaesthesia, this may be done by lanc ing the externa l surface of the g ing iva l swelling or through the peri odontal pocket beneath the swelling.
T horough debridement to remove plaque and calculus deposits should be performed at this time plus irrigation w ith water, saline solution or local anaesthetic solution.
In advanced cases where the tooth cann ot be retained, drainage of pus Acute odontogenic and sho uld be obtained by extraction of the tooth and, if required, thorough irri gation and curettage of the socket should be undertaken. If systemic salivary gland infections signs and symptom s are present, the pat ient is not responding to local treatment see ' Periodontitis: Management', p.
They can arise from the dental pulp secondary to restoration breakdown, caries, OR or loss of tooth structure fro m trauma , the peri odonta l tissues most commonly due to advanced periodontitis , or the pericoronal tissues 2 amoxycillin mg child: The infection usually consists of mi xed anaerobic and aerob ic oral bacteria.
For patients hypersens itive to penicillin see p. Occasionally it becomes L udw ig's angina or For patients hypersensi ti ve to penicillin who are unab le to swallow spreads to the brain or mediastinum. The medical status of the patient is c lindamycin capsules, see 'Lincosam ides' p. First-line management should be active dental treatment, ora ll y, hourly for 5 days. If patients seek Patients who are not responding to treatment and w ish to retain their treatment from medical practitioners, they shou ld be promptly directed to Treatment with antibiotics alone, teeth require specialist management.
However, patients often ca n lead to more severe Further reading seek or are given anti biotic-only episodes of acute odontogenic treatment, obtain initial symptomatic infection with risk of airway An update in contemporary periodontics. Aust Dent J ;54 3 Suppl 1.
Prescribing good oral hygiene for adults. Austral ian Prescriber compromise and increased antibiotic resistance. Clinical periodontology and implant dentistry. Oxford: Blackwell Mun ksgaard; The vario us types of localised odontogenic infections are presented in Figure 2 p. A localised dental abscess is a collecti on of pus that can be periapical, pericoronal or periodontal in origin. Schematic diagram of localised odontogenic replacement. Antibiotics should not be used for dental pain, pulpitis or infections and the stages of dental caries infection localised to the teeth, or to delay providing dental treatment.
Tooth A: Localised odontogenic infections Tooth B: Stages of dental caries If referral to a dentist is not immediately possible, see 'Acute dental pain' p. Box 7. Treatment options for acute localised odontogenic infections Periapical abscess endodontic root canal treatment extraction.
Periodontal abscess see also p. Pericoronal infection local treatment Diagram showing pericoronal disease and periodontal disease on tooth A, and caries and its - remove or recontou r the opposing tooth if it is impinging on the operculum sequelae on tooth B: 1.
Spreading odontogenic 7. Removal of the infection source inflammatory swelling -is by: c ca can be via extraction, endodontic root canal treatment or periodontal draining any pus ,. S:;::; only when the infection has spread Antibiotics should not be used supporting the patient with analgesia and rehydration C , OQ for dental pain, pulpitis or considering antibiotics.
Antibiotic use is then an adjunct to active dental treatment not a until antibiotics are given. OR 2 amoxycillin mg child: For patients hypersensitive to penicillin seep. If superficial infections are inadequatel y treated, they may spread- If a patient presents with recurrent infection after inappropriate canine fossa infections may spread intracrani ally via the orbital veins; antibiotic-only treatment, the appropriate dental or hospital referral buccal space infections may spread to the neck and become deep must be made and followed through.
Both can lead to life-threatening situations. Advise the patient to contact their All patients with infection Deep infections dentist fo r prompt review if their shou ld be reviewed within Odontogenic infections that spread to the submandibular and pharyngeal condition deteri orates. All patients 48 to 72 hou rs of co mmencing spaces in the upper neck are potentially life-threatening, as there is a risk with infection should be reviewed treatment.
Any patient who has trismus and cannot open within 48 to 72 hours of commencing their mouth more than 2 em interincisal must be assessed for signs treatment. If the infection has not resolved within 5 days, do not just of airway compromise. Signs and symptoms of airway compromise ' repeat the antibiotic'. Check that any pus has been drained, the cause include stridor noisy breathing , dyspnoea difficult breathing , has been removed, the appropri ate antibiotic is being used for the dysphagia difficulty in swallowing , and elevation and firmness of particular microbial susceptibility, and the patient's general condition the tongue.
Patients require urgent referral to an are severely ill and have a significant risk of death, usually from training in the management of such appropriate specialist or hospital airway obstruction. Older medically compromised patients may die of patients.