#423 Dental Pain, Caries, Gingivitis, and Oral Care Tips & Tactics for Primary Care With Dr Lisa Simon
Jan 22, 2024
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Dr. Lisa Simon, an expert in dental care for primary care physicians, discusses a range of topics including dental pain, caries, gingivitis, dry mouth, TMJ dysfunction, and dental side effects of medications. She provides tips for diagnosing dental pain, treatment options, and post-operative care. She also talks about managing complications and emergencies in dental care, as well as oral health in patients with opioid use disorder. Additionally, she addresses the use of anticoagulants during dental procedures and offers recommendations for antibiotic prophylaxis.
Dry mouth can be managed with lifestyle adjustments and medications if symptoms are severe.
Improving dental hygiene, including regular brushing and flossing, can help clear up gingivitis.
Deep dives
Dry Mouth and Bleeding Gums
Alma, a 30-year-old patient, presents with dry mouth and sensitive bleeding gums. She has a history of tobacco use, takes an oral contraceptive pill, and occasional antihistamines for hay fever. She also has Sjögren's syndrome. The dry mouth can be managed with lifestyle adjustments, such as staying hydrated and using sugar-free candies to stimulate salivary flow. Biotin gel or rinse may also provide relief. If the symptoms are severe, medication options like pilocarpine can be considered, but have potential undesirable side effects. The bleeding gums indicate gingivitis, which is often caused by plaque buildup. Improving dental hygiene, including regular brushing and flossing, can help clear up gingivitis.
Tooth Pain and Inflammation
Bob, a 20-year-old smoker, presents with worsening pain in the back of his upper right jaw. Upon examination, no facial swelling and fever are noted. This suggests a dental problem, possibly tooth decay. Local anesthesia may provide immediate pain relief, and short-term pain can be managed with ibuprofen and acetaminophen. Antibiotics like amoxicillin may also be prescribed to control infection temporarily until the patient can see a dentist. In severe cases, like facial cellulitis, immediate referral to the emergency room may be necessary.
Treatment for Gingivitis and Periodontitis
The main treatment for gingivitis and periodontitis is focused on maintaining good oral hygiene. This includes brushing and flossing regularly, as well as using mouthwash if desired. It is also important to address dry mouth and avoid foods that can be harmful to the teeth.
Trench Mouth or Vincent Angina
Trench mouth, also known as Vincent angina, is an acute bacterial infection that causes painful and suppurative gingivitis. This condition is rare but can occur due to poor oral hygiene. It is associated with systemic symptoms such as fever and fatigue. Treatment for trench mouth involves addressing oral hygiene and may also require the intervention of a dental professional.
Join Lisa Simon, MD, DMD (@lisathedoc) as we discuss dental care for the PCP- from examination techniques, treatment options, emergencies in dental care, and general dental advice. Help your patients manage caries, gingivitis, dry mouth, and temporomandibular joint (TMJ) dysfunction. Be aware of dental side effects of medications, how to manage anticoagulants during dental procedures, and when to recommend antibiotic prophylaxis.
00:00 Introduction and Overview
09:13 Diagnosing Dental Pain and Examination Techniques
18:44 Treatment Options for Dental Pain
29:34 Complications and Emergencies in Dental Care
32:36 Post-operative Care and General Dental Advice
40:35 Dry Mouth and Treatment Options
44:05 Gingivitis
49:39 Temporomandibular Joint (TMJ) Dysfunction
55:43 Medications and Dental Side Effects
56:12 Anticoagulants and Dental Procedures
01:00:55 Endocarditis Prophylaxis
01:03:15 Joint Replacements and Antibiotic Prophylaxis
01:04:10 Oral Health in Patients with Opioid Use Disorder
Credits
Written and produced, Show Notes, Infographic and Cover Art by Dr Kate Grant
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Molly Heublein MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Lisa Simon MD, DMD
Transcript Disclaimer
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