Dental Abscess

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of ‍toothacheswellingjaw pain

Location is in the ‍upperlower ‍rightleft jaw

Symptoms include:

‍toothache

‍swelling of the gums

‍swelling of the face

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills

‍difficulty opening the mouth



Worsening factors: ‍noneeatingdrinkingchewing

Alleviating factors: ‍none, ‍effectiveineffective



Contributing factors:

‍untreated dental caries

‍poor oral hygiene

‍smoking

no history of: ‍diabetes, ‍dental abscess, ‍recent dental procedures, ‍immunodeficiency





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Mouth: mucosa ‍normal, dentition ‍normal

Throat: ‍normal, ‍erythema, ‍exudate, ‍

Neck: ‍normal, ‍lymphadenopathy, ‍, c-spine ‍





ASSESSMENT:

‍Dental infection ‍likelysuspectedpossible

DDx: periapical abscess, periodontal abscess, gingival abscess, cellulitis, osteomyelitis, acute sinusitis, temporomandibular joint disorder, trigeminal neuralgia, herpetic stomatitis, angina, myocardial infarction, deep neck infection, salivary gland infection, oral cancer, foreign body reaction





PLAN:

Investigations:

- Blood work: ‍CBC, ‍CRP

- Pus culture

Treatments:

- ‍Antibiotics

- ‍Analgesics

- Incision and drainage

- Warm salt water rinses

- Avoid hot or cold foods

Further care:

- Referral to dentist

- Referral to maxillo-facial surgeon

- Follow-up in ‍ ‍daysweeks

- Referral to ER if severe pain, difficulty breathing, or high fever occurs