EM Forum Case #139 "Chomper
Challenges"
by Charlene Babcock Irvin, MD, FACEP
 |
|
A 22 y/o male presents with jaw pain. He
notes he has had a toothache for the past
week, but yesterday his jaw began to swell.
Today the pain is worse.
PE: Fever
101.8, RR=18, HR=110, BP=138/88, Sat=97%
(RA)
He has facial swelling on his
right mandible and cheek area. He has
difficulty opening his mouth more than 2 cm.
Oral examination reveals severe caries to
#29-31. Tooth number 30 is very tender, and
is essentially dissolved down to the gum
line second to destruction of the tooth from
caries. There is mucosal swelling throughout
these teeth and on palpation the mucosa is
indurated. No fluctuance is palpated.
Neck is supple, and otherwise exam is
unremarkable.
Questions:
1. What is the numbering system for
teeth? How are primary teeth identified in
children?
2. Can you name at least 4
different locations of dental space
infections?
3. How are tooth
fractures described?
4. How has the
addition of fluoride to public drinking
water affected the incidence of dental
caries in the US?
Click here for answers and to respond
