Arctic health: Wilderness dentistry

WILDERNESS DENTISTRY

REVERSIBLE PULPITIS (Sharp transient pain, response to pain stimuli)

– Remove debris

– Temporary filling

– NSAIDS

– Antibiotics

IRREVERSIBLE PULPITUS (spontaneous pain, persistent pain response to thermal stimuli)

– Removal of pulp or tooth extraction

LOST FILLING

– Temporary filling

– Smooth rough and sharp edges

LOST CROWN

-Clear old cement

– Remove debris

– Place temporary filling material, place crown back

– Bite down

ORAL INFECTIONS

COLD SORES

-Pain medications, Acyclovir, mouth wash

FUNGAL

– Nystatin

BACTERIAL

– Antibiotics

ODONTOGENIC ABCSESS

– Evacuation to civilisation if possible

ACUTE APICAL ABSCESS

– Incision and drainage

PERICORONITIS AROUND WISDOM TEETH

– Saline rinses q 2 hourly, antbiotics, pain

FASCIAL SPACE ABCSESSES

– Evacuation to civilisation if possible

– Antibiotics, airway protection, pain

UNCOMPLICATED CROWN FRACTURE

– Pain treatment, smoothen sharp edges ( Cabit, IRM, soft wax, tape)

UNCOMPLICATED CROWN-ROOT FRACTURE

-Remove loose fragment, temporary filling, pain medications

COMPLICATED CROWN FRACTURE

– Remove or stabilise loose fragment

ROOT FRACTURE

– Reposition tooth and splint

CONCUSSION AND SUBLUXATION OF TOOTH

– Soft diet, rest and NSAIDS

INTRUSION LUXATION

– Tooth us back and stable; get to orthodontic specialist within 2 weeks

EXTRUSION LUXATION

– Tooth is extremely mobile; reposition tooth, splint tooth

LATERAL LUXATION

– Reduce with 2 finger technique, splint

EXARTICULATION (AVULSION)

– Time is crucial, rinse tooth if dirty, transport in Save Tooth or milk or saliva. Extended transportation time ┬áin saline leads to tooth damage.

– Tooth must be moist at all times, don’t touch root… only crown; if root dirty, wash with saline, then replant, lightly irrigate socket to remove clot gently. Splint rigidly if there is a jaw bone fracture, nom-rigidly with fishing line, suturing material as a sling through gingiva and crown