Chapter 77: Dental Abscess Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. A patient reports tooth pain in a lower molar and the provider notes a mobile tooth with erythema and edema of the surrounding tissues without discharge. Which is the initial course of action by the provider?

a. Perform an incision and drainage of the edematous tissue.

b. Prescribe amoxicillin and refer to a dentist in 2 to 3 days.

c. Recommend oral antiseptic rinses and follow up in 1 week.

d. Refer to an oral surgeon for emergency surgery.

ANS: B a. Hospitalize the patient for an endodontist consultation. b. Prescribe amoxicillin clavulanate for 10 to 14 days. c. Recommend follow-up with a dentist in 2 to 3 days. d. Suggest using warm compresses to the eyes for comfort.

The primary provider may prescribe antibiotics, especially if the surrounding tissues are infected. Patients should follow up with a dentist in 2 to 3 days. The primary provider generally does not perform I&D; this should be done by the dentist. Follow-up should be with a dentist in 2 to 3 days, not 1 week. Emergency surgery is indicated if there is a question of airway compromise.

2. A patient has been taking amoxicillin for treatment of a dental abscess. In a follow-up visit, the provider notes edema of the eyelids and conjunctivae. What is the next action?

ANS: A

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This patient has signs of complications and requires hospitalization with management by a dentist or endodontist. Changing the antibiotic without consultation is not recommended. Prompt hospitalization is required.