Treatment Option #1
Date Time Needed
1/03/2022 Abscess drainage plus root canal 45 minutes
Re evaluation 20 minutes
Treatment Option #2
1/03/2022 Tooth extraction 50 minutes
Suture removal 10 minutes
Treatment Plan Option #1
Periapical abscess in a known diabetic type one patient and hypertension, presented with history of throbbing
pain, increased teeth sensitivity swollen lymph nodes and bad breath. on examination the gums are inflamed
(red) the tooth is loose (16) and a coincidental cavity noticed at (26).
plan of action includes dental x ray plus bitewings
radiology reveals the teeth is salvageable and plan of care includes abscess drainage and root canal.
Abscess drainage will involve use of local anesthetic to numb the gum then an incision is made to drain the pus
that collected around the tooth and the area left open to continue draining. After all the pus is out the gums will
start healing, usually relief is immediate when the pus is removed.
In the root canal procedure, the dentist will drill the affected tooth remove all of the affected pulp and then fill it
seal it and the tooth will be in the same shape as before.
Depending on the extend of infection antibiotics are prescribed
Patient is then allowed home on oral pain killers and given a return date for evaluation of treatment plan
Teaching on periapical abscess and root canal procedure
With the aid of dental dummies, pictures of dental abscess and illustrations we are going to learn how the
procedure is going to be performed step by step until the end. Start by assessing patient knowledge on periapical
abscess to create basis and baseline of teaching, then introduce the topic explaining what it is and how it occurs.
The demonstrate how the procedure is going to be done using the dummy (first the area will be anesthetized
then the abscess drained through an incision, the incision will then be left open for it to continue draining after
all the pus is drained the gum will start healing) for root canal the dentist will remove the crown of the teeth,
then evacuate all the infected tooth pulp then replace it with seal then return back the crown. For this to be
comfortable for you we will use sedation or general anesthesia. After the procedure you are advised to keep you
head elevated avoid flossing immediately and eat soft foods with the non-affected teeth.
allow the patient to internalize and ask question then assess patient knowledge on the learned subject by asking
question relevant to the topic and preparation. If the patient is to undergo the procedure under general
anesthesia, then advise them to starve six to eight hours prior to the procedure to reduce the risk of aspiration.
Once both parties agree then set the date and time for the procedure.
Treatment Plan Option #2
If the extend of infection is not salvageable then tooth extraction is the best treatment plan to be done. It
involves pulling out the infected tooth them. This might be done under local, sedation or general anesthesia then
the doctor will prescribe pain killers later to manage the pain.
Teaching about tooth extraction
Mode of teaching will include discussion, lecture and demonstration, teaching aid include dental dummy, charts
and the recipient are the patient and spouse. The lesson is expected to take 30 minutes ,20 minutes teaching then
10 minutes questions and clarifications.
The lesson begins by explaining to Mrs. green what causes dental abscess and explain to her that having
diabetes is one of the risk factors of having abscesses among others like poor dental hygiene injury and
weakened immune system. Prevention of dental abscess include flossing regularly, brushing teeth and regular
visit to the dentist.
How Mrs. green the tooth affected and that is what is to be extracted and explain to her that with the use of local
anesthesia the area is going to be numbed before the tooth is extracted and demonstrate how, allow her to ask
questions and address them then agree on the best plan and the one she is most comfortable with.
Of note is to mention the complications that may rise during this procedure and how they are to be handled and
allow the patient to make informed consent.