Management and prognosis

Cracked-tooth-syndrome is managed by the application of a band around the tooth or a temporary crown. If this does not relieve the pain, endodontic treatment or

extraction may be necessary.

Reversible pulpitis can be treated by prescription of an NSAID for relief of the pain due to inflammation of the pulp. Definitive treatment consists of removal of the stimulus that is evoking the pain, such as treating the carious lesion. This condition does not require treatment with antibiotics or opioid analgesics.147

Treatment for irreversible pulpitis consists of endo-

dontic treatment (removal of the inflamed pulp tissue)

and prescription of analgesics, either NSAIDs or para cetamol with 30 mg of codeine, one to two tablets every four to six hours as needed for pain. Systemic administration of antibiotics is not indicated.147[V]

Dentine hypersensitivity can be quite difficult to manage. Treatment consists mainly of application of fluoride gel or a desensitizing agent to the hypersensitive tooth surface.147,156[III]

Apical pariodontitis also requires endodontic treatment (removal of the necrotic tooth pulp and bacteria). If an abscess is present, it must be drained and systemic antibiotics may be indicated. Surgical removal of the periapical granuloma can be performed if proper healing is not obtained by endodontic treatment.

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