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  • image Dental caries is one of the most common chronic health conditions in both children and adults. Dental caries stems from an imbalance in saliva defense, microbial load, and lifestyle habits. Modifiable risk factors include oral hygiene practices and lifestyle factors. Dental caries can lead to tooth sensitivity, cause oral pain, and have implications for overall health.

  • image For oral health maintenance, teeth should be brushed twice daily with fluoride toothpaste. Patients should floss daily and follow recommended technique for brushing and flossing. Oral health maintenance also includes the use of athletic mouthguards, denture care, and regular dental care by an oral healthcare professional.

  • image Toothpaste contains fluoride as its primary active ingredient to prevent tooth decay and gum disease. Other active ingredients, such as potassium salts, may be added for tooth sensitivity, as well as abrasives and carbamide peroxide for tooth whitening.

  • image The first-line treatment for dental pain is nonsteroidal anti-inflammatory drugs (NSAIDs), with or without acetaminophen.

  • image Benzocaine is available over the counter in numerous products for adults, children, and infants as a local anesthetic for oral pain. While widely available, benzocaine has significant safety concerns and should not be used for teething pain in children younger than 2 years of age.

  • image Canker sores are one of the most common ulcerative conditions of the mouth. Treatment options include pain management with topical agents and eliminating irritating food and drink from the diet.

  • image Cold sores are recurrent oral lesions resulting from infection with herpes simplex virus type 1. Referral of patients to their primary care physician is likely warranted, as the most effective treatment options are available as prescription only products.

  • image Xerostomia or dry mouth is a common oral condition often caused by medical conditions, medications, or medical treatments. Treatment of xerostomia greatly depends on the cause of the condition, but can be treated symptomatically with a number of OTC products.

  • image Dentistry has few true emergencies; however, dental trauma where a permanent tooth is displaced or avulsed constitute a dental emergency, and immediate referral to an oral healthcare provider or urgent care center is warranted.

  • image Fluoride is effective in preventing dental caries by inhibiting the demineralization of tooth enamel, enhancing the remineralization of enamel, and inhibiting bacterial enzymes involved in the metabolism of carbohydrates by cariogenic bacteria. Sources of fluoride include toothpaste, fluoridated drinking water, professionally applied topical fluorides, and oral fluoride supplementation.


Pateint Care Process for Xerostomia



  • Patient characteristics

  • Patient medical history (personal and family)

  • Social history and dietary habits (eg, smoking status, daily water consumption)

  • Current medications


  • Hydration status

  • Presence of precipitating factors (See Table e15-12)

  • Emotional status (eg, presence of anxiety and/or depression)

  • Impact on quality of life (eg, difficulty speaking, swallowing, chewing)

  • Severity of condition (eg, affecting surrounding tissues, presence of complications)

  • Willingness to quit smoking (if applicable)

  • Ability/willingness to try nonpharmacologic treatment options

  • Ability/willingness to pay for pharmacologic treatment options


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