An approach to toothache: Tips and red flags for GPs

In this episode of The Good GP, Dr Tim Koh talks to Dr Elaine Cheung, an experienced dentist, and provides practical and relevant advice to assist GPs in recognising, assessing, and managing dental pain in the primary care setting. Addressing the most common causes of toothache, including dental infections (periapical and periodontal), caries, broken teeth, lost fillings, and pericoronitis from partially erupted wisdom teeth.

Exploring the key aspects of examination for GPs, the importance of looking for facial and intraoral swelling, lymph node involvement, signs of abscess, mobile teeth, or visible decay. Recognising red flags such as spreading infection, trismus, fever, and systemic symptoms is highlighted as essential for timely referral and escalation of care.

Antibiotic stewardship is also addressed, with clear guidance that antibiotics are not a substitute for definitive dental treatment and should only be prescribed when there are systemic signs or spreading infection. Giving emphasis on prevention, encouraging regular dental reviews, consistent oral hygiene, and patient education as effective strategies to minimise preventable dental disease.

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