Landero Dental Clinic

06/05/2026

Ludwig Angina

🔹 Rapidly spreading bilateral cellulitis of submandibular, sublingual, and submental spaces
🔹 Usually from mandibular 2nd/3rd molar infection
🔹 Cellulitis → hard diffuse swelling, not localized abscess

Clinical
🔹 Bull neck
🔹 Woody/board-like induration
🔹 Elevated, posteriorly displaced tongue
🔹 Dysphagia, odynophagia, drooling
🔹 Hot potato voice, trismus
🔹 Fever, tachycardia, malaise

Main danger
🔹 Airway obstruction = most serious complication
🔹 Death usually from asphyxiation

Management
🔹 Airway first
🔹 Hospitalize
🔹 IV broad-spectrum antibiotics
🔹 Incision and drainage / decompression
🔹 Remove source: extract or treat offending tooth

High-yield pearl
🔹 Bilateral board-like submandibular swelling + tongue elevation = Ludwig angina

06/05/2026

🩸 “The socket won’t stop bleeding… what now?” 😰

Post-extraction bleeding management every dentist MUST master

You’ve done a clean extraction… everything looked perfect…
And then 💥 the patient calls—“Doctor, it’s still bleeding!”

Let’s break down the exact stepwise approach—the way examiners LOVE and clinics DEMAND 👇

🥇 STEP 1: DIRECT PRESSURE (FIRST LINE – NEVER MISS THIS)

👉 This solves most cases

Place a sterile gauze over socket

Ask patient to bite firmly for 30–60 minutes

Slightly moistened gauze works better (helps clot formation)

🧠 Why?
Pressure = vessel compression + clot stabilization

💡 If bleeding stops here → you’re done. Don’t over-treat.

🥈 STEP 2: INSPECT THE SOCKET

👉 If bleeding persists, don’t blindly pack—look first

Remove the existing clot

Irrigate gently

Identify source:

🦴 Bone (oozing)

💉 Soft tissue tear

⚠️ Foreign body / root fragment

🧠 Why?
You can’t fix what you don’t identify.

🥉 STEP 3: LOCAL HEMOSTATIC MEASURES

👉 Now we actively control bleeding

🧪 Place inside socket:

Gelfoam

Surgicel (oxidized cellulose)

Collagen plug

Topical thrombin

🧠 These act as a scaffold → clot formation → stabilization

🧵 STEP 4: SUTURING (EXAM FAVORITE)

👉 Figure-of-8 suture = GOLD STANDARD

Compresses socket

Holds clot in place

Provides mechanical stability

💡 If you remember ONE suture for exams → this is it

💊 STEP 5: PHARMACOLOGIC SUPPORT

👉 Especially important in medically compromised patients

Tranexamic acid (TXA)

Mouthwash OR gauze soaked in TXA

Prevents clot breakdown (antifibrinolytic)

⚠️ Avoid unnecessary NSAIDs in bleeding-prone patients

🚨 STEP 6: THINK SYSTEMIC (BIG EXAM TRAP)

👉 Bleeding not stopping? Don’t keep packing blindly

Check for:

💊 Drugs:

Warfarin

DOACs (Apixaban, Rivaroxaban)

Aspirin / Clopidogrel

🩸 Disorders:

Hemophilia A

Von Willebrand disease

👉 Investigations:

INR (ideal

05/05/2026

28/04/2026

❌❌ Huwag kang magpapa-braces kung:

𝟭. 𝗛𝗶𝗻𝗱𝗶 𝗸𝗮 𝗿𝗲𝗮𝗱𝘆 𝘀𝗮 𝗳𝗶𝗻𝗮𝗻𝗰𝗶𝗮𝗹 𝗿𝗲𝘀𝗽𝗼𝗻𝘀𝗶𝗯𝗶𝗹𝗶𝘁𝘆.
Hindi porket may pang downpayment ka, okay na—may iba pang expenses kapag naka-braces ka. Kailangan mo ng pambayad for monthly adjustments, restorations, extractions, appliance, lost brackets at iba pang kailangan sa case mo.

𝟮. 𝗛𝗶𝗻𝗱𝗶 𝗸𝗮 𝗺𝗮𝗴𝘀-𝘀𝘁𝗮𝘆 𝘀𝗮 𝗶𝘀𝗮𝗻𝗴 𝗰𝗶𝘁𝘆 / 𝗽𝗹𝗮𝗰𝗲 𝗳𝗼𝗿 𝗮 𝗹𝗼𝗻𝗴 𝘁𝗶𝗺𝗲.
Dahil ang braces, kailangan ng regular monthly adjustment. Kung palipat-lipat ka ng lugar, mahihirapan kang ma-follow up ang treatment mo nang consistent. Ending, parehas lang kayo maha-hassle ng dentista mo.

𝟯. 𝗛𝗶𝗻𝗱𝗶 𝗸𝗮 𝗿𝗲𝗮𝗱𝘆 𝗺𝗮𝗴-𝗰𝗼𝗺𝗺𝗶𝘁 𝘀𝗮 𝟭–𝟯 𝘆𝗲𝗮𝗿𝘀 𝗻𝗮 𝘁𝗿𝗲𝗮𝘁𝗺𝗲𝗻𝘁.
Tooth movement is slow and gradual. Hindi ito mabilisang fix. Kung naghahanap ka agad ng improvement o results in the first 3 months, iba ang procedure na para sa'yo.

𝟰. 𝗛𝗶𝗻𝗱𝗶 𝗸𝗮 𝗱𝗶𝘀𝗶𝗽𝗹𝗶𝗻𝗮𝗱𝗼 𝘀𝗮 𝗼𝗿𝗮𝗹 𝗵𝘆𝗴𝗶𝗲𝗻𝗲.
Food particles na nasstuck sa wires/brackets can cause cavities and bacterial growth in the long run. Kapag tamad ka mag-toothbrush or floss, mabubulok lang ang ngipin mo.

𝟱. 𝗛𝗶𝗻𝗱𝗶 𝗸𝗮 𝗽𝗿𝗲𝗽𝗮𝗿𝗲𝗱 𝘀𝗮 𝗱𝗶𝘀𝗰𝗼𝗺𝗳𝗼𝗿𝘁 𝗮𝘁 𝗮𝗱𝗷𝘂𝘀𝘁𝗺𝗲𝗻𝘁𝘀
Normal na sasakit after braces installation dahil gagalaw ang mga ngipin mo. Ganito rin every monthly adjustment, pero kailangan mo itong kayanin consistently.

⚠️ At eto ang mas importante: 𝙆𝙖𝙥𝙖𝙜 𝙃𝙄𝙉𝘿𝙄 𝙣𝙖-𝙢𝙖𝙞𝙣𝙩𝙖𝙞𝙣 𝙖𝙣𝙜 𝙗𝙧𝙖𝙘𝙚𝙨 𝙥𝙧𝙤𝙥𝙚𝙧𝙡𝙮, 𝙞𝙩𝙤 𝙖𝙣𝙜 𝙥𝙤𝙨𝙨𝙞𝙗𝙡𝙚 𝙚𝙛𝙛𝙚𝙘𝙩𝙨:

❌ 1. Tooth decay (bulok na ngipin)
Dahil naiipon ang pagkain sa brackets, mabilis mag-build up ang plaque kapag hindi malinis nang maayos. Mabubulok ang ngipin kapag napabayaan that may lead to infections, or worse, extractions.

❌ 2. Permanent white spots o stains sa teeth
Ito yung “mark” na natitira kahit natanggal na ang braces—hindi na fully nawawala.

❌ 3. Bad breath (chronic halitosis)
Dahil sa trapped food particles at bacteria sa paligid ng braces, pwede palaging mabaho ang hininga mo.

❌ 4. Delayed or worse treatment results
Imbes na maayos ang alignment, puwedeng humaba pa ang treatment time o hindi maging optimal ang outcome.

𝗛𝗶𝗻𝗱𝗶 𝗽𝗼𝗿𝗸𝗲𝘁 𝗗𝗲𝗻𝘁𝗶𝘀𝘁 𝗮𝗻𝗱 𝗻𝗮𝗴𝗸𝗮𝗯𝗶𝘁 𝗻𝗴 𝗯𝗿𝗮𝗰𝗲𝘀 𝗺𝗼, 𝘀𝗲𝘁 𝗸𝗮 𝗻𝗮 𝗳𝗼𝗿 𝗹𝗶𝗳𝗲. ❌
Tandaan: Once a month lang kayo nagkikita ng dentista mo. The other 30 days? Ikaw ang responsable sa pangangalaga ng braces mo. Iwasang matanggalan ng brackets at i-maintain ang proper hygiene.

Sobrang mahal ng investment mo sa braces, sulitin mo na! 💎

27/04/2026

🚫 Dry Socket Management: Evidence-Based Strategies for Effective Post-Extraction Care

Dry socket (alveolar osteitis) is one of the most painful postoperative complications in oral surgery, typically occurring 2–4 days after tooth extraction when the blood clot fails to form or becomes dislodged. Characterized by intense radiating pain, foul odor, and exposed bone, it requires prompt and structured management to reduce patient discomfort and support proper healing.

☑️ Clinical Management of Dry Socket

1. Thorough Irrigation

The first step is gentle but adequate irrigation of the socket using sterile saline or chlorhexidine solution to remove debris and reduce bacterial load. Curettage is not recommended, as it can delay healing.

2. Medicated Dressings

Application of a medicated dressing—commonly containing eugenol, butamben, or iodoform—provides immediate analgesia and creates a protective environment. Products such as Alvogyl or Alvocure are widely used due to their soothing, antiseptic, and anesthetic properties. Dressings should be replaced according to clinical judgment, usually every 24–48 hours.

3. Pain Control

Analgesic therapy should be individualized. NSAIDs are typically effective, although severe cases may require a short course of combination therapy. Avoid unnecessary antibiotics unless systemic infection or high-risk conditions are present.

4. Supportive Measures

Patients should be advised to maintain gentle oral hygiene, avoid smoking, and follow a soft diet. Warm saline rinses can help reduce discomfort after the acute phase.

👉 Timely identification and evidence-based management allow clinicians to dramatically improve patient comfort and reduce healing time. Understanding the pathophysiology of dry socket and applying standardized treatment protocols ensures predictable outcomes in everyday practice.

27/04/2026

🚨 A Tooth Infection Can Turn Into a Medical Emergency

What starts as a small pocket of pus around a tooth (dental abscess) is actually a growing bacterial infection—not just “tooth pain.”

If ignored, these bacteria don’t stay limited to the tooth. They can spread into the face, jaw, and neck… and in severe cases, enter the bloodstream.
At that point, the body can go into a dangerous inflammatory state that affects vital organs and may require emergency medical care.

Watch for these red flags:
Swelling of the face, severe or worsening pain, fever, difficulty swallowing, or feeling unusually weak. These are warning signs your body is struggling to control the infection.

Treatment is not optional here—it’s urgent.
Draining the abscess, root canal treatment, or removing the infected tooth stops the infection at its source before it spreads further.

A dental infection is not “just dental.”
In rare but serious cases, it can become a whole-body problem.