Dr. Monica Teodorescu - Stomatologie

Dr. Monica Teodorescu - Stomatologie Coordonator Ambulatoriu,Medic Primar Endodontie, Doctorand, Competenta Managementul Serviciilor de Sanatate

14/07/2026

🦷 Periajul nu este suficient pentru a proteja dinții de lapte.

👶 Un zâmbet sănătos începe încă din primele luni de viață. Iată cele mai importante recomandări pentru prevenirea cariilor la copii:

🧼 Curățați gingiile înainte de apariția primului dinte.

🪥 Folosiți pastă de dinți cu fluor de la primul dinte (cantitate cât un bob de orez până la 3 ani, apoi cât un bob de mazăre).

🥤❌ Evitați băuturile îndulcite și biberonul cu lapte sau suc la culcare.

🔍 Fiți atenți la petele albe de lângă gingie – pot reprezenta primul semn al unei carii și pot fi tratate dacă sunt descoperite la timp.

🦷📅 Programați primul consult stomatologic până la vârsta de 1 an.

🤸‍♂️🦷 Protejați dinții de traumatisme, mai ales când copilul începe să meargă.

🍼❌ Renunțați la suzetă și la suptul degetului până la vârsta de 2 ani, pentru a reduce riscul apariției problemelor de ocluzie.

🌙 Noaptea este perioada cu cel mai mare risc pentru apariția cariilor. După erupția dinților, dacă există alimentație nocturnă, curățați dinții după hrănire, atunci când este posibil.

🥄🚫 Nu împărțiți lingurița, periuța sau suzeta cu copilul – bacteriile care produc cariile se pot transmite de la adulți.

❤️ Nu uitați: dinții de lapte sunt esențiali pentru masticație, vorbire, dezvoltarea armonioasă a maxilarelor și ghidarea corectă a erupției dinților permanenți.

✨ Cariile pot fi prevenite! Prevenția începută din primii ani de viață este cea mai simplă, sigură și eficientă investiție în sănătatea copilului.

💙 Dinții permanenți sănătoși încep cu dinți de lapte sănătoși!

05/07/2026

Cracked tooth syndrome ⬇️

22/06/2026

Post-op Complications of Extraction

🔹 Delayed bleeding
🔹 Reactionary hemorrhage: 24–48 hrs
🔹 Secondary hemorrhage: 7–14 days, usually due to infection

🔹 Pain
🔹 Normal pain peaks at ~12 hrs then improves
🔹 Severe/increasing pain after 48 hrs → think dry socket or infection

🔹 Dry socket (alveolar osteitis)
🔹 2–3 days after extraction
🔹 Severe throbbing pain radiating to ear
🔹 Empty socket, exposed bone, foul odor/taste
🔹 No pus
🔹 Common in mandibular 3rd molars, smokers, OCP users

🔹 Post-op edema
🔹 Peaks at 48–72 hrs
🔹 Resolves in 5–7 days
🔹 Ice first 24 hrs, then warm moist heat

🔹 Hematoma / ecchymosis
🔹 Blood collects in tissues → bruising
🔹 May spread downward by gravity
🔹 Usually resolves in 7–14 days

🔹 Infection
🔹 Fluctuant swelling, pus, fever, lymphadenopathy
🔹 Swelling continues to worsen rather than improve

🔹 Trismus
🔹 Muscle spasm, usually medial pterygoid/masseter
🔹 Caused by surgical trauma, prolonged opening, IAN injection
🔹 Treat with warm compresses, NSAIDs, soft diet, jaw exercises

High-yield pearl
🔹 Dry socket = most classic delayed complication
🔹 Severe pain on day 2–3 + empty socket + foul odor + no pus

20/06/2026

Trigeminal Neuralgia (TN)

🔹 Also called tic douloureux
🔹 Sudden, severe, electric shock–like facial pain along CN V
🔹 Usually idiopathic; may be due to vascular compression
🔹 Young patient with TN → suspect multiple sclerosis

Clinical
🔹 Usually older adults, more common in females
🔹 Mostly unilateral
🔹 Commonly involves V2 and V3
🔹 Pain is sharp, stabbing, lancinating
🔹 Attacks last seconds to minutes
🔹 Pain-free between attacks
🔹 May have facial tic/spasm

Triggers
🔹 Trigger zones on face/lips/nose/cheek
🔹 Triggered by light touch, washing, shaving, breeze, eating, smiling
🔹 Has refractory period after attack

Management
🔹 Carbamazepine = drug of choice
🔹 Also: oxcarbazepine, gabapentin, phenytoin
🔹 Refractory cases: microvascular decompression or rhizotomy

High-yield pearl
🔹 Brief unilateral electric facial pain triggered by light touch = trigeminal neuralgia

20/06/2026

Local Anesthesia Complication

16/06/2026

Articaine (Septocaine)

🔹 Amide LA with an ester group = unique
🔹 Has thiophene ring → ↑ lipid solubility, excellent tissue pe*******on

Metabolism
🔹 Mainly metabolized in blood (plasma cholinesterase)
🔹 Small amount in liver
🔹 Shortest half-life among common dental amides

Clinical use
🔹 Available as 4% solution with epinephrine
🔹 1 cartridge (1.8 mL) = 72 mg
🔹 Excellent for maxillary infiltration
🔹 Very good bone pe*******on
🔹 Useful for some mandibular buccal infiltrations

High-yield warnings
🔹 Higher paresthesia risk with IAN block
🔹 Especially linked to lingual nerve
🔹 Often preferred for infiltration rather than IANB

Other points
🔹 True allergy is rare
🔹 Safe in sulfa allergy
🔹 Pregnancy category C → lidocaine preferred in pregnancy

High-yield pearl
🔹 Articaine = amide with ester linkage + excellent bone diffusion + higher paresthesia risk in IANB

08/06/2026

Ibuprofen in Dentistry

🔹 NSAID for pain, inflammation, fever
🔹 Reversible COX-1/COX-2 inhibitor → ↓ prostaglandins

Dental uses
🔹 Post-op dental pain
🔹 Extraction / surgical extraction
🔹 Endodontic pain
🔹 Periodontal/implant pain
🔹 Best for inflammatory dental pain

Dose
🔹 400 mg commonly used in adults
🔹 Max = 3200 mg/day
🔹 Often combined with acetaminophen for stronger pain control

Why preferred
🔹 Dental pain is often inflammatory
🔹 Often better than opioids for routine dental pain
🔹 Helps reduce opioid need

Adverse effects
🔹 Dyspepsia / gastric irritation
🔹 GI bleeding
🔹 Renal risk

Avoid in
🔹 Peptic ulcer disease
🔹 Kidney disease
🔹 Liver disease
🔹 Bleeding disorders
🔹 3rd trimester pregnancy
🔹 NSAID allergy / aspirin-sensitive asthma

High-yield pearl
🔹 Ibuprofen = first-line for inflammatory dental pain
🔹 If NSAIDs contraindicated → acetaminophen
🔹 Ibuprofen + acetaminophen = very effective for moderate/severe dental pain

03/06/2026

Pseudomembranous Candidiasis (Thrush)

🔹 White curd-like plaques on oral mucosa
🔹 Wipes off, leaving red, raw, sometimes bleeding surface

Common sites
🔹 Buccal mucosa
🔹 Tongue
🔹 Palate
🔹 Oropharynx

Predisposing factors
🔹 HIV/AIDS
🔹 Diabetes mellitus
🔹 Antibiotic use
🔹 Corticosteroid inhalers
🔹 Xerostomia
🔹 Immunosuppression
🔹 Denture wearing

Symptoms
🔹 May be asymptomatic
🔹 Or causes burning, soreness, altered taste

Key differential
🔹 Thrush wipes off
🔹 Oral hairy leukoplakia does not wipe off

Management
🔹 Topical antifungals: nystatin, clotrimazole
🔹 Severe/recurrent cases: systemic fluconazole
🔹 Also correct the underlying cause

12/05/2026

Scientists have discovered that antibodies passed from mother to baby during pregnancy and breastfeeding may help “programme” the developing oral immune system to better control harmful bacteria linked to gum disease later in life.

The study, published in Nature Communications, found that maternal antibodies influenced how immune cells developed in the mouth and helped maintain a healthier balance of oral bacteria.

Researchers observed that offspring lacking these early antibodies developed more inflammation, higher bacterial loads, and greater susceptibility to periodontitis-like disease in adulthood.

This is important because gum disease is not just a dental problem. Periodontitis is associated with tooth loss, jawbone destruction, diabetes, cardiovascular disease, and chronic inflammation throughout the body.

📄 Source: Naamneh et al. Maternal antibodies regulate the establishment of murine oral and salivary mucosal immunity. Nat Commun (2026).

06/05/2026

Cum îngrijim dinții copiilor. Sfaturi despre îngrijirea corectă a dinților copiilor. Sfaturi de la specialist. Îngrijirea dinților copiilor

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