Medical Emergencies · patient case question
At the end of the appointment she stands up and feels dizzy and lightheaded. What should you do?
Patient case: Rapid attachment loss in a young adult
Patient: 26-year-old patient.
Chief complaint: Gums bleed and some teeth feel loose.
History: Non-smoker, no systemic disease. A sibling lost teeth young.
Findings: Radiographs show bone loss disproportionate to the visible plaque, with only light calculus on posterior teeth. Perio charting shows 4 to 5 mm pockets on almost all teeth with bleeding on probing. Clinically, heavy calculus is present on the anterior teeth. Working diagnosis: aggressive (Grade C) periodontitis.
Show answer and explanation
Correct answer: C. Place her supine with the legs slightly elevated
- A. Epinephrine is for anaphylaxis or cardiac arrest. Giving it in vasovagal presyncope is dangerous and inappropriate.
- B. Sitting upright worsens cerebral hypoperfusion and is what precipitated the symptom.
- C. CORRECT. Postural lightheadedness after a dental appointment is presyncope. Lay her SUPINE with the legs slightly elevated to restore cerebral perfusion, loosen tight clothing, give oxygen, and monitor. Recovery is usually rapid.
- D. Discharging a symptomatic patient without observing recovery risks a syncopal collapse and injury on the way out.
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