In the ED, their vitals/exam are as above. The differential for pain just behind the molar includes acute vs. chronic pericoronitis (inflammation of the soft tissues surrounding the crown of a partially erupted tooth) +/- abscess, paradental cyst, food impaction causing peridontal pain, pulpitis from dental caries, acute myofascial pain in TMJ, and oropharyngeal malignancy. No evidence of airway compromise. Low suspicion for RPA, PTA, Ludwig’s angina.
– Labs/Tests: None
– Imaging: Consider XR panorex
– Treatments: Motrin, Tylenol, Magic mouthwash 30mL BID PRN
– Consults: None
– Dispo: Likely discharge with Amoxicillin 500mg TID x1 days and dental/OMFS clinic follow-up for potential biopsy, tooth extraction, or operculectomy (removal of soft tissue surrounding tooth)