One of my patient had severe pain due to impacted molars and I told surgical extraction is needed to be done.I had written prescription for the same.Patient took multiple course on its own and has been abusing the prescription for long later developed peptic ulcer.She is under GP for the same.Patient came to me today.what to do? Accept this case or refuse it?

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Proper counseling Have you confirmed the peptic ulcer or it is simple gastritis Yes you should accept the case for dental problems and take help of gasteroenterologist for peptic ulcer

GP diagnose peptic ulcer.But I am confused what to give for severe pain as PCM cannot control moderate to severe dental pain.My concern is if other NSAIDs lead to bleed.
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NEED'S.. TO TREAT..PEPTIC ULCER.. WITH.. PPI .. PANTAPRAZOLE + ONDANCETRAN.. H PYLORI MANAGEMENT WITH.. AMOXYCLAV AND CLARITHROMYCIN.. ANTACIDS.. SYMPTOMATIC T/T.. ANXIOLYTIC..SOS.. DENTAL MANAGEMENT WITH.. PRECAUTIONS FOR PEPTIC ULCER.. ENDOSCOPY AND GASTROENTEROLOGIST OPINION..

I am confused what to give for severe pain as PCM cannot control moderate to severe dental pain.My concern is if other NSAIDs lead to bleed.Help.
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Peptic Ulcer peptic ulcer will be there.... You are missing something....Take Case Again on Ayurved Ground.... Kaaran Binaa Kaarya Nahi.... sarve rogaSpi mandegnau.... So Take Case Again And Then Try To Find Medicines from Grantha.Or Repost It For Suggestions... Secondly, As Patient is not getting any Upashay From Peptic Ulcer Treatment, Hetoo (Root Cause) is 100% different... Try To Find It....As Nidaan Parivarjan Is Basic Treatment in any case

Refuse treatment or may treat pt after reassurance and counciling. Take help from GP if Peptic ulcer is there you just treat dental ailments after explaining prognosis.

Write proper case history of patient with advised treatment from your side. Take countersignature of patient on the case sheet with the note that patient has been made to understand all the above written in case sheet. Take patient for treatment after signature on consent form. Get patient consulted from gastroenterology side for suspected peptic ulcers. Give Tramadol or selective Cox 2 inhibitors like celecoxib/valdecoxib for controlling pain and ask patient to get treatment done asap. In the meantime local treatment like irrigation/ curettage can be done for pericoronitis. Check for caries in second molar/ third molar for suspected pulpitis and do rc opening if it's there.

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Peptic ulcer proper diagnosis and treatment needs and endoscopic examination.so kindly refer him for that..regarding treatment of dental infection you can give antibiotics with Tramadol and an anti-inflammatory enzyme combination like trypsin chymotripsin and rutoside

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Yes doc, u can prescribe tramadol as analgesic, can continue with the dental procedure

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U should accept this case as the patient has shown his trust in u for dental treatment

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Accept this case Dr.try to give pain killer by IM .Intra muscular to reduce the severe pain .

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