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Proper treatment of painful carious tooth of 4 year child

Sir I gave clavam 228.5 mg dry syrup,metrogyl 200 mg/5 ml syrup,ibugesic plus syrup to 4yr child for 5days for huge buccal swelling and carious upper d,e.but after 5 days swelling is not reduced.in what dose can I give serratiopeptidase or other drug to reduce swelling? @

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Do emergency access opening irrigate cavity with normal saline or hypochlorite solution and give open dressing with LA soaked cotton swab do not push inside too much or no biomechanical preparation only access opening . Adv .syrup augmentin 228 mg 5 ml bd .Syp ibugesic plus 5 ml tds. .syp metrogyl 200 mg 2.5 ml tds All medicines for 7 more days . (Plz adjust dose according to patient weight because you didn't mention here.) Luke warm water rinses thrice a day. Recall the patient after 5 days .after 5 days if swelling subsides, then you can start further pulpectomy procedure.

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Do emergency access opening irrigate cavity with normal saline or hypochlorite solution and give open dressing with LA soaked cotton swab do not push inside too much or no biomechanical preparation only access opening . Adv .syrup augmentin 228 mg 5 ml bd .Syp ibugesic plus 5 ml tds. .syp metrogyl 200 mg 2.5 ml tds All medicines for 7 more days . (Plz adjust dose according to patient weight because you didn't mention here.) Luke warm water rinses thrice a day. Recall the patient after 5 days .after 5 days if swelling subsides, then you can start further pulpectomy procedure.

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Access open and drainage the pus. Rx:- Syp Cefexime 250 mg half tsp twice daily Syp Ibugesic half tsp twice daily Warm saline rinses between meals Along with pulpectomy also incision and drainage of abscess with antimicrobial mouthwash like betadine Warm saline rinses between meals

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Serratiopeptidase is a proteolytic enzymes that has been used for reducing inflammations but its use should be limited in case of abscess due to its fibrinolytic activity. Sometimes it may cause the spread of abscess into deeper planes( may spread the infection).

Yes you can give serratiopeptidase 2.5mg tid for 7day. If need be you can give cepodoxime 100mg bid for 7 days. Report compliance and progress

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Along with serratiopeptidase 2.5mg Continue metrogyl till the inflammation is reduced, as it will help reduce infection spread

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Yes dr.along with claim 228.5mg,met totul 200mg/5ml you can give 2.5mg serratiopeptidase 2.5mg tid for u days

Chlorhexidine mouthwash twice daily for 14 days Warm saline rinses between meals

Start pulpectomy and then continue these medications

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