Recorded figures can be based on three sources: psychiatric samples, hospital admissions and general population surveys.The World Health Organization estimates that, as of 2010, 880,000 deaths occur as a result of self-harm. About 10% of admissions to medical wards in the UK are as a result of self-harm, the majority of which are drug overdoses. However, studies based only on hospital admissions may hide the larger group of self-harmers who do not need or seek hospital treatment for their injuries, instead treating themselves. Many adolescents who present to general hospitals with deliberate self-harm report previous episodes for which they did not receive medical attention. In the United States up to 4% of adults self-harm with approximately 1% of the population engaging in chronic or severe self-harm.Current research suggests that the rates of self-harm are much higher among young people with the average age of onset between 14 and 24. The earliest reported incidents of self-harm are in children between 5 and 7 years old. In the UK in 2008 rates of self-harm in young people could be as high as 33%. In addition there appears to be an increased risk of self-harm in college students than among the general population. In a study of undergraduate students in the US, 9.8% of the students surveyed indicated that they had purposefully cut or burned themselves on at least one occasion in the past.
Common tests would include ethyl chloride test or electric pulp test. Other examples of tests would be laser doppler flowmetry (LDF), pulse oximetry etc. Tender to TouchThe tooth is extremely tender to touch, and it may be high on occlusion as it may be extruded from the socket. MobileMobility may be observed. Radiographic Features
Radiographically, there will be a periapical lesion associated with the tooth. This lesion is normally existent prior to this episode. Widened periodontal ligament (PDL) space is visible. Treatment
For most situations urgent treatment is required to eliminate the pain and swelling. 1) Further Endodontic Treatment
Further root canal treatment is often the best option. Firstly, the tooth should be accessed and thoroughly irrigated using sodium hypochlorite. Following this the canals should be dried using paper points. The tooth should then be debrided, and drainage established. 2) Medications
i) Antibiotics
In certain circumstances it may be necessary to provide an antibiotic. These circumstances include the presence of a diffuse swelling or cellulitis, when immediate drainage cannot be achieved, or the patient has systemic involvement. ii) Analgesics
Analgesics may also be advised for pain control. 3) Extraction
If the tooth is unrestorable then extraction may also be an option. 4) Bite Adjustment
Adjusting the bite may provide some relief but this will not be a permanent solution to the problem. == References ==