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an acute disorder of oral health that requires dental and/or medical attention, including broken, loose, or evulsed teeth caused by traumas; infections and inflammations of the soft tissues of the mouth; and complications of oral surgery, such as dry tooth socket.
An acute condition affecting the teeth, such as inflammation of the soft tissues surrounding teeth or post-treatment complications of dental surgery. It is best treated by a dentist. Nevertheless, the primary care physician and other health care professionals must be familiar with these emergency conditions and their management.See: table
|Condition||Signs and Symptoms||Management|
|Periodontal abscess||Localized pain; swelling of gingivae; possible sinus tract; lack of response to percussion; periodontal pocketing||Curettage to establish drainage; antibiotics; warm saline rinses; soft diet; referral to dentist|
|Pericoronitis||Pain and generalized soreness; inflamed operculum over partially erupted tooth||Irrigation; warm saline rinses; gentle massage with toothbrush; antibiotics for fever and lymphadenopathy; referral to dentist for possible tissue excision or tooth removal|
|Necrotizing ulcerative gingivitis||Generalized pain; bleeding gums; fetid odor; generalized gingival inflammation; necrotic tissue; loss of interdental papillae; fever||General débridement; daily saline rinses; hydration; referral to dentist; antibiotics if necessary; dietary recommendations; rinse twice daily with 1.2% chlorhexidine; brushing and flossing after resolution|
|Primary herpetic gingivostomatitis (highly infectious)||Gingival ulceration; fever; punctate lesions of gingivae and possibly dorsum of tongue; buccal mucosa, floor of mouth, lips; malaise; headache; irritability; lymphadenopathy||Rest; diluted mouthwashes; increased fluid intake; soft diet; topical analgesics; referral to dentist|
|Pulpitis and periapical problems|
|Reversible pulpitis||Sharp, transient pain response to cold stimuli; recent dental restoration||Analgesics; avoidance of thermal stimuli; referral to dentist|
|Irreversible pulpitis||Spontaneous pain; persistent or lingering pain response to thermal stimuli||Referral to dentist for removal of pulp and root canal therapy or extraction of tooth|
|Periapical inflammation||Acute pain on percussion||Examination for lymph node involvement, intraoral and extraoral; swelling; fever; analgesics; referral to dentist|
|Periapical abscess||Tooth sensitive to touch; tooth mobile; fever; swelling or sinus tract; possible fever if systemic involvement||Thorough systemic examination; incision and drainage; antibiotics; analgesics; warm water rinses; referral to dentist|
|Alveolar osteitis (dry socket)||Throbbing pain 2–4 days after extraction||Irrigation of extraction site; sedative dressing (eugenol); analgesics; gauze packs, bone wax, ; referral to dentist|
|Tooth sensitivity||Imbalance when teeth contact; thermal sensitivity; pain on closing mouth||Referral to dentist|