dental emergency


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dental emergency

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 SOURCE: Adapted from Comer, RW, et al: Dental emergencies. Postgrad Med 85(3):63, Feb. 1989.
ConditionSigns and SymptomsManagement
Periodontal disease
Periodontal abscessLocalized pain; swelling of gingivae; possible sinus tract; lack of response to percussion; periodontal pocketingCurettage to establish drainage; antibiotics; warm saline rinses; soft diet; referral to dentist
PericoronitisPain and generalized soreness; inflamed operculum over partially erupted toothIrrigation; warm saline rinses; gentle massage with toothbrush; antibiotics for fever and lymphadenopathy; referral to dentist for possible tissue excision or tooth removal
Necrotizing ulcerative gingivitisGeneralized pain; bleeding gums; fetid odor; generalized gingival inflammation; necrotic tissue; loss of interdental papillae; feverGeneral 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; lymphadenopathyRest; diluted mouthwashes; increased fluid intake; soft diet; topical analgesics; referral to dentist
Pulpitis and periapical problems
Reversible pulpitisSharp, transient pain response to cold stimuli; recent dental restorationAnalgesics; avoidance of thermal stimuli; referral to dentist
Irreversible pulpitisSpontaneous pain; persistent or lingering pain response to thermal stimuliReferral to dentist for removal of pulp and root canal therapy or extraction of tooth
Periapical inflammationAcute pain on percussionExamination for lymph node involvement, intraoral and extraoral; swelling; fever; analgesics; referral to dentist
Periapical abscessTooth sensitive to touch; tooth mobile; fever; swelling or sinus tract; possible fever if systemic involvementThorough systemic examination; incision and drainage; antibiotics; analgesics; warm water rinses; referral to dentist
Post-treatment complications
Alveolar osteitis (dry socket)Throbbing pain 2–4 days after extractionIrrigation of extraction site; sedative dressing (eugenol); analgesics; gauze packs, bone wax, ; referral to dentist
Tooth sensitivityImbalance when teeth contact; thermal sensitivity; pain on closing mouthReferral to dentist
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References in periodicals archive ?
A spokesman said: "Should any former NHS patient of the Academy Dental Practice have a dental emergency they should contact the NHS Highland Dental Helpline on 08456 442 271.
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