Dental Emergencies in Urgent Care: Management Strategies That Improve Outcomes (Trauma CME, Pain Management CME, Infectious Disease CME, and Pharmacology CME) -

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Publication Date: May 2023 (Volume 2, Number 5)

CME Credits: 4 AMA PRA Category 1 Credits™. CME expires 05/01/2026.

Specialty CME: Included as part of the 4 credits, this CME activity is eligible for 1 Pharmacology and 3 Trauma, 2 Pain Management, 1 Infectious Disease, and 1 Pharmacology CME credit, subject to your state and institutional requirements.

Urgent Care Update Author

Peer Reviewer

Charting & Coding Author

Abstract

Acute dental emergencies are a common chief complaint presenting to ambulatory healthcare settings, and they are increasing substantially in frequency. The diagnosis and management of dental emergencies is a core competency of frontline clinicians, and proper therapeutic strategies can significantly improve cosmetic and functional outcomes for patients. This issue provides a systematic review of the literature on common acute traumatic and atraumatic dental emergencies; it focuses on the historical and physical examination findings that must be uncovered to identify dangerous infections, relieve pain, salvage natural teeth, and communicate with the specialists who will assume care of these patients at follow up.

Case Presentations

A 20-year-old man presents to the urgent care clinic following a physical altercation...

• On physical examination, you note that in addition to a small lower lip laceration, he has subluxation of the left lateral maxillary incisor and a chipped left central maxillary incisor.
• You wonder if either the mobile tooth or the chipped tooth need any specific urgent interventions…

An 18-year-old woman presents with a complaint of severe, dull pain 3 days after wisdom-tooth removal...

• Upon inspection, the socket that previously held her right mandibular third molar is devoid of any blood clot.
• You recognize this as “dry socket,” or alveolar osteitis.
• You consider what, if anything, you can do about this condition in the urgent care setting...

A 60-year-old man presents with lower jaw pain and swelling, malaise, and trouble fully opening his mouth...

• On examination, he has a temperature of 37.8°C, trismus, fullness and tenderness of the gingiva of the left first mandibular molar, and left submandibular swelling and tenderness to palpation.
• You wonder if it’s safe to treat him with antibiotics and instruct him to urgently follow up with a dentist...

Accreditation:

EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.