Dental Emergencies: Management Strategies That Improve Outcomes -
Publication Date: June 2017 (Volume 19, Number 6)
Ryan Anthony Pedigo, MD
Director of Undergraduate Medical Education, Harbor-UCLA Medical Center, Torrance, CA; Assistant Professor of Emergency Medicine, David Geffen School of Medicine, Los Angeles, CA
Boyd Burns, DO, FACEP
George Kaiser Foundation Chair in Emergency Medicine, Associate Professor and Program Director, Department of Emergency Medicine, University of Oklahoma School of Community Medicine, Tulsa, OK
Marlaina M. Norris, MD, MBA
Assistant Professor, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
Acute dental emergencies are a common chief complaint presenting to emergency departments, and they are increasing substantially in frequency. The diagnosis and management of dental emergencies is a core competency of the emergency clinician, 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 with a focus on the historical and physical examination findings that must be understood to identify life-threatening infections, relieve pain, salvage natural teeth, and communicate with specialists in the further management of patients after emergency treatment.
Excerpt From This Issue
Your first patient of the shift is a 20-year-old man who was involved in an altercation. On physical examination, you note that he is missing 2 teeth and has chipped another. EMS found 1 of the teeth on the scene and has stored it in milk. You wonder, “Was milk the best storage medium? Do I need to worry about the missing tooth or other injuries? How do I replant a tooth? Does the chipped tooth need any specific intervention?”
As you ponder these questions, your next patient arrives. She is an 18-year-old woman complaining 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, but think, “What can I even do about this?”
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