Dental Emergencies: Management Strategies That Improve Outcomes (Trauma CME and Pharmacology CME) -
Publication Date: June 2017 (Volume 19, Number 6)
CME Credits: 4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits. CME expires 6/1/2020
Specialty CME Credits:: Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME and 0.5 Pharmacology CME credits, subject to your state and institutional approval.
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?”
Todd Kessinger, MD - 07/23/2018 Concise presentation of material. high yield.
David Zimcosky - 04/18/2018 As a result of this article, I have more accurate descriptions of dental pathology and traumatic injuries, as well as greater confidence in managing dental emergencies.
James Yates, MD - 02/01/2018 This article will improve dental care
Hannah Evans, MD - 01/30/2018 Great article. I will do some resident and mid level training on this
Brenda Barnes, DPM - 11/15/2017 Great review of blocks!
Heith Pumphrey, NP - 11/11/2017 This article helped me feel more comfortable treating dental complaints
Margaret Carman, NP - 11/08/2017 I now have a better understanding of the types of blocks; I had never been taught about splinting.
Donald Correll, DDS - 11/07/2017 This article will help me provide better care of dental conditions
Christine Gisness, NP - 11/06/2017 Great article. I will now be able to describe to students the types of blocks.
Angela Cooey, PA-C - 09/21/2017 After reading this article, I can use the various dental blocks for pain relief.
Burnette Sharon, NP - 09/21/2017 Excellent pictures and description of blocks.
Philip Guzzetta III, PA-C - 09/18/2017 Great content! This gave me increased confidence with performing nerve blocks.
Michael Menowsky, MD - 09/18/2017 Great review of dental emergencies. I feel more comfortable with reimplantation.
Michael A Kutmas, DO - 09/07/2017 Excellent article on nerve blocks and anatomy.
Bill Vermilion, MD, FACEP - 09/07/2017 I now have a better understanding of how to treat these problems.
Kimber Ward - 09/05/2017 I will have a better evaluation and care of dental emergencies.
Erica Waterman, MD - 09/05/2017 I now feel more competent with minor dental trauma and infection.