Because so many patients equate the practice of dentistry with pain, they may often wait to seek dental care. However, patients who neglect to attend their regular dentist appointments can be more susceptible to a possible progression of infection and/or dental disease, which can lead to more serious damage in the future. Therefore, it is important for clinicians to have pre-established plans to easily handle a dental emergency. Step-by-step methodology is an easy way to alleviate some of the stress of dental emergencies.
The first step in this process is to establish a differential diagnosis of tooth pain vs. non-tooth pain. The patient’s chief complaint during a dental emergency must be taken into account when performing diagnostic tests of the tooth that is suspected to be the cause of pain, especially since it may not be tooth-related. Any anesthesia that is applied to the suspected tooth should reduce or eliminate pain. If the pain is not alleviated, the tooth may not be the source of the issue. Also, if the clinician suspects any nerve involvement in the pain, an etiology can easily be deduced, especially if the patient has had recent dental treatment, restorations that are failing, tooth decay, and/or recent trauma; any of these events can lead to inflammatory pain. A clear diagnosis must be established before moving onto the next stage of treatment.
Dental treatment reduces the inflammatory process, which is the underlying cause of most acute dental pain emergencies. Treatment of the tooth can relieve pain by reducing tissue levels of inflammatory mediators, which can lead to symptoms such as apparently random throbbing and chewing pain.
The prescription of a specific drug, such as an antibiotic or an analgesic to reduce inflammation, is the final step in managing a dental emergency. It is important to note that antibiotics should only be prescribed to patients that have signs of odontogenic infections, including swelling, fever, malaise, or compromised airways.
Toothaches are one of the most common forms of pain that overwhelm emergency rooms and dental offices. With the appropriate methodologies for treating the anxious patient, a skilled clinician can easily accommodate an acute emergency dental patient and can provide an appropriate referral for non-tooth related pain conditions.
