Dental emergency

Facial inflammation from an infected left molar at one week.

A dental emergency is a type of medical emergency involving the teeth or gingiva. Pain involving these parts of the mouth, even when minor, can indicate a severe underlying problem that could worsen with time. It is important to contact a dentist as soon as possible for a professional evaluation to minimize damage to the teeth, gums, and the supporting bone. Short-term action can be taken to relieve oral pain, which can be very severe.

Causes

• Pulpitis
• Periodontal abscess
• Necrotizing ulcerative gingivitis^[1]
• Infection of odontogenic cyst
• Dental trauma,^[2] especially avulsion^[3]
• Dental barotrauma^[4] and barodontalgia.^[5] A sudden incapacitation of diver or aviator due to barometric-induced tooth fracture or toothache, respectively, may be life-threatening to the individual and the airplane passengers.^[6]
• Trigeminal neuralgia^[7] and other neuropathies such as cytotoxic chemotherapy-induced neuropathy^[8]
• Ludwig angina
• Temporomandibular disorder

Palliatives

Oil of cloves, which contains eugenol, can be used to treat dental pain; a drop can be applied with a cotton swab as a palliative. After wisdom tooth extraction, for example, a condition known as dry socket can develop where nerve endings are exposed to air. A piece of sterile gauze or cotton soaked in oil of cloves may be placed in the socket after careful cleaning with saline to relieve this form of pain.

Over-the-counter topical anesthetics containing active ingredients such as benzocaine or choline salicylate may be applied directly to the gum in order to deaden sensation.

Analgesics such as aspirin, paracetamol (acetaminophen) and ibuprofen are also commonly used; aspirin and ibuprofen have the additional benefits of being anti-inflammatories. Ice and/or heat are also frequently applied. A dentist may prescribe an anti-inflammatory corticosteroid such as Dexameth for pain relief prior to treatment. [1]

See also

• Treatment of knocked-out (avulsed) teeth

References

1. ^ "Definition of Acute necrotizing ulcerative gingivitis (ANUG)". Medterms.com. 1999-02-18. http://www.medterms.com/script/main/art.asp?articlekey=6577. Retrieved 2010-02-13. 
2. ^ Flores MT, Andersson L, Andreasen JO, et al. The International Association of Dental Traumatology (April 2007). "Guidelines for the management of traumatic dental injuries. I. Fractures and luxations of permanent teeth". Dent Traumatol 23 (2): 66–71. doi:10.1111/j.1600-9657.2007.00592.x. PMID 17367451. 
3. ^ Zadik Y (December 2008). "Algorithm of first-aid management of dental trauma for medics and corpsmen". Dent Traumatol 24 (6): 698–701. doi:10.1111/j.1600-9657.2008.00649.x. PMID 19021668. 
4. ^ Zadik Y (Jul-Aug 2009). "Dental barotrauma". Int J Prosthodont 22 (4): 354–7. PMID 19639071. http://www.quintpub.com/journals/ijp/abstract.php?iss2_id=367&article_id=4557&article=8&title=Dental%20Barotrauma. 
5. ^ Zadik, Yehuda (April 2009). "Barodontalgia". J Endod 35 (4): 481–5. doi:10.1016/j.joen.2008.12.004. PMID 19345791. http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B82X7-4VPKR45-2&_user=10&_coverDate=04%2F30%2F2009&_rdoc=4&_fmt=high&_orig=browse&_srch=doc-info(%23toc%2333023%232009%23999649995%231030066%23FLA%23display%23Volume)&_cdi=33023&_sort=d&_docanchor=&view=c&_ct=30&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=939bae3affd716753f70a314a4b0b935. Retrieved 2009-06-01. 
6. ^ Zadik, Yehuda; Chapnik, L; Goldstein, L (June 2007). "In-flight barodontalgia: analysis of 29 cases in military aircrew". Aviat Space Environ Med 78 (6): 593–6. PMID 17571660. http://www.ingentaconnect.com/content/asma/asem/2007/00000078/00000006/art00009. Retrieved 2009-01-27. 
7. ^ Drangsholt, M; Truelove, EL (July 2001). "Trigeminal neuralgia mistaken as temporomandibular disorder". J Evid Base Dent Pract (Mosby, Inc) 1 (1): 41–50. doi:10.1067/med.2001.116846. http://www.jebdp.com/article/S1532-3382%2801%2970082-6/abstract. Retrieved 25 November 2010. 
8. ^ Zadik Y, Vainstein V, Heling I, et al. (September 2010). "Cytotoxic chemotherapy-induced odontalgia: a differential diagnosis for dental pain". J Endod 36 (9): 1588–92. doi:10.1016/j.joen.2010.05.004. PMID 20728733. http://www.jendodon.com/article/S0099-2399(10)00458-9/abstract. 

External links

• Colgate on dental emergencies