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Dental Pain

Author
Zack Olson, MD
Published
Sun 15 Jan 2017
Episode Link
https://emclerkship.blubrry.net/2017/01/15/dental-pain/




Minor complaint. Huge SLOE points!











Step 1: Identify Which Tooth is Causing Pain











* Bonus points if you number teeth correctly!* Number 1-32* Tooth #1 is top right* Tooth #32 is bottom right* Refer to dental chart for reference











Step 2: Correct Terminology When Making Diagnosis











* Pulpitis* Pain in the tooth itself* Reversible* Triggered by hot/cold etc (then goes away)* Irreversible* Does not resolve* Gingivitis* Pain of the gingiva around the tooth* Periapical abscess* Pain with percussion of tooth











Step 3: Give Pain Medicine











* NSAIDS have been shown to work best* Naproxen* Ibuprofen* Opiates for breakthrough pain* Hydrocodone-acetaminophen (Norco)* Oxycodone-acetaminophen (Percocet)











Step 4: Consider Antibiotics











* Pulpitis does not require antibiotics* Gingivitis/Periapical abscess frequently improve on antibiotics* Penicillin VK











Step 5: Inferior Alveolar Nerve Block











* Watch HERE











Additional Reading











* Inferior Alveolar Nerve Block (YouTube)* Common Dental Emergencies (AFP)

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