According to a survey, 22% of the population
in a period of six months is affected by dental emergencies.
This proves that dental emergencies are very common in the United
States. Dental emergencies are of mostly dental rather than non-dental
Dental emergencies can be because of carious, periodontal, wisdom
tooth and dental trauma causes. It is advised to see the dentist
immediately on each dental emergency case.
Carious origins of dental emergencies
Bacterial attack on the teeth can cause dental caries. It does
not show any symptom until the patient feels the pain when the
illness reaches the inner tissues and causes inflammation.
Inflammation of the inner tissues or pulp is called reversible
pulpitis. It is a dental emergency where hot, cold and sweet
stimuli cause temporary pain lasting for a few seconds. Immediate
treatment should be done because this may lead to complications
such as periapical abscess and cellulitis if treatment is not
implemented. Treatment may include removing of affected cloth
and restoration or filling.
Severe inflammation on the tissues or pulp that is caused by
untreated reversible pulpitis is called irreversible pulpitis.
Pain is usually worse, impulsive and continuous, and persistent
and is not centralized. The only options to treat the disease
are root canal treatment where infected tissues of pulp id removed
and empty pulp chamber is filled or tooth removal. It is upon
the level of pain to determine the urgency of dental examination,
which will be managed until the examination by appropriate implementation
of analgesias, or a weak opoid combined with analgesia or acetaminophen.
In this phase periapical abscess and cellulites may also develop
if remained untreated for a long period of time.
When an acutely affected tissue develops into inflammation around
the apex of the tooth, apical abscess will develop. Pain is intense,
impulsive and relentless, but contained only on the affected
tooth. Teeth are sensitive to beating with metal things. The
patient must visit the dentist if there’s inflammation
or increase of infection. Apical abscess needs antibiotics simply
if cellulitis develops. The last treatment is root canal treatment
When apical abscess infects the surrounding tissues, cellulitis
develops. Painful inflammation of the tissue occurs. If the infection
reaches into major fascial spaces of the head or neck it can
be life threatening, carrying the risk of airway compromise.
In worse cases where the periorbital area is affected, the patient’s
vision and the central nervous system is threatened.
The first examination is done to see if the cellulites is localized
or has spread. Outpatient treatment with oral penicillin, erythromycin
or clindamycin is given if cellulitis is localized. The ultimate
therapy is root canal treatment or tooth removal. Otherwise,
the condition requires hospitalization where imaging, scanning,
and drainage (if abscess is detected) will mandatory. Intravenous
broad spectrum antibiotics are immediately administered.
Treatment of caries in the primary and permanent teeth is done
on the same manner. The systemic effects are more common in children
with rapid rise in temperature, higher threat of dehydration,
and rapid spread of infection.
Periodontal origin of dental emergencies
Periodontal disease is swelling and damaging of the periodontal
ligaments and the cavity bone by bacterial plaque. Severe periodontal
abscess is common in patients having chronic periodontal disease
or in patients having a foreign object stuck in the gingival.
Symptoms include throbbing pain with erythema and inflammation
of the affected tissue. The abscess may break if left untreated,
or less likely develop into cellulitis.
Wisdom tooth origin of dental emergencies
The inflammation of the pulp around the crown of frequently
partially erupted wisdom teeth is called pericoronitis. It
happens when food fragments collect under the flap of the gum
covering the partly erupted tooth. Inflammatory edema secrets
pus can cause pain and bad taste in the mouth. Cellulitis and
inability to open the mouth can occur. Oral airway can be compromised
in worse cases.
In most cases, localized pericotonotis can be treated by warm
salty mouthwashes and irrigation below the flap. The acute non-localized
cases may require penicillin and pain treatments, and surgery
to eliminate the flap.
Trauma origin of dental emergencies
Dental trauma is very frequent and more likely to affect children.
Tooth injury caused by dental trauma is divided mainly into three
types. Broken tooth results to these tooth fracture. Tooth luxation
results to loose tooth and tooth avulsion results to missing
tooth. All traumatized teeth require extensive care to avoid
The crown and/or root with or without tissue or pulp exposure
are involved in tooth fractures. Fractures involving the enamel
and little amounts of dentine are not serious. But urgent dental
examination is required when pulp is involved that may cause
pain. For detection, radiography is often used.
Loose teeth that are primary are extracted. But permanent loose
teeth require repositioning, splinting or root canal treatment.
Any permanent loose tooth requires immediate examination to avoid
pain and later complication.
Missing teeth are a true dental emergency. Re-implantation should
be done as soon as possible when missing permanent teeth. Losing
primary teeth is natural.