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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

Additional Reading

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