Table 1.

Treatment Guidelines for Various Emergencies

Diagnosis	Primary management	Secondary management
Symptomatic irreversible pulpitis/ symptomatic apical periodontitis	Pain management:First line:• 400–600 mg ibuprofen + 325–500 mg APAP or• naproxen sodium 220 mg + 500 mg APAP 16, 17, 18Second line:• Dexamethasone 0.07–0.09 mg/kg (19) and• Consideration for supplementation with long-acting local anesthetic - bupivacaine for immediate pain relief (20)	Full pulpotomy 21, 22
Acute apical abscess	Intraoral swelling:Incision and drainage• Augmentin 500 mg/clindamycin 300 mg (23) and• 400–600 mg ibuprofen + 325–500 mg APAP 17, 18, 19 orConsideration for supplementation with long-acting local anesthetic - bupivacaine for immediate pain relief (20)Extraoral swelling:• Augmentin 500 mg/clindamycin 300 mg (23) and• 400–600 mg ibuprofen + 325–500 mg APAP 17, 18, 19	Call Oral Maxillofacial Surgery for further instructions for a possible referral
Avulsion/luxation	If tooth is replanted, follow pain management protocol:Pain management: dosage dependent on ageFirst line: ibuprofen + APAP 17, 18, 19	If tooth is not reimplanted, replant and follow IADT guidelines 24, 25 as best as possible
Tooth fracture resulting in pain	Pain management: dosage dependent on age ibuprofen + APAP 17, 18, 19	Vital pulp therapy 21, 22, 26
Trauma involving facial bones, potentially compromising the patient’s airway	Refer to Oral Maxillofacial Surgery
Cellulitis or a diffuse soft tissue bacterial infection with intraoral or extraoral swelling that potentially compromises the patient’s airway	Refer to Oral Maxillofacial Surgery

IADT, International Association for Dental Traumatology.