Assoc. Prof. (Dr) Rashidi Ahmad
Dept. of Emergency Medicine
Common dental emergencies – What? When?
How? Where? Who?.
Basic approach to dental emergencies
Factors increasing risk during dental
Increased number of older patients
Medical advances – drug therapy, surgical
Increased drug use – LA, sedatives,
Most emergency situations: potentially life threatening BUT death
8 deaths a/w GA in a 20-year period
(1 death in every 673,000 GA administration)
Lytle JJ, Stamper EP: The 1988 anesthesia survey of the Southern
California Society of Oral Surgeons, J Oral Surg 32:739. 1974
“10% of all non-accidental deaths are classified as sudden,
unexpected death & unpreventable.”
McCarthy EM. J Am Dent Assoc. 1971 83:1091
Is the heart beating?
Is there serious external bleeding?
Does patient have radial pulse?
Absent radial = systolic BP < 80
Does patient have carotid pulse?
Absent carotid = systolic BP < 60
Serious oral bleeding?
Clear the airway/suction
Treat the cause/stop the bleeding – bone wax, stitches
GXM – blood transfusion
Is patient perfusing?
Cool, pale, moist skin = shock UPO
Capillary refill > 2 sec = shock UPO
Restlessness, anxiety, combativeness = shock