Emergencies in dentistry and first aid: guide, first aid kit

Many dentists have had to deal with emergency care in their work. Before starting therapeutic or surgical treatment, the doctor must find out from the patient the presence of chronic diseases and allergic reactions to anesthesia.

If the patient is at risk, then treatment is carried out with the utmost care. In the event of a complication, the dentist must be ready to provide care in case of emergency and have the necessary set of medicines on hand.

Who is at risk

A critical condition is a combination of factors requiring immediate medical attention or hospitalization. The risk group includes people with the following pathologies:

1. Mental disorders, in connection with which it is necessary to take potent drugs (tranquilizers, antidepressants). In this case, other methods of anesthesia are needed.
2. Cardiovascular diseases. The patient must necessarily tell about the drugs taken that affect the state of the blood.
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3. Renal failure - Patients with these conditions are more susceptible to anesthesia.
4. Hyperthyroidism is a pathology of the thyroid gland that can cause bleeding.
5. Pulmonary insufficiency - all dental procedures are carried out for such a patient only in a hospital setting.
6. Allergic reactions on the constituent component of anesthesia. It manifests itself in the form of redness, shortness of breath and anaphylactic shock.
7. Porphyria is a disease of pigment metabolism. Pain relief should only be carried out with the use of an amide anesthetic.

First aid kit in the dental office

The dental office should be equipped with a first aid kit with medications that are used in case of complications. The dental emergency kit contains:

1. Benadryl is an antihistamine that blocks histamine in the body.
2. Antiallergic drug - weakens the negative effect of the drug.
3. A syringe with Epinephrine is a hormone that provokes the production of medulla in the adrenal glands.
4. Aspirin - a non-steroidal drug with analgesic and antipyretic effects.
5. An oxygen cartridge is necessary to restore breathing in the course of its violation.
6. Means with a high sugar content - used in the course of lowering sugar levels in diabetic patients.
7. Nitroglycerin in different forms of release - is used with a sharp increase in intracranial pressure, pulmonary edema, myocardial infarction.
8. Bronchodilators - applied to patients with asthma and bronchospasm.

Every dentist must have the skills to provide emergency care.

Emergencies and first aid

Dentist interventions, like any others, can provoke an exacerbation of diseases that are classified into:

• not iatrogenic - they can develop on their own, that is, without the fault of a specialist;
• iatrogenic - associated with the wrong actions of the doctor.

The table describes the main conditions in which urgent help is needed.

Emergencies and symptoms	First aid	Effects
Fainting: pallor; violation of consciousness; weakness; a sharp drop in blood pressure.	Tilting the upper body to the lower - this helps to improve blood circulation. Bring a tampon soaked in ammonia to your nose. Take Validol.	A slight fainting remains without consequences, but in order to avoid global health problems, you can be examined. Prolonged unconsciousness can lead to: memory impairment; sinking of the tongue; coma.
Convulsions: loss of consciousness; hallucinations; movement disorders.	Lay the patient down, put a roller under the shoulder blades. Fix the tongue. Inject Relanium intravenously and Prednisolone.	Establishing a diagnosis of epilepsy. Increased seizures.
Hypertensive crisis: headache; pallor; nausea; fever.	Nifedipine under the tongue. Lasix intravenously. Calling a medical team.	Small vessel spasm. Disruption of the work of internal organs.
Quincke's edema: barking cough; swelling of the mucous membrane; cyanosis.	Calling an ambulance. The horizontal position of the patient with a cushion under the neck. Inject Adrenaline and Diphenhydramine. With increasing suffocation, a puncture of the trachea is necessary.	abdominal pain; cystitis; death.
Myocardial infarction: painful sensations lasting 10 minutes, radiating to the left arm and lower jaw; lack of positive effects of nitroglycerin; a sharp decrease in the level of pressure.	Complete rest in a horizontal position. Nitroglycerin every 2 minutes. Introduce Fentanyl and Lidocaine intravenously.	thrombosis; pulmonary edema.
Coma: tremor; the smell of acetone in the mouth, but it may be absent; loss of consciousness.	May be caused by an increase in blood sugar levels, or vice versa. Actions depend on the diagnosis. With hyperglycemic coma, urgent hospitalization is indicated. In hypoglycemic coma, urgent intravenous glucose is required.	Inability to move and speak. Decreased alertness. Lethargy.
Anaphylactic shock is a complex allergic reaction: violation of the rhythm of breathing; vomiting and nausea; a sharp drop in pressure; lack of pulse; itching.	Remove the allergen. Inject Adrenaline. Apply a drug to increase blood pressure. Introduce antihistamines and anticonvulsants.	Violation of the internal organs. Death.
Clinical death: loss of consciousness for a long time; lack of pulse; lack of eye reaction to light	Call an ambulance. Put the patient in a horizontal position. Remove clothing from the chest. Make a heart massage in conjunction with a set of measures for starting breathing through the lungs.	Depends on the amount of time spent unconscious: If less than 4 minutes, then there will be no consequences. Otherwise, loss of vital functions and death.

Other conditions requiring urgent care:

1. Risk of miscarriage. Symptoms include: dizziness, lower abdominal pain, discharge. The only help will be lying in a horizontal position with ice on the stomach and urgent hospitalization in the gynecological department.
2. Asthma, symptoms of which are choking with wheezing, itching in the nose, loss of consciousness. Help: remove the allergen as much as possible, open windows and doors, unfasten clothes. Introduce: intravenous Euphyllin, intramuscularly Prednisolone.
3. Angina is accompanied by pain and sudden feelings of anxiety and fear. The painful sensations radiating to the shoulder blade last for 15 minutes before taking the medicine. Help: taking Nitroglycerin, access to oxygen. If taking the drug did not help, it is necessary to inject Analgin and saline intravenously.
4. Bleeding. Signs: multiple bleeding after injection. Tactics of action: intravenous injection of plasma, put a tampon in the wound, inject calcium chloride intravenously.
5. Collapse is a short-term loss of vascular tone. Symptoms are lack of oxygen, weakness, increased heart rate. Actions: lay the patient down, legs should be much higher than the head; inject drugs that contribute to vasoconstriction; monitor blood pressure and pulse.

The dosage of medicines is determined by the doctor, it depends on the initial condition, weight and age.

When an emergency dental treatment is required

Emergency dental care is required if:

1. Swollen gums next to a tooth - this can lead to gingivitis, mechanical injury.
2. Mouth ulcers. They can be caused by various infections that need to be treated once diagnosed.
3. Chipped tooth or loss of filling. Failure to provide assistance in time can lead to hypersensitivity and tooth decay.

A dental emergency is important in other cases:

• fistulaformed in the gum;
• acute toothache;
• bleeding gums.

When visiting the dentist, you need to immediately tell about the medicines that you are currently taking, as well as the dosage. If you are currently experiencing a headache, nosebleed, you also need to notify the doctor about this. This will reduce the risk of developing critical conditions.

At the reception, you should inquire about the availability of funds for first aid in case of deterioration. The further state of human health, and in some cases even life, depends on the timely provision of assistance to the patient.