The Management of Common Endodontic Emergencies

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KEY TAKEAWAYS:

• General practitioners average 230 emergency patients per year, and an estimated 85% of these arise from pulpal or periapical disease
• By adhering to the S.O.A.P. principle of endodontic diagnosis, the clinician should be able to make a dual diagnosis (pulpal and periradicular)
• The two most common emergency situations are handled in completely different ways.

With many walk-in patients, general practices must be prepared to diagnose and treat a variety of moderately complicated endodontic emergencies. Developing a systematic plan for various common emergencies—either to relieve the patient’s pain immediately or complete the endodontics definitively—will help facilitate the process.

Endodontic specialist Gary Glassman, DDS, shares his treatment action plans for three emergency situations: irreversible pulpitis; a nonvital situation with extreme pain and swelling; and a nonvital situation with pain but without swelling. By adhering to the S.O.A.P. principle of endodontic diagnosis, Glassman explains how the clinician should be able to arrive at the appropriate treatment.