Pharmacology for Dentistry

Pharmacotherapy of Common Oral Conditions and Dental Emergencies 427

pulp are often painful and immediately
require referral to a dentist and definitive
treatment may involve root canal treatment
or extraction depending on the exact nature
of the root fracture.

Injuries to teeth and their supporting
structures can be classified as fractures.

(i) Lateral or extrusive (loosening and

displacement of the tooth)- It requires

immediate referral to dentist. Luxated

permanent teeth require repositioning,

splinting or root canal treatment and

long term follow up. Any luxated

tooth that interferes with normal

occlusion requires immediate dental

evaluation and treatment for pain and

other complications.

(ii) Instrusion (displacement of the tooth

vertically into the alveolar bone)-

Teeth subject to intrusive luxation

have been intruded into the alveolar

bone, which may occur at the point

that the teeth are not visible. Dental

referral is required for monitoring to

determine if the teeth will re-erupt. For

permanent teeth, monitoring and

treatment is required to promote re-

eruption (surgical or orthodontic) and

often coupled with root canal

treatment.

(iii) Avulsion (complete displacement of

the tooth out of its socket- It is a true

dental emergency. Primary teeth are

never implanted. Permanent teeth

that are avulsed should be

reimplanted as soon as possible and

care should be taken not to touch or

clean the root, which could remove

periodontal ligament fibres and

which ultimately reduce the chance

of successful re-implantation. The

patient should be immediately

referred to dentist for splinting and

antibiotic prophylaxis. Antibiotic

prophylaxis with penicillin should be

given and tetanus toxoid vaccine

should be administered

Dental caries and peridontal disease

which can lead to certain dental

emergencies can be minimised by regular

dental care i.e. regular tooth brushing,

appropriate fluoride use, decreasing

ingestion of sugar containing confectionery

items and regular dental examination.

Dental trauma especially in children and

sport persons can be avoided by using

certain mouth guards and face shields.