Emergency dental treatment by a physician is sometimes required when a dentist is unavailable to treat the following conditions:
Postextraction problems (eg, bleeding, swelling and pain, alveolitis and osteomyelitis, and osteonecrosis of the jaw [ONJ])
Analgesia and treatment of infection
Prophylactic antibiotics
For prevention of infective endocarditis, the 2021 American Dental Association guidelines (2), as well as the American Heart Association (3), recommend prophylactic antibiotics in patients undergoing dental procedures only for patients with
Prosthetic cardiac valves, including transcatheter-implanted prostheses or with prosthetic material used for valve repair
Previous infective endocarditis
Specific congenital heart diseases
Cardiac transplant recipients with heart valve problems (valvulopathy)
For patients with prosthetic joint implants, the American Dental Association 2021guidelines (2) state that prophylactic antibiotics are not typically recommended but may be considered for patients with
Immunocompromised state
Uncontrolled diabetes
Past joint infection
Recent joint placement
Dental procedures requiring prophylaxis are those that require manipulation or perforation of gingival or oral mucosa or that involve the root end area of the teeth (ie, those most likely to cause bacteremia
References
1. Lockhart PB, Tampi MP, Abt E, et al: Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling: A report from the American Dental Association. J Am Dent Assoc 150(11):906-921.e12, 2019. doi: 10.1016/j.adaj.2019.08.020
2. American Dental Association (ADA) Science and Research Institute, LLC: Antibiotic Prophylaxis Prior to Dental Procedures. Accessed September 15, 2022. https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/antibiotic-prophylaxis.
3. Wilson WR, Gewitz M, Lockhart PB, et al: Prevention of viridans group streptocococcal infective endocarditis: A scientific statement from the American Heart Association. Circulation 143(20):e963-978, 2021. DOI: 10.1161/CIR.0000000000000969