Overview of Dental Emergencies

Oral analgesics

Antibiotics for dental infections

Clostridium difficile

1).

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

1. 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. 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. 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