Acute dental pain II: pulpal and periapical pain

Abstract

Acute dental pain most often occurs in relation to inflammatory conditions in the dental pulp or in the periradicular tissues surrounding a tooth, but it is not always easy to reach a diagnose and determine what treatment to perform. The anamnesis and the clinical examination provide valuable information, and a systematic ap- proach is necessary. This paper will focus on diagnosis and treat- ment of pulpitis, pulp necrosis and apical periodontitis, periodontal abscess and endo- dontic-periodontal lesions, pericoronitis and post-operative problems. When the patient seeks the dentist suffering from acute dental pain, they expect that the dentist starts treatment at once and that the treatment should provide pain relief. In this situation many patients are fragile, anxious and nervous. If the dentist is able to manage emergency treatment of acute dental pain this will build confidence and trust between patient and dentist. often the dentist does not have sufficient time to carry out more time- consuming procedures. This paper provides a guide for rational emergency treatments. It describes how or whether the entire treatment or a less time-consuming pain relieving proce- dure should be carried out. The administration of local anaesthesia, the role of antibiotics and analgesics is discussed.