Highland EM - February 20, 2016
"Dental pain is hard to argue with. A rotten tooth is crazy painful and emergency clinicians want to help their patients get out of pain. But, too many of us have been trained to equate compassionate pain treatment with opioids like the omnipresent Norco (hydrocodone).
Lets fix this....
Beyond opioids emergency treatment of dental pain
STEP I.
Dental Block with bupivicaine
STEP 2.
Dexamethasone 4 mg sub cutaneous near hurting tooth or 8mg IM systemic.
STEP 3.
NSAIDs: Ibuprofen 400-600 mg + Acetaminophen 1000 mg Q 6 hours
STEP 4.
Acute dose gabapentin /pregabalin"