Emergency dentistry

[Perrotfish]

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Did anyone here have a good rotation to learn the basics of emergency dentistry (pulling teeth, etc)? Or was that all on the job learning for you guys?

 

[WilcoWorld]

Yes, but I learned blocks, putting putty on fractured teeth and abscess drainage. I do not pull teeth in the ED.

 

[alpinism]

Dental complaints get a nerve block and pain meds and are then promptly discharged with dental follow up instructions.

 

[Rendar5]

Only dental procedures within our scope of practice are nerve blocks, splinting subluxed teeth ( I don’t know anybody who does that), sealing of fractured teeth, and incision of obvious dental abscesses.
Pulling teeth is well outside our scope of practice

 

[tkim]

Only dental procedures within our scope of practice are nerve blocks, splinting subluxed teeth ( I don’t know anybody who does that), sealing of fractured teeth, and incision of obvious dental abscesses.
Pulling teeth is well outside our scope of practice

My residency I pulled teeth in our two week dental rotation. I actually was going to do that in practice in rural Maine, but my wife put her foot down on hot and cold running moose, so I never got to do it.

 

[CajunMedic]

, splinting subluxed teeth ( I don’t know anybody who does that

Learned that on an EM rotation in OKC. Little dermabond and the metal strip off a non-rebreather or out of a surgical mask does the trick

 

[tkim]

Learned that on an EM rotation in OKC. Little dermabond and the metal strip off a non-rebreather or out of a surgical mask does the trick

Did this couple months ago.

 

[BJJVP]

I have tried this but I was unsuccessful. I had a very tough time getting the metal piece to adhere to the tooth, even with drying and using dermabond. Am I missing a crucial step? Any tricks or tips?

 

[TooMuchResearch]

Learned that on an EM rotation in OKC. Little dermabond and the metal strip off a non-rebreather or out of a surgical mask does the trick

They do better if you use 0 silk suture. Try multiple pieces together. The less stiff splint allows for better healing.

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[TooMuchResearch]

I have tried this but I was unsuccessful. I had a very tough time getting the metal piece to adhere to the tooth, even with drying and using dermabond. Am I missing a crucial step? Any tricks or tips?

Do you have a dental box/cart, and does it have those little abrasive stick things to help scuff up the tooth first? Gives the adhesive something to grab.

If your department has a dental cement of some kind, sometimes the dentist will leave the ED splint on for weeks as the permanent splint, at least that's what the one I asked said.

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[shoal007]

I have tried this but I was unsuccessful. I had a very tough time getting the metal piece to adhere to the tooth, even with drying and using dermabond. Am I missing a crucial step? Any tricks or tips?

You have to get the teeth very dry. Use a nasal cannal with the O2 cranked way up to dry it out before dermabond placement then during adherience. You may need an extra hand to help.

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[d2305]

Stopping the bleeding after a tooth extraction could be a problem. Best to refer to dental (who won't see them without payment).

 

[bravotwozero]

If your department doesn't have a dental box, i highly recommend taking to your director to get one. www.dentalbox.com Has a great kit with videos on how to use it, and has materials for making splints and sealing fractured teeth.