In dental practice, there is a risk of dental medical emergencies (DMEs), which are critical and unexpected events that compromise a patient’s health during dental care in the treatment room.
In the study by Müller et al., 620 surveys conducted with dentists were analyzed to assess the number of DMEs they encountered in their professional practice.
Of these, 57% (353) reported facing at least three DMEs in a year, while 36%
(223) experienced up to ten DMEs.
The most common DMEs described in scientific literature, ranked by frequency, are:
✔ Vasovagal Syncope
✔ Hypertensive Crisis
✔ Allergic Reaction/Anaphylaxis
✔ Angina Pectoris
✔ Postural Hypotension
✔ Convulsions
✔ Bronchospasm
✔ Hyperventilation
✔ Hypoglycemia
✔ Cardiac Arrest
✔ Acute Myocardial Infarction
✔ Local Anesthesia Overdose
✔ Hyperglycemic Crisis
✔ Cerebrovascular Accident
When a DME occurs, dentists must have the knowledge and skills to resolve them.
According to Lawson et al. a lack of theoretical knowledge will hinder the practical performance of each DME, potentially increasing patient morbidity and mortality.
DMEs may have both unique and shared characteristics, which is why accurate assessment and effective diagnosis will allow a better approach to the emergency and its treatment.
In case
of a DME, the initial measure is to suspend dental care immediately and to seek immediate medical attention.
Provisionally, there are some initial actions that the dentist should be aware of, as well as having some of the necessary supplies for a first response.
► DENTAL BOOK: Little and Falace's Dental Management of the Medically Compromised Patient – 10th Edition (2023)
However, the best way to deal with this type of event is prevention, by performing a complete preoperative clinical evaluation to
define the patient’s risk and thus prevent a possible DME.
This paper describes the most frequent DMEs, the procedures, supplies and actions required by the dentist for initial management, resolution and, if necessary, referral to a hospital center.
