Page 220 - ATP-P 11th Ed

DENTAL PAIN PROTOCOL

SPECIAL CONSIDERATIONS
1. Most common causes are deep decay, fractures of tooth crown/root, acute peri-
apical (root end) abscesses, or pericornitis (pain associated with an impacted
wisdom tooth).
2. If tooth pain occurs during flight, consider barodontalgia and refer to the
SECTION 2 Signs and Symptoms
Barotrauma Protocol.

1. Intermittent or continuous pain (usually intense), heat or cold sensitivity
2. Visibly broken/cracked tooth
3. Severe pain on percussion
4. Intraoral swelling/abscess
5. Partially erupted wisdom tooth
6. Lost filling
Management
1. Treat per Pain Management Protocol.
2. If signs and symptoms of infection are present, administer amoxicillin/clavulanic
®
®
acid (Augmentin ) 875mg PO bid for 7 days OR azithromycin (Zithromax ) Z-PAK
®
500mg PO initially followed by 250mg PO daily × 4 days.
3. If gums appear swollen and red, encourage increased oral hygiene and warm saline
rinses bid.
4. If filling is lost, consider temporary filling/patch.
Disposition
1. Evacuation usually not necessary.
2. Routine evacuation if not responding to therapy.

210 SECTION 2 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) ATP-P Handbook 11th Edition 211