Page 110 - PJ MED OPS Handbook 8th Ed
P. 110
Dental Pain
SPECIAL CONSIDERATIONS:
1. Most common causes are deep decay, fractures of tooth crown/root, acute periapical
(root end) abscesses, or pericoronitis (pain associated with an impacted wisdom tooth).
2. If tooth pain occurs during flight, consider barodontalgia and refer to the Barotrauma
Protocol.
Signs and Symptoms:
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 (Aug-
mentin) 875mg PO bid for 7 days OR azithromycin. (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.
108 n Pararescue Medical Operations Handbook / 8th Edition
