Dental Problems




  • Age
  • Past medical history
  • Medications
  • Onset of pain / injury
  • Trauma with "knocked out" tooth
  • Location of tooth
  • Whole vs. partial tooth injury


Signs and Symptoms


  • Bleeding
  • Pain
  • Fever
  • Swelling
  • Tooth missing or fractured




  • Decay
  • Infection
  • Fracture
  • Avulsion
  • Abscess
  • Facial cellulitis
  • Impacted tooth (wisdom)
  • TMJ syndrome
  • Myocardial infarction


Universal Patient Care Protocol


  • Control bleeding with pressure


Tooth Avulsion ?


  • Yes


    • Place tooth back in socket if feasible.
    • Secure to surrounding teeth with tape


  • No (not feasible)


    • Place tooth in milk or normal saline



    • Reassess and Monitor


  • Notify Destination or Contact Medical Control




  • Recommended Exam: Mental Status, HEENT, Neck, Chest, Lungs, Neuro
  • Significant soft tissue swelling to the face or oral cavity can represent a cellulitis or abscess.
  • Scene and transport times should be minimized in complete tooth avulsions. Reimplantation is possible within 4 hours if the tooth is properly cared for.
  • All tooth disorders typically need antibiotic coverage in addition to pain control.
  • Occasionally cardiac chest pain can radiate to the jaw.
  • All pain associated with teeth should be associated with a tooth which is tender to tapping or touch (or sensitivity to cold or hot)
  • DO NOT replace tooth if:
    • obtunded patient
    • Spinal Immobilization
    • AMS
    • Multiple Teeth missing