Medical Emergencies in Dentistry: Prevention and Preparation

Why Most Dental Emergencies Do Not Have to Happen

Just as it is true that an emergency may occur in any medical office or hospital, there is always a chance that medical emergencies in dentistry may also happen. Both offices involve surgery, blood, medications, and anesthesia, and this increases the possibility of complications. These conditions can easily result in medical emergencies in the dental office that a dentist and staff should be trained to know how to handle.

Why Preparedness Is Essential

Even if a dentist has never experienced a dental emergency after years of practice, it seems that it is still likely to happen. Out of 4,309 dentists who responded to a survey, there were 30,602 dental emergencies over a 10-year period – an average of 7.5 per dentist. Slightly more than half of these emergencies occurred right after administering anesthesia. 

The same survey discovered that 28 percent of the emergencies took place during root canal therapy. 37 percent of them occurred during extraction. These statistics seem to reveal that medical emergencies in dental practice are more likely to occur when patients have anxiety, fear, or pain in relation to the procedure. 

Because lawsuits abound today for even some of the smallest problems, a dentist is most likely to be prepared to handle emergencies in the office. They know that being unprepared or unequipped is not excusable in a court of law, especially when steps were not taken to become prepared. It is apt to be considered malpractice. 

The Emergency Plan

Dentists know that the best way to be prepared to face an emergency is to start by creating an emergency plan. The plan needs to include four aspects:

  • Seek Prevention
  • Develop a Plan of Action
  • Be Able to Recognize Patient Distress
  • Have Emergency Equipment and Drugs Available.

Some states already require dentists to have some form of emergency plan in writing, especially if they use deep sedation or sleep dentistry. They are required to have and know how to use an automated external defibrillator (AED). This requirement does not apply to those who only use local anesthetics. More states are developing similar laws. 

Preparing for Emergencies

Keeping up with recommended equipment plans and treatment methods for emergencies is very important. All office staff members are trained to recognize and manage emergency situations. This includes running through simulations of emergency events to ensure that staff members are familiar with treatment methods and use of equipment. 

The dental team is aware that the presence of certain medical conditions in patients may raise their propensity for possible emergencies. This can include such conditions as hypertension, angina, seizures, diabetes, bronchospastic disease, and more. The presence of these conditions requires that staff watch them more closely. 

Even though a dental office has the right equipment and drugs on hand, each staff member should be thoroughly trained and familiar with their use. They also need to be trained and certified in Basic Life Support for Healthcare Providers. Knowing who to call must also be understood with lists printed and available for emergency purposes, as well as indicating what information should be provided on the call. 

Careful records are also kept of all training and refresher courses taken by each staff member. Practice sessions are also recorded and the names of all staff that participated in them. 

Equipment Needed

Having the right equipment available enables staff to successfully treat a patient having a medical emergency. The equipment required will vary by state and the type of anesthesia used. An AED that is easily portable enables early defibrillation and can bring an arrhythmia back to normal sinus rhythm. 

The staff is able to provide oxygen from an “E” cylinder that contains more than 600 liters. There will also be an oxygen delivery system that can supply oxygen to patients who are spontaneously breathing and to patients who are unconscious and apneic. 

A blood pressure cuff will also be available in various sizes. Dental offices often have a device that automatically monitors various vital signs. Elevated blood pressure prior to a dental procedure may indicate a possible emergency during a procedure. 

Emergency drug kits are immediately accessible in medical emergencies in the dental office. They know that, when needed, getting drugs into the patient’s body quickly, such as epinephrine, may save a life. They are also aware of the importance of dosages, especially where children are concerned. The staff also watches to ensure that all drugs are up to date and not expired. 

Preventing Emergencies

The best way to help prevent medical emergencies in the dentist’s office is for the staff to understand the patient’s medical condition prior to treatment. This starts with a thorough medical history questionnaire and then goes further by asking specific questions derived from issues stemming from it. Being aware of any drugs that each patient is currently taking to control health conditions is also absolutely necessary to prevent drug interaction. 

Dentists and staff should always be prepared for the possibility of medical emergencies in dentistry. Training should be recent and each staff member should know what to do. When you want a dentist that is prepared for dental emergencies, and will take steps to help prevent them, you want the dental services of Dr. Kumar T. Vadivel, DDS, MS, MBA, FDSRCS, a Board Certified Periodontist. His offices in the Carrollton, Cedar Hill, Mockingbird/SMU, and Grapevine, TX areas provide a wide range of dental treatments for patients of all ages. Most dental insurance plans are accepted. For help with dental emergencies, you can contact his office at 469-470-2546