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Oral Health Topics

Medical Emergencies in the Dental Office

Introduction

A medical emergency in the dental office may be an unexpected event that can include accidental or willful bodily injury, central nervous system stimulation and depression, respiratory and circulatory disturbances, as well as allergic reactions.

Dentists, through their academic, clinical and continuing education, should be familiar with the prevention, diagnosis, and management of common emergencies. In addition, they should provide appropriate training to their staff so that each person knows what to do and can act promptly. Since these skills are not used every day, regular review is necessary: at least annually but preferably more often. Conducting mock emergencies may help office staff to be more confident with their roles when a real emergency occurs. As a result, dentists and their staff should be prepared to recognize, respond and effectively manage a medical emergency.

The components of a sound medical emergency plan for the dental office should include:

  • Medical emergency prevention
  • Development of an action plan
  • Recognizing a patient’s distress and management of medical emergencies
  • Emergency drugs and equipment

Some states may require that dentists have emergency drugs and equipment. For example, in 2010 Illinois became the first state to enact a law requiring dental offices that administer deep sedation to not only have an automated external defibrillator (AED) available, but also a written medical emergency plan. This new law does not apply to practices that use local anesthetics for routine dental care. However, many states require dentists, whether they administer general anesthesia or deep sedation, to have an AED available. For more information about the safety requirements in your state, consult with your state dental association and/or your state’s board of dental practice.

In the following sections, you will find information on recognizing, responding and effectively managing medical emergencies, as well as preventive preparation. New information and resources will be added to this area as they become available.

The Journal of the American Dental Association

ADA Resources

ADA CE Online

  • Emergency Medicine: a multi-part program that discusses common medical emergencies in the dental office, including ways to prevent, prepare, and manage their occurrence. 
    • Part 1: Prevention. Preparation of the office and staff for medical emergencies is discussed in this course. Basic life support; an in-office emergency response team; activating emergency medical services; and emergency drugs & equipment are reviewed.
    • Part 2: Preparation. This course describes the most common medical emergencies occurring in the dental environment and describes the steps necessary to prevent their occurrence.
    • Part 3: Basic Management. This course reviews the basic management protocol for all medical emergencies occurring in the dental office environment –P-C-A-B-D (Positioning – Circulation – Airway – Breathing – Definitive Care). 
    • Part 4: Altered Consciousness. Syncope, hypoglycemia and seizures are not uncommon emergencies in the dental office. This program reviews the prevention, recognition and management of these common causes of altered consciousness.
  • Additional courses on specific emergencies are also available, including: respiratory distress, drug allergies or overdoses, chest pain, and cardiac arrest.

Boards of Dentistry

Contact information for the 53 state and territorial dental licensing boards may be found here

Additional Resources