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Odontalgia
MICHAEL T. SCHULTZ AND MICHAEL S. RUNYON
n Agents
n NSAIDs
n Opioids
n Acetaminophen
n Local anesthetics
n Eugenol
n Vitamin C
n Evidence
Patients with odontogenic pain (OP) represent a broad spectrum of both
disease etiology and severity. From the infant with teething to the older
patient with denture-related OP, cases of tooth-related discomfort require
an individualized approach, tailored to the patient and the diagnosis. This
chapter does not attempt to assess all of the symptomatic therapies for all of
the potential causes of OP. Instead, the goal is to overview the most important
systemic, parenteral, and topical analgesic choices available to the acute care
provider trying to relieve OP. The use and applicability of the three pharmacologic
approaches for OP is sufficiently variable that the chapter is divided
into three subsections: systemic, local injection, and topical therapy.
Regardless of the analgesic modality selected, ED relief of OP is usually
provided with the understanding that acute care is intended only as a bridge
to appropriate dental follow-up.
SYSTEMIC ANALGESICS
NSAIDs are among the most widely used and well-studied drug classes used
in management of acute and chronic OP, or odontalgia. 1 Data demonstrate
superiority of NSAIDs over most other approaches for OP. For post-extraction