From the Research
The treatment for an active dental crown flare typically involves addressing both the inflammation and any underlying infection, with a focus on scheduling an appointment with a dentist as soon as possible to adjust the crown fit, treat any underlying infection, or address other issues causing the flare-up, as recommended by the American Dental Association in their 2019 evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling 1. In managing the symptoms, patients can take over-the-counter pain relievers such as ibuprofen (400-600mg every 6 hours) or acetaminophen (500-1000mg every 6 hours) to manage pain and reduce inflammation. Rinsing with warm salt water (1/2 teaspoon salt in 8 ounces of water) 3-4 times daily can help reduce bacteria and soothe the area. Applying a cold compress to the outside of the face for 15 minutes on, 15 minutes off can reduce swelling. It's also advisable to avoid hot, cold, sweet, or acidic foods that may trigger sensitivity. The decision to prescribe antibiotics should be based on the presence of systemic involvement due to the dental condition or a high risk of experiencing progression to systemic involvement, as suggested by the expert panel in the 2019 guideline 1. If antibiotics are necessary, options may include amoxicillin or clindamycin, considering the susceptibility of common microorganisms such as Enterococcus, Streptococcus, Aerococcus, and Clostridium, as identified in a 2021 study on root canal microorganisms and their antibiotic susceptibility 2. However, the use of antibiotics should be judicious, given the potential for negligible benefits and large harms, as highlighted in the guideline 1. Key considerations in treating an active dental crown flare include:
- Scheduling a prompt dental appointment to address the underlying cause
- Managing symptoms with over-the-counter pain relievers and warm salt water rinses
- Avoiding triggers of sensitivity
- Judicious use of antibiotics based on systemic involvement or high risk of progression
- Considering the antimicrobial efficacy of different antibiotics, such as clindamycin, as studied in a 2019 in vitro study comparing its effectiveness with triple antibiotic paste 3.