From the Guidelines
When experiencing dental pain, it's crucial to watch for signs of airway emergencies, such as severe swelling, difficulty swallowing, and breathing difficulties, which require immediate medical attention. These symptoms can indicate a serious infection that may compromise breathing, and prompt recognition and treatment are essential for preventing life-threatening complications.
Key Symptoms to Look Out For
- Severe facial or neck swelling, especially if it's spreading rapidly
- Difficulty swallowing, muffled voice, drooling, or the feeling that your throat is closing
- Breathing difficulties, including rapid breathing, shortness of breath, or the need to sit upright to breathe
- High fever (above 101°F/38.3°C) accompanying dental pain
- Trismus (inability to fully open the mouth) These symptoms represent medical emergencies requiring immediate hospital evaluation, typically in an emergency department, as they may necessitate urgent airway management, IV antibiotics, and possibly surgical drainage, as noted in the management of oropharyngeal and laryngeal attacks 1. Dental infections can spread rapidly through the fascial planes of the neck and face, potentially obstructing the airway within hours.
Importance of Prompt Medical Attention
The management of oropharyngeal and laryngeal attacks is primarily focused on maintaining the patency of the airway, and patients experiencing these symptoms should be observed in a medical facility that can perform intubation or tracheostomy should it become necessary 1. Elective intubation should be considered if the patient exhibits signs and symptoms of impending airway closure, and immediate availability of backup tracheostomy is necessary in case the intubation is not successful 1.
From the Research
Airway Emergencies in Dental Pain
When someone has dental pain, there are several concerning things to look out for in terms of airway emergencies. These include:
- Upper airway obstruction, which can be caused by the tongue, edema of the oropharynx and larynx, trauma, foreign body, or infection 2
- Partial airway obstruction due to lingual tonsillar hypertrophy, which can cause dysphagia, odynophagia, muffled voice, and neck swelling 3
- Difficult intubation or conditions associated with difficult airway, which require organized primary and secondary plans for airway management 4
Signs and Symptoms
Signs and symptoms of airway emergencies in dental pain may include:
- Shortness of breath
- Dysphagia (difficulty swallowing)
- Odynophagia (painful swallowing)
- Muffled voice
- Neck swelling
- Rapid and potentially life-threatening hypoxia if left untreated 3
Management
Management of airway emergencies in dental pain depends on the cause of the obstruction and the training and skills of the rescuer. Simple protocols can be presented for the treatment of common respiratory emergencies 5. In some cases, intubation may be necessary, and the choice of technique depends on the experience and skills of the rescuing physician or paramedic 2. Advanced airway management techniques and equipment may also be necessary to improve patient safety 4.