Medical emergencies in the dental office can be a frightening experience for both patients and dental professionals. Syncopy, or fainting, is by far the most common medical emergency seen in dentistry, affecting more than 60% of patients. Myocardial infarction, or heart attack, is also common and requires immediate care, particularly during and after local anesthesia, such as during tooth extraction and endodontics. The body's response to stress can cause a buildup of blood in the extremities, a physiological process known as the fight or flight response.
However, this buildup of blood is not helpful when a person is in the dental chair due to their position and lack of mobility. This can lead to syncope, or fainting. If a dental professional suspects that a patient has presyncope, they should immediately and calmly place the patient in the Trendelenburg position with their head below their heart and feet raised 10 to 15 degrees. Once the patient recovers, it is recommended to monitor them before discharge.
In many cases, it is wise to have a friend or family member take the patient home and monitor them until they return to normal. The dental office staff should also be familiar with all emergency medical equipment, supplies, and medications found in the emergency kit. It is also important that all personnel know the procedures to be followed in an emergency situation and are able to provide basic life support (BLS). Prevention of medical emergencies should be the primary objective for any dental office.
However, it is nearly impossible to predict and prevent all emergency scenarios. Therefore, effective emergency management requires a team approach with everyone playing an important role during an emergency. If opioids are used as part of a sedation regimen, naloxen must also be present for emergency treatment of an involuntary overdose.
