Medical emergencies in the dental office

OBJECTIVES. To review the factors that can provoke medical emergencies in patients undergoing dental procedures and to identify appropriate measures for managing patients at risk for such events before, during, and after treatment. MATERIALS AND METHODS. Dentists are frequently faced with patients suffering from systemic diseases that can be associated with medical emergencies. The risk of such events is also conditioned by factors related to dental procedures themselves, including local anesthesia, stress, and pain. This article examines measures designed to reduce this risk, the importance of a complete history in identifying true high-risk patients, and methods that can be used to control pain and anxiety, with emphasis on the most appropriate types of local anesthesia for various procedures. RESULTS AND CONCLUSIONS. Protocols are provided for the management of medical emergencies, with emphasis on the maneuvers and drugs that can be used in dentist's office and on the importance of early requests for hospitalization in emergency situations characterized by high risk.