| Volume 30 | NumBeR 3 | JuNe 2007
medical management of dental and oral pain
Paul V Abbott, Professor, Clinical Dentistry, Head, School of Dentistry, Director, Oral
Health Centre of Western Australia, and Deputy Dean, Faculty of Medicine, Dentistry
and Health Sciences, The University of Western Australia, Perth
Patients may consult medical practitioners
because of painful dental or oral conditions.
medical practitioners need to be aware of
common dental and oral diseases in order
to manage the patient's pain, but it is even
more important to encourage the patient to
see a dentist. Typically there is an underlying
disease that must be managed by dental or
surgical means rather than medication alone.
Pain-relieving drugs are considered to be an
adjunct to dental treatment rather than a
'first-line' approach. When drugs are needed,
anti-inflammatory drugs are appropriate as most
dental pain is caused by inflammation. Antibiotics
are not necessary in many cases.
Key words: antibiotics, anti-inflammatory drugs, dental pain,
(Aust Prescr 2007;30:77–9)
Patients will sometimes present to medical practitioners for the
management of pain or other dental and oral problems.1,2 There
are several reasons why patients may seek medical assistance
rather than going to a dentist. These reasons include:
n	 the lack of timely access to a dentist – especially in rural and
n	 dentists are not always available, particularly for 'after-hours'
n	 the cost of dental treatment
n	 a fear of pain associated with dental treatment
n	 trauma to the face, mouth, teeth
n	 ignorance or a lack of knowledge about the role of dentists
and the scope of dental practice – especially regarding the
management of soft tissue problems and infections
n	 not realising their problem has a dental or oral origin
n	 drug dependent patients seeking opioids.
The majority of medical practitioners have little, or no, formal
training in the diagnosis and managemen