Emergency pain management of untreated pulpitis during COVID-19 lockdown
by telephonic communication.
Abstract
To evaluate the beneficial effects of orally administered
corticosteroids in alleviating the pain of symptomatic pulpitis.
Methods: . Out of the 87 patients who contacted expert panel
telephonically during the period of COVID-19 lockdown , 55 patients
complaining of moderate to severe dental pain were included in the study
and thus advised to take oral tablets of paracetamol 650 mg post-meal
thrice a day for 3-5 days along with a single oral dose of 4mg of
Dexamethasone. The patients were asked to report the pain status after
every 24 hours for at least 72 hours. In case of severe pain not
controlled by these medicines even after 3 days, two tablets of
dispersible ketorolac tromethamine (10mg) were advised once on fourth
day followed by single tablet three times a day for another 3 days. In
case the pain did not subside within 3 days of taking the second line of
treatment, or there was a development of swelling/lymphadenopathy, the
patient was advised to get the tooth extracted Results: Out of 55
patients taking a single dose of dexamethasone, 47 (85.45%) patients
reported a ‘significant’ reduction of pain within 24-72 hrs. Remaining 8
patients (14.55%) in which severe pain was not controlled by
paracetamol and Dexamethasone even after 3 days, two tablets of
ketorolac tromethamine (10mg) were advised. 6 patients (75%) reported a
‘significant’ reduction in the pain while 2 (25%) patients still in
pain did were advised tooth extraction and referred emergency department
of tertiary care centre.. Conclusions: The pain felt by patients
diagnosed with symptomatic irreversible pulpitis, the systemic
corticosteroids administration is an adequate strategy in controlling
pain for up to 48-72 hours, the time during which the pain felt most.