NM Department of Health Directive

1. Dental emergency

Dental emergencies are potentially life threatening and require immediate treatment to stop ongoing tissue bleeding, alleviate severe pain or infection, and include:

• 􏰀  Uncontrolled bleeding
• 􏰀  Cellulitis or a diffuse soft tissue bacterial infection with intra-oral or extra-oral swelling that

  potentially compromise the patient’s airway

• 􏰀  Trauma involving facial bones, potentially compromising the patient’s airway

  Urgent dental care focuses on the management of conditions that require immediate attention to relieve severe pain and/or risk of infection and to alleviate the burden on hospital emergency departments. These should be treated as minimally invasively as possible.

• 􏰀  Severe dental pain from pulpal inflammation
• 􏰀  Pericoronitis or third-molar pain
• 􏰀  Surgical post-operative osteitis, dry socket dressing changes
• 􏰀  Abscess, or localized bacterial infection resulting in localized pain and swelling.
• 􏰀  Tooth fracture resulting in pain or causing soft tissue trauma
• 􏰀  Dental trauma with avulsion/luxation
• 􏰀  Dental treatment required prior to critical medical procedures
• 􏰀  Final crown/bridge cementation if the temporary restoration is lost, broken or causing gingival

  irritation
  Other urgent dental care:

􏰀 Extensive dental caries or defective restorations causing pain
o Manage with interim restorative techniques when possible (silver diamine fluoride,

glass ionomers)

• 􏰀  Suture removal
• 􏰀  Denture adjustment on radiation/oncology patients
• 􏰀  Denture adjustments or repairs when function impeded
• 􏰀  Replacing temporary filling on root canal access openings

• 􏰀  Snipping or adjustment of an orthodontic wire or appliances piercing or ulcerating the oral mucosa
• 􏰀  Orthodontic adjustments that cannot be reasonably delayed without causing harm to the patient
• 􏰀  Debridement to control periodontal disease in medically-compromised individuals

• 2. Dental non emergency procedures

  Routine or non-urgent dental procedures include but are not limited to:

• 􏰀  Initial or periodic oral examinations and recall visits, including routine radiographs
• 􏰀  Routine dental cleaning and preventive therapies
• 􏰀  Orthodontic procedures which can be reasonably delayed three months or more without

  causing harm to the patient

• 􏰀  Extraction of asymptomatic teeth except in conjunction with another procedure to eliminate

  pain

• 􏰀  Restorative dentistry of asymptomatic carious lesions unless delay will result in permanent

  loss of function, tooth loss or imminent pain

• 􏰀  Aesthetic dental procedures