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Emergency pain management of untreated pulpitis during COVID-19 lockdown by telephonic communication.
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  • Akhil Rajput,
  • Umesh KUMAR,
  • nikhil sihna,
  • gulshan kumar,
  • ruchi vashisht,
  • krishan gauba
Akhil Rajput
BSA Medical College and Hospital
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Umesh KUMAR
PGIMER
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nikhil sihna
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gulshan kumar
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ruchi vashisht
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krishan gauba
PGIMER
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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.