Question

A patient of record calls late Saturday night because of severe, throbbing pain aggravated by "heat, biting and touching" in a mandibular premolar. What procedure is recommended?

A. Instruct the patient to apply ice intermittently, take aspirin, and call Monday for an appointment.
B. See the patient at the office and initiate endodontic treatment.
C. See the patient at the office, remove the carious dentin and place a sedative zinc oxide-eugenol cement.
D. Prescribe an analgesic and refer the patient to an endodontist.
E. Refer the patient to the hospital oral surgery department for extraction.

Answer 1

The recommended procedure for a patient experiencing severe, throbbing pain in a mandibular premolar aggravated by heat, biting, and touching is to see the patient at the office and initiate endodontic treatment (Option B).

Step-by-step explanation:

The recommended procedure for a patient experiencing severe, throbbing pain in a mandibular premolar aggravated by heat, biting, and touching is to see the patient at the office and initiate endodontic treatment (Option B). Endodontic treatment involves the removal of the infected pulp inside the tooth and the sealing of the root canal to eliminate pain and prevent further infection. This procedure is typically performed by a dentist who specializes in endodontics.

In the case of severe pain, it is important to address the underlying cause of the pain rather than simply providing temporary relief with analgesics or sedatives. Prescribing an analgesic (Option D) or referring the patient to an endodontist (Option D) may be necessary in certain cases but given the severity of the patient's symptoms it is best to initiate endodontic treatment as soon as possible to provide immediate relief.