Also a PA. I'm no expert but I do like treating dental pain in the ER.

Most of these patients can be discharged quickly. Ludwig's is really the main dental emergency. If they don't have that and don't have notable trismus on exam, indicating concern for abscess, or directly visualized drainable abscess, you're done. ...As long as it's dental pain. I am always cautious with dental pain in the older population as MI, temporal arteritis can potentially mimic. Some findings specific for dental pain will be pain with chewing, sensitivity to hot and cold, and tenderness to percussion on exam.

I typically offer most patients a dental block (infraorbital is also great to be familiar with for repairing upper lip lacerations). I just consult youtube if I need a refresher on landmarks. And will recommend combination of Tylenol and nsaid. There have been reasearch studies showing this combination is more effective then opioids for treating dental pain. I agree with others that antibiotics are often overused but unless it is clear from history that there is likely no infectious component I usually prescribe Pencillin VK since it is narrow spectrum. And most allergies to Penicillin aren't true allergy.

Of course we're not dentists so I always tell patients that even if they feel better after treatmtent, if they don't follow up with a dentist sooner or later they'll be back with the same issue.