The ADA's baseline dental emergency kit is seven items: epinephrine, an injectable antihistamine, oxygen, nitroglycerin, a bronchodilator, a sugar source, and aspirin. Your state board can require more, especially if you sedate. Here's the list and how to keep it in date.
· 4 min read
Written and clinically reviewed by Jacob Fuchs, PharmD
Reviewed on
The American Dental Association's baseline emergency kit has seven items: injectable epinephrine, an injectable antihistamine, oxygen with positive-pressure delivery, nitroglycerin, a bronchodilator inhaler, a fast sugar source, and aspirin. That's the floor, not the ceiling. Your state dental board sets the actual requirement, and it goes up fast if you offer sedation.
Here's the list, what each item is really for when you're buying it, and how to keep the kit from quietly expiring in a drawer.
The ADA Council on Scientific Affairs published its report "Office emergencies and emergency kits" in JADA in 2002 (JADA 2002;133(3):364-5). It's still the list most dental risk-management guidance points to. As summarized by the California Dental Association, the minimum kit is (CDA):
| ADA minimum item | What you're actually buying |
|---|---|
| Epinephrine 1:1,000 (injectable) | Epinephrine 1 mg/mL, as ampules, vials, or auto-injectors |
| Histamine blocker (injectable) | An injectable antihistamine, most often diphenhydramine |
| Oxygen with positive-pressure administration | A cylinder, regulator, and a bag-valve mask (not from a drug wholesaler) |
| Nitroglycerin (sublingual tablet or aerosol spray) | Tablets or spray. The ADA flags contraindications, so whoever gives it needs to know them |
| Bronchodilator (asthma inhaler) | An albuterol inhaler |
| Sugar | A fast glucose source. The ADA example is orange juice; offices often use glucose gel or tablets |
| Aspirin | Chewable or regular aspirin tablets |
The same CDA guidance adds the supporting equipment most offices keep with the kit: aromatic ammonia, a blood pressure monitor, a CPR pocket mask, syringes, tourniquets, and high-volume suction (CDA).
That report is from 2002. It's the baseline, not the last word. Your state board's rules and your sedation permit come first.
It depends on the state and on what you do. The CDA puts it simply: the answer "varies depending on individual state dental board requirements," some states have "more rigorous emergency kit requirements," and practices offering oral conscious sedation have to meet additional standards (CDA).
If you hold any sedation or anesthesia permit, get your board's equipment and drug list in writing, and build the kit from that list, not from this article. Then add the ADA items it doesn't already include.
This is the purchasing trap. The ADA list says "epinephrine 1:1,000." Since May 1, 2016, USP labeling standards have removed ratio strengths like that from single-ingredient injectable labels, so the box you receive says 1 mg/mL (FDA).
Same drug, different words. The danger is the other epinephrine. A 0.1 mg/mL prefilled emergency syringe (the old "1:10,000") is a crash-cart product. It doesn't belong in the slot where the 1 mg/mL product goes. We wrote a full breakdown of the epinephrine formats and the mix-ups in our clinic anaphylaxis kit guide.
When you order, order by concentration and NDC, never just "epi." If you're not sure which product an NDC belongs to, the NDC lookup shows it.
Kits don't fail because someone forgot to buy them. They fail because the epinephrine expired eight months ago and nobody looked.
Premier Pharma supplies licensed dental practices, physician offices, clinics, and pharmacies, and every invoice lists the lot number and expiration date for each item. From the ADA list, we carry epinephrine 1 mg/mL ampules, an epinephrine auto-injector 2-pack, diphenhydramine 50 mg/mL vials, and albuterol inhalers from Lupin and Teva. Oxygen and equipment you'll get from your medical gas and equipment suppliers. Open a free account. Credential review typically takes 1–2 business days.
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