Dental Emergencies in Wilderness, Military & Expedition Medicine: Prevention, Field Management, and Future Directions

The increasing popularity of wilderness recreation, expedition travel, military deployments, and scientific missions in remote environments has heightened the importance of medical preparedness for conditions that cannot be managed through immediate access to definitive healthcare. Although dental emergencies rarely threaten life directly, they may cause severe pain, impair nutrition and hydration, reduce operational performance, and necessitate premature evacuation, potentially compromising the success of an expedition or mission. Despite these consequences, dental emergencies remain comparatively underrepresented in the wilderness medicine literature. This narrative review summarizes the current evidence regarding the epidemiology, prevention, diagnosis, and field management of dental emergencies occurring in wilderness, expeditionary, military, maritime, and other austere environments. Evidence was synthesized from studies involving trekking expeditions, Antarctic research stations, military operations, and other isolated settings, together with relevant publications from emergency dentistry and travel medicine. Across these environments, dental caries and failed restorations consistently represent the leading causes of dental emergencies, followed by pulpal and periapical disease, periodontal infections, third molar pathology, traumatic dental injuries, and prosthodontic complications. Most emergencies are potentially preventable through appropriate pre-departure dental assessment and optimization of oral health. Furthermore, many conditions can be managed conservatively in the field using basic analgesia, temporary restorative materials, and simple emergency dental kits, whereas a smaller proportion require evacuation for definitive treatment. Current evidence is largely derived from observational military and expedition studies, with limited data from civilian wilderness expeditions.