Analysis of dental emergencies presenting to a community paediatric dentistry centre

The aim of this study was to investigate characteristics of child patients treated as emergencies in a community paediatric dentistry centre in Athens during the year 1992. DESIGN, AND METHOD: Cross sectional analysis of records. From the emergency clinic records, the patient's day of presentation, area of residence, age, sex, diagnosis made and treatment provided were recorded. The sample of children was divided into six groups according to their presenting complaint for purposes of analysis.

1271 children aged 8 months to 12 years, 680 boys and 591 girls presented as emergencies during the year 1992.87 (7%) of the children were 0-3 years old, 276 (22%) 4-6 years, 610 (48%) 7-9 years and 298 (23%) were aged 10 years or over.

At their attendance as an emergency, 533 children (42%) presented with gingival swelling or sinus, 446 (35%) with toothache due to pulpitis, 142 (11%) following trauma, 86 (7%) with diffuse cellulitis and extra oral swelling, 52 (4%) for recementation of stainless steel crowns and space maintainers, and 12 (1%) for acute oral pathology problems. Amongst those presenting with symptoms arising as a result of dental caries, 607 children (57%) were treated endodontically with pulpotomy or pulpectomy (antibiotics were prescribed in 128 (27%) of these), and the remaining 458 (43%) by extraction of the teeth responsible. The 142 cases who presented following trauma had injuries to 20 primary and 221 permanent teeth. The most prevalent type of injury was crown fracture without pulp exposure (112 cases, 51%) followed by crown fractures with pulp exposure (73 cases, 33%), lateral luxation (9 cases, 4%), extrusive luxation (8 cases, 4%), crown and root fractures (6 cases, 3%), concussion and subluxation (6 cases, 3%), intrusion (4 cases, 2%) and avulsion (3 cases, 1%).

The results of this study clearly show that although the prevalence of caries in Greece is declining, the disease still accounts for the majority of dental emergencies in child patients at this specialist centre. Provision of emergency dental care appears to be a vital part of NHS Community Services in our country, while a 24-hour service, including weekends, could prove to be of greater value.