Nontraumatic dental complaints in a pediatric emergency department

To determine the prevalence, types, and treatment of nontraumatic dental emergencies that present to a tertiary care pediatric emergency department (ED).

A retrospective chart review of all children coming to a tertiary care pediatric emergency department with nontraumatic dental complaints from January 2005 to December 2005 was conducted. Demographic information, the time and day of presentation, presenting complaints, history of previous dental treatment, interventions, and disposition details were collected and analyzed.

The 247 visits for nontraumatic dental complaints comprise 0.5% of all patients who presented to the ED in 2005. Fifty-nine percent were younger than 5 years (primary dentition), with males representing 52% of the children. Half of the visits were during normal dental office hours, and more than half presented during the weekday. Fifty-three percent complained of pain. Twenty-eight percent were referred to the dental clinic after being seen by an ED physician. Eight percent of children required hospitalization for intravenous antibiotics. Most children (82%) were discharged from the ED with oral antibiotics.

The ED is an important point of care for nontraumatic pediatric dental complaints, and about 60% of these children are younger than 5 years. Only 8% of them had severe infections requiring hospitalization, and most patients could have been treated in the community.