Managing pediatric dental trauma in a hospital emergency department

The purpose of this study was to: (1) examine types of dental trauma presenting to a hospital emergency department (ED); (2) describe the medical services provided to these patients; and (3) quantify time spent during ED encounters for dental trauma emergencies.

Records of 265 patients who presented to the ED with dental trauma over a three-year period were reviewed. Demographics, injury types, triage acuity, pain scores, and dental/medical treatment and times were analyzed.

Patient demographics and injury types were similar to previous studies. Eighty-two percent of patients received mid-level triage scores; 41 percent of patients had moderate to severe pain. The most frequently provided medical services were administration of analgesics and/or prescriptions (78 percent). The mean times were: 51 minutes waiting for a physician; 55 minutes with dentists; and 176 minutes total time. Higher triage acuity and pain levels resulted in significantly longer wait times for physician assessment. Dental evaluation, including treatment, averaged 32 percent of time spent at the hospital.

A dental clinic is the most efficient venue for treating routine dental trauma. Patients in this study spent the majority of time waiting for physicians and receiving nondental services. Most patients required no medical intervention beyond prescriptions commonly used in dental practice.