title: Diagnosis and treatment of dental caries-related emergencies in a children's hospital.
abstract: A comprehensive review of 362 caries-related emergency visits presenting to a children's hospital was completed to investigate aspects of care which have not been previously reported. Areas of interest included patient characteristics such as age and whether the emergency visit was the first contact with a dentist, association of the emergency visit with a nursing bottle habit, diagnoses, treatment provided, and behavior management techniques used at the emergency visit. The emergency appointment was the first contact with a dentist for 27% of all patients and for 52% of children 3.5 years and younger. Patient visits related to nursing caries totaled 19% and these patients had a disproportionately high share of all primary tooth diagnoses. Nursing caries patients accounted for 48% of patients requiring papoose restraint and were the majority of patients receiving multiple extractions. Papoose restraint was used most often for young patients needing extraction who presented during clinic hours and were treated by an attending dentist. Maxillary first and second primary molars were implicated in a high number of cellulitis patients (57%) yet represented only 23% of primary tooth diagnoses.
authors.affiliation: Department of Dental Medicine, Children's Hospital and Medical Center, Seattle, Washington, USA.
authors.forename: B
authors.initials: B
authors.lastname: Sheller
authors.forename: B J
authors.initials: BJ
authors.lastname: Williams
authors.forename: S M
authors.initials: SM
authors.lastname: Lombardi
mesh_terms: D000038:Abscess / Q000175:diagnosis / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001071:Appointments and Schedules; D001521:Behavior Therapy; D001903:Bottle Feeding / Q000009:adverse effects; D002481:Cellulitis / Q000175:diagnosis / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D019140:Dental Care for Children; D003731:Dental Caries / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D003751:Dental Fistula / Q000175:diagnosis / Q000628:therapy; D003793:Dental Restoration, Permanent; D003796:Dental Service, Hospital; D004630:Emergencies; D005145:Face; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D008437:Maxilla; D008963:Molar / Q000473:pathology; D012149:Restraint, Physical; D012189:Retrospective Studies; D014076:Tooth Diseases / Q000175:diagnosis / Q000628:therapy; D014081:Tooth Extraction; D014094:Tooth, Deciduous / Q000473:pathology; D014098:Toothache / Q000175:diagnosis / Q000628:therapy