title: Experience and policy implications of children presenting with dental emergencies to US pediatric dentistry training programs.
abstract: OBJECTIVE
  The purpose of this study was to describe and substantiate the experience of children, their families, and their caregivers with children's dental pain and to explore implications of these experiences for public policy.
  
  
  METHODS
  Data for 301 children presenting to 35 pediatric dentistry training programs during a 1-week period in 2000 for pain relief were collected with a questionnaire asking for: (1) sociodemographic characteristics; (2) oral health status; (3) dental care history; (4) presenting problem; (5) clinical findings; and (6) clinical disposition. Descriptive statistics are presented.
  
  
  RESULTS
  Among children presenting to training programs with oral pain, 28% were under age 6, 57% were on Medicaid, and 38% were regarded by their dentists to have "likely or obvious" functional impairment-with 22% reporting the highest pain level. Parents reported that 59% had "poor or fair oral health" and 29% had a prior dental emergency in the previous year. Pain, experienced for several days by 73% of children, was associated with difficulty: (1) eating; (2) sleeping; (3) attending school; and (4) playing. Parent-reported barriers to seeking dental care included: (1) missed work (24%); (2) transportation costs (12%); and (3) arranging child care (10%).
  
  
  CONCLUSIONS
  In this study of children with dental pain, many suffered significant pain: (1) duration; (2) intensity; (3) recurrence; and (4) consequences. This study demonstrates the ongoing need for public policies that assure timely, comprehensive, and affordable dental care for vulnerable children.
authors.affiliation: Social and Behavioral Sciences, College of Dental Medicine, Columbia University, New York, NY, USA. ble22@columbia.edu
authors.forename: Burton
authors.initials: B
authors.lastname: Edelstein
authors.forename: Clemencia M
authors.initials: CM
authors.lastname: Vargas
authors.forename: Devanie
authors.initials: D
authors.lastname: Candelaria
authors.forename: Maryen
authors.initials: M
authors.lastname: Vemuri
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019140:Dental Care for Children / Q000458:organization & administration; D004522:Educational Status; D004632:Emergency Medical Services / Q000458:organization & administration; D005191:Family Characteristics; D001068:Feeding and Eating Disorders / Q000209:etiology; D005260:Female; D006291:Health Policy; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D007182:Income; D007223:Infant; D008297:Male; D008484:Medicaid; D009909:Oral Health; D010377:Pediatric Dentistry / Q000193:education*; D011050:Policy Making; D012893:Sleep Wake Disorders / Q000209:etiology; D014098:Toothache / Q000628:therapy; D014481:United States