Pathways to emergency dental care: An exploratory study.
OBJECTIVE
To describe the pathways to care associated with acute dental infections in children.


METHODS
Primary carers of children presenting with facial cellulitis completed a semistructured interview that sought to establish their pathway to the emergency department and definitive treatment. Descriptive statistics were used to describe the patterns of healthcare attendances, treatment received, medications prescribed and referrals made from the time the problem was first noted.


RESULTS
Interviews were completed for 12 children presenting with acute cellulitis as a result of caries in the primary dentition (mean age of 6.8 + 2.6 years). The median time lapsed since carers first became aware of the problem was 15.5 days (range 3 to 63). The mean number of health service attendances made per child was 4.5 + 1.98. A total of 17 courses of oral antibiotics were prescribed prior to definitive treatment (mean 1.4 + 1.24, range 0 to 3). Half the teeth involved had been previously 'restored'.


CONCLUSIONS
Children presenting with acute facial cellulitis represent the last stage in a pathway of failed clinical care that is associated with significant costs to both the individual family and the community. Further work is required to understand the barriers to children accessing timely and appropriate dental treatment.
Tran
C
C
School of Dental Sciences, University of Melbourne, Melbourne, Australia.
Gussy
M
M
Kilpatrick
N
N
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001315:Australia; D002481:Cellulitis / Q000209:etiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D019140:Dental Care for Children; D003731:Dental Caries / Q000150:complications*; D004636:Emergency Service, Hospital; D005145:Face; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D010290:Parents; D010342:Patient Acceptance of Health Care; D014081:Tooth Extraction; D014094:Tooth, Deciduous / Q000601:surgery; D014098:Toothache / Q000209:etiology / Q000628:therapy*
D000900:Anti-Bacterial Agents
Br Dent J. 2004 Sep 25;197(6):331-4; discussion 323
15455000
Br Dent J. 2008 Nov 22;205(10):537-8
19023306
Br Dent J. 2006 May 27;200(10):551-5
16732242
Community Dent Health. 2004 Dec;21(4):277-84
15617412
Community Dent Oral Epidemiol. 1992 Jun;20(3):144-7
1623706
Aust Dent J. 2000 Sep;45(3):204-7
11062939
J Public Health Dent. 2000 Winter;60(1):28-32
10734613
Am J Emerg Med. 2003 Nov;21(7):540-4
14655232
J Public Health Dent. 2008 Spring;68(2):82-7
18221320
Pediatr Dent. 2002 Mar-Apr;24(2):109-13
11991312
Spec Care Dentist. 2001 Nov-Dec;21(6):208-15
11885669
J Dent Res. 2001 Oct;80(10):1873-4
11706943
Int J Paediatr Dent. 2004 Sep;14(5):317-25
15330997
Br Dent J. 2002 Feb 23;192(4):219-23
11931484