The First Response: Triage with Heart When a dental emergency situation comes through the dental practice door, Dr. Sharma’s team springs into action—but not with tools or X-rays just yet. First comes empathy and calm. “You have a child in pain and a parent in panic,” he says. “There’s a lot of emotion. So, I tell my staff: expect some chaos but stay open and stay kind.” The clinical response depends on the urgency. “If it’s a knocked-out tooth or pulp exposure, we need to act fast,” he says. “I have sections of my schedule blocked off just for these cases.” For less urgent cases, like toothaches or minor injuries, these are triaged thoughtfully, with a strong emphasis on anxiety management. “Kids don’t walk in saying, ‘My #46 is symptomatic.’ They are crying. They hide. They cling. So, I let them sit in the chair, chat with them, maybe put on a cartoon. I don’t look in their mouth right away—I gather data from the parent and build trust with both.” presents with swelling, we need to determine if it’s an abscess or cellulitis,” Dr. Sharma explains. “If it’s draining, it’s less urgent. If it’s not, we may need antibiotics and possibly an extraction.” Facial swelling that crosses into danger zones— near the eye or lower jaw—requires urgent hospital referral. “That’s cellulitis, and it can spread fast,” he warns. “IV antibiotics and fluids may be needed.” Managing Pain and Fear Pain is rarely just physical in pediatric emergencies, it’s also emotional. That’s why Dr. Sharma addresses the anxiety before the analgesics. “My younger self used to zero in on the tooth,” he recalls. “Now I focus on the child. Are they scared? Are the parents scared? What’s the mood in the room?” Once trust is established, Dr. Sharma says definitive treatment is with sedation and local anesthesia, but temporary relief can be obtained with antibiotics, analgesics and sedative materials. “Acetaminophen and Ibuprofen are the usual protocols for home management,” he adds, “but in the chair, in some cases, even plugging a cavity temporarily with a glass ionomer or Intermediate Restorative Material can bring huge relief.” Infections Sometimes, what starts as a simple toothache in a primary tooth becomes more serious. “When a child When a dental emergency situation comes through the dental practice door, Dr. Sharma’s team springs into action—but not with tools or X-rays just yet. First comes empathy and calm. Dr. Sharma’s Pediatric Dental Emergency Management Tips Tooth pain: Assess, X-ray, analgesics, sedative filling, as needed. Abscess: Drainage? If not, antibiotics and plan for extraction. Cellulitis: Hospital referral for IV treatment. Trauma (Primary): Do not reimplant. Fractures: smooth, cap or extract as needed. Trauma (Permanent): Reimplant immediately, if possible; store tooth in milk or saline. Non-tooth problem: Rule out ulcers, HSV-1, soft tissue causes. 29 Issue 5 | 2025 | Supporting Your Practice
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