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Dentistry Emergency

Paediatric Dentistry Emergency

Information

As part of the Oral Health Service (OHS), the Paediatric Dental Service provides advice, assessment and treatment for children and young people under 16 years of age who present with an acute dental condition that cannot be managed in a primary care setting.

Referrals are accepted from primary and secondary health, education and social care professionals.  Individual referral pathways have been created for General Dental Practitioners  and non-dental service providers.

Patients meeting our acceptance criteria will be seen in the Department of Paediatric Dentistry at the Edinburgh Dental Institute (EDI), Lauriston Place, Edinburgh.   This department is open:

  • Monday – Thursday 09:00 – 16:45
  • Friday 09:00 – 16:15

Outwith these hours, please contact NHS 24 (telephone 111)

There are no NHS charges for patients under 18 years of age.

Who can refer:

Referrals to the Paediatric Dental Service are accepted from General Dental Practioners (GDPs) and non-dental service providers.  

Who to refer:

The Paediatric Dental Service will accept emergency referrals for children / young people under 16 years of age with the following acute conditions:

  • Acute dental trauma requiring emergency management outwith the skills and expertise of their General Dental Practitioner (GDP) e.g.
    • Luxation injuries (where the tooth has been displaced).
    • Crown fractures involving the pulp.
    • Treatment of young / immature permanent teeth.
    • An injury to a child / young person considered too anxious or too young to accept dental treatment.
  • Orofacial swelling unable to be adequately managed within primary care (see important caveat below under ‘Who not to refer’).

For patients with lesions in their mouth considered ‘urgent suspicion of cancer’, please see section on ‘Who not to refer’.

Who not to refer:

  • Children or young people with lesions in their mouth considered ‘urgent suspicion of cancer’. Referral should be made directly to the Oral & Maxillofacial Surgery service at St John’s Hospital using the specific SCI Gateway. 
  • Patients presenting with:
  • Orofacial swelling associated with any of the following
    • Restriction of swallow
    • Raised floor of mouth
    • Compromised breathing
    • Significant trismus
    • Extension to the eye

OR

  • Bleeding from an oro-dental condition which has continued despite local measures.

OR

  • Oro-dental conditions with systemic symptoms which require medical support.

…should be directed immediately to the Accident and Emergency Department of a medical hospital.

The Paediatric Dental Service will not accept emergency referrals where the presenting complaint does not meet the ‘Who to refer’ acceptance criteria.

If the child / young person does not meet the acceptance referral criteria and is:

  • Registered with a General Dental Practitioner (GDP): They should attend their GDP in the first instance.
  • Not registered with a GDP: Referrals should be made via NHS 24 (telephone 111). 
  • Requiring treatment ‘out-of-hours’: Emergency dental care for both registered and unregistered children and young people can be accessed through NHS 24 (telephone 111).

How to refer:

The referring practitioner should phone the ‘Emergency Referral Line’ on 0131 536 3480.  The duty clinician will discuss the case and advise on management. 

If an appointment is required, details will be confirmed with the referrer.  The referrer must then:

1.      Complete the emergency appointment patient information leaflet and give this to the patient / parent / guardian.

2.      Provide an urgent written referral:

  • GDPs providing NHS dentistry must refer to ‘OHS Paediatric Dentistry>EDI Paediatric Dentistry’ via SCI Gateway, marking the referral as ‘Urgent’.
  • If you are not registered with SCI Gateway, please download, complete and send / provide the patient, parent or guardian with the referral form.
    • Please note that the secure transmission of emails containing patient information is the referrer’s responsibility.

Relevant radiographs / images should be included in your referral. These can be sent as an ‘attachment’ in SCI Gateway (maximum file size of 2MB, with a total attachment capacity of 5MB).  If you are not registered with SCI Gateway, have images exceeding the file size or have relevant non digital images, please use an alternative option for the transfer of images.

Discharge criteria:

On completion of emergency dental care, the child or young person will be returned to the care of their General Dental Practitioner (GDP) or, where applicable, recommended to register with a GDP.