Introduction

Although rare, medical emergencies do occur in the dental office. While the majority of medical emergencies occur in adult patients, pediatric medical emergencies can occur too. Pediatric medical emergencies occur quickly, without warning, and with possible severe consequences due to the child’s under-developed physiology coupled with small oxygen reserves. Successful resolution of the emergency requires early recognition of the problem and swift definitive treatment.

The primary focus of this course is the pediatric dental patient. However, adult medical emergencies will also be addressed as adults accompany pediatric patients to their appointments. Although the child is the one receiving dental treatment, there is a strong possibility it will be the accompanying adult that will experience the emergency. The most common medical emergency seen by dentists is syncope, and the vast majority of these events occur in adults.

In a survey conducted at the 2004 American Academy of Pediatric Dentistry “Pediatric Emergencies in the Dental Office” course, the incidence of specific emergency situations reported by 66 pediatric dentists over a 10-year period were:

Incidence of Specific Emergency Situations.

Situation# Incidents
Syncope (fainting)75 (mostly parents)
Hysteria23 (mostly children)
Allergy, mild22
Seizures13
Hypoglycemia9
Hyperventilation7
Aspiration5
Respiratory distress4
Bronchospasm3
Airway obstruction3
Allergy, anaphylaxis1
Drug overdose1
Local anesthesia overdose1
Cardiac arrest1
Source: 2004 AAPD Course Survey, “Pediatric Emergencies in the Dental Office”

The dental office’s successful management of medical emergencies requires preparation, prevention and response not just by the dentist but by all dental staff.