In this section
The RCH Department of Dentistry only provides 'routine' dental care for children with
chronic illness that may be impacted by dental caries (eg cerebral palsy, cardiac disease, bleeding disorders).
Tooth caries (decay) are common in Australian children and can begin soon after the eruption of the first incisors (around 7 months).
'Nursing caries' are frequently seen (18 months onwards), mainly affecting the upper front teeth.
Caries are often easy to
recognize by the medical practitioner and this provides an
important opportunity for education about dental care.
Encouragement of good dental hygiene and dental review are
important in preventing progression of decay and subsequent
Dental caries noted
Refer to a dentist (see services below) and provide dental care
Toothbrushing and fluoride:
Regular dental check-ups
Children presenting with toothache:
Referral for dental care:
Treatment of dental
abscesses in children almost always involves tooth extraction +/-
incision and drainage, particularly if primary
Antibiotics will help to
treat infection and pain but will only be a temporising measure until definite treatment of the
underlying carious tooth can occur.
Consider non-dental causes (eg. cervical lymphadenitis, parotitis) for facial swelling/ cellulitis.
Consider dental causes (toothache will not necessarily be a presenting complaint):
Treatment usually involves tooth extraction +/- incision and
Dental registrar referral is required for:
Fast patient until dental
Consider OPG (discuss with ED consultant or dental registrar); Generally children under 3 years are not able to cooperate for OPG.
Antibiotics - IV penicillin or oral amoxicillin (if well enough for
If well enough for
discharge from ED, the patient needs review by a dentist in next
May be after dental treatment, or due to underlying bleeding disorder or vascular anomaly.
For bleeding disorders, also
For severe bleeding
Accessing dental services for Victorian children
Dental Health Services Victoria
Royal Dental Hospital, 720 Swanston Street, Melbourne: will accept
emergency patients with a health care or pension card, open daily
until 9pm (03 9341 1000).