A parent telephones to report that her child is crying and screaming with dental pain. What is the appropriate response?

Correct answer: B. Arrange an immediate (same-day) appointment for assessment

• A. Incorrect. The emergency department is appropriate only for signs of spreading infection — facial swelling closing the eye, swelling crossing the midline or extending to the neck, trismus, dysphagia, fever or a compromised airway. Isolated dental pain is treated by the dental office, and the ED typically cannot provide definitive dental care.
• B. Correct. Uncontrolled acute pain in a child is a TRUE DENTAL EMERGENCY. The child should be seen the same day so the source can be diagnosed and definitively managed — pulpotomy, pulpectomy, extraction or drainage. Analgesics alone do not treat the cause, and delay risks the spread of an odontogenic infection, which progresses far more rapidly in children than in adults.
• C. Incorrect. Waiting is inappropriate for uncontrolled pain and allows an odontogenic infection to spread into fascial spaces.
• D. Incorrect. Prescribing without examination is poor practice, and antibiotics do not resolve pulpal pain — removing the source does. Antibiotics are indicated only for systemic involvement or spreading infection, always alongside definitive treatment.