Paediatric Hospital Presentations for Odontogenic Pain and Infection in Western Australia.

Abstract

Background: Oral health-related conditions are a leading and preventable cause of paediatric hospital presentations in Australia, contributing substantially to healthcare expenditure and placing increasing pressure on public hospital infrastructure. Preschool-aged children are disproportionately affected, often presenting late with advanced disease requiring resource-intensive care, including emergency extractions under general anaesthesia. In Western Australia, these challenges are further compounded by geographic barriers that limit timely access to public dental services.

Methods: This study provides longitudinal data on dental-related emergency presentations at Perth Children's Hospital (PCH) and its predecessor, Princess Margaret Hospital for Children (PMH), over six years (2016-2021). The primary aim was to characterise the nature, volume, and demographic profile of unplanned emergency presentations associated with odontogenic infection.

Results: Emergency presentations for odontogenic infections accounted for 46% of all presentations to the dental department. Children under five years accounted for nearly 60% of these cases, demonstrating a pronounced age-related disparity. A consistent year-on-year increase was observed in emergency presentations, with over 30,000 teeth being extracted, the majority of these requiring general anaesthesia. Posterior primary teeth comprised the majority of extractions, likely reflecting advanced, untreated early childhood caries.

Conclusions: These findings highlight a persistent and escalating burden of preventable disease presenting at a late stage, where care is more invasive, costly, and resource-intensive. Without strategic investment in early, accessible, and preventive models of care, increasing demand will continue to strain hospital-based services and divert resources from other critical areas of paediatric healthcare.