Emergencies such as toothaches or broken fillings are common among clinic patients. Many clinics make time available for emergencies by keeping one or more appointment slots open each day until 24 hours before the appointment time. If no one calls for an emergency visit, then the appointment can be scheduled for a regular visit. The clinic may choose to differentiate between “patients of record” (who receive priority for the emergency time slots) and those who have never been seen in the clinic. Failure to accommodate patients of record with urgent needs, especially if those needs are post-operative problems from services that your clinic provided, can lead to charges of patient abandonment.

Treating patients with dental emergencies, or walk-ins, can be a significant part of the services a clinic provides. Following are recommendations that many clinics have found helpful with regard to emergency care:

• Provide basic preventive and restorative services early during the treatment plan, before providing more complex services such as root canals, crowns, bridges, and removable prosthetics. Many patients who miss appointments, especially episodic users, will do so early in the treatment plan; examinations and basic preventive services are less time-consuming than complex services. If a patient misses a short appointment, it impacts the schedule less than missing a long appointment does.
• If the patient has an abscessed tooth, explain the sequence of root canal treatment (RCT) necessary to save the tooth so that the patient can decide if he or she is willing to go through the required steps. The patient should be informed that basic preventive treatment will be provided before RCT. If the patient agrees to commit to attending appointments to complete RCT, the tooth is opened for RCT during the emergency visit. If the patient is unable or unwilling to commit, an immediate extraction can be offered so the patient will not have to endure more pain. If the patient is undecided, it is best to err on the side of caution and open the tooth for RCT. If the patient fails to attend follow-up appointments and presents again with a toothache in the same tooth, the options should be presented once more. Usually at this visit the patient will find it easier to make a decision.
• Perform emergency treatment during the emergency visit whenever possible, rather than providing only pain medication, antibiotics, or both and asking the patient to return on another day.

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