Recently, hospital emergency departmentment visits have increased as patients of low socioeconomic status flock to these facilities as health care providers of last resort. These patients also use emergency departments to treat dental trauma, even though most emergency departments are not equipped to provide optimal treatment for such injuries. Mitchell et al from the Seattle Children’s Hospital, Washington, examined the types of dental trauma presenting to a hospital emergency department and evaluated the outcomes of these visits. The authors reviewed the records of 265 pediatric patients who received emergency dental treatment at a tertiary-care pediatric teaching hospital over a 3-year period. The hospital included a dental clinic; the par-ticipants presented outside of clinic hours. All patients arriving at the emergency department go through a tri-age procedure, during which their status is assessed by a pediatric nurse on a scale of 1 (most acute) to 5 (least acute). Pain is measured by a standardized scale and cat-egorized as low (0–3), moderate (4–6) or severe (7–10). Average time between dental injury and check-in at the emergency department was >2 hours. Of the 215 patients for whom triage and pain scores were available, 59% reported low pain scores, 82% were triage grade 3 or 4; no dental patients were assessed at triage grade 1. Treatment ranged from examination to tooth reimplan-tation, splinting and intraoral sutures. Mean wait time to see a physician was 50.9 ± 39.1 minutes; overall length of stay was nearly 3 hours. One-third of the time these patients spent in the emer-gency department was spent actually receiving dental care. Managing pediatric dental trauma in a hospital emergency department is more expensive, less effective and less efficient than managing it in a dental office. Mitchell JM, Sheller B, Velan E, et al. Managing pediatric den-tal trauma in a hospital emergency department. Pediatr Dent 2014;36:201-210.