Early childhood caries–related complications in pediatric dental emergencies: a 7-year retrospective study from Romania

OBJECTIVES: Early childhood caries (ECC) is a highly prevalent and largely preventable disease that may lead to severe complications requiring emergency dental care. This study aimed to retrospectively analyze the presentation patterns, clinical characteristics, and management of ECC-related complications among children presenting to a pediatric dental emergency service over a seven-year period. MATERIALS AND METHODS: A retrospective observational study was conducted using medical records from the dental emergency department of the County Clinical Emergency Hospital in Oradea, Romania, covering the period January 2019 to December 2025. Children aged 0-71 months presenting with ECC-related complications were included. Demographic variables, diagnosis, tooth location, and emergency treatment were recorded. Descriptive statistics were applied, and associations between variables were assessed using chi-square and Kruskal-Wallis tests. RESULTS: A total of 1490 children were included (mean age: 4.81 ± 1.11 years). Furcation periodontitis (38.1%) and pulpitis (36.8%) were the most frequent diagnoses, followed by dental abscesses (22.4%). Mandibular posterior teeth were predominantly affected (59.5%). Children from rural areas presented proportionally more often with advanced complications (p = 0.009). Significant associations were observed between diagnosis and tooth location (p < 0.001), as well as between diagnosis and age (p < 0.001). A marked reduction in emergency presentations was observed during 2020-2021, followed by a progressive increase after 2022. CONCLUSIONS: ECC-related complications remain a major cause of pediatric dental emergency visits, with most children presenting at advanced stages of disease. CLINICAL RELEVANCE: These findings highlight delayed access to preventive dental care and underscore the need for early, community-based preventive strategies to reduce severe ECC complications and emergency dental service utilization.