Sir, with the problem of limited access to out of hours dental care an increasing number of patients with dental/maxillofacial emergencies are presenting to the emergency department (ED) and this may contribute to up to 4% of the ED workload.1 Furthermore, most medical professionals do not receive any formal dental training at either undergraduate or postgraduate level. The result is that many dental emergencies may be mismanaged as ED physicians do not feel confident in managing even simple dental emergencies2 causing significant morbidity and cost for the patient not to mention the medico-legal implications for the clinician.

Not every hospital has access to a 24-hour on call maxillofacial specialist. It is not uncommon for a patient with a dental trauma to wait three hours in the ED before being referred to another unit for definitive treatment. This is not only less than ideal for the patient but may also have a significant impact on the overall prognosis of the tooth.

At present there are few resources which ED physicians can access in order to learn the necessary skills required to manage basic dental/maxillofacial emergencies. As a dually qualified ED clinician I have founded a national course for ED physicians to learn and practise core dental skills. The Advanced Tooth Life Support (ATLS) course uses the stepwise ABC approach favoured by other life support courses (Advanced Life Support) to teach non-dentists how to safely manage common dental emergencies. Recently this course was developed into a national training workshop for ED doctors held at the national Emergency Medicine Trainee Association conference held in July at the Royal Society of Medicine in London. Trainees from around the UK spent the day practising replanting teeth in simulated models, learning how to perform intra-oral blocks and making dental trauma splints.

In order to ensure that patients receive the highest quality of treatment I feel there is a need to support our medical colleagues by collaboratively developing and implementing resources that will enhance their dental knowledge and practical skills. There is great need for such courses as well as further research in this field of emergency (dental) medicine so that every medical practitioner has the basic knowledge and skills to manage dental emergencies competently.