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Telephone Triage for Dental Emergencies Donald A. Crumb, DDS

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The word "triage" is derived from the French word trier, meaning to separate, sort or select. Most of us are familiar with the triage process that takes place in hospital emergency rooms. It is a process of determining the priority of patients' treatments based on the severity of their condition. Put another way, triage is the initial assessment of a situation in order to determine the patient's need and the course of action to follow.

Whenever a patient presents to our dental offices with a dental emergency, the dentist or dental staff routinely perform triage to ascertain the extent and nature of the patient's problem and implement treatment to effectively diagnose and resolve the problem. Our objectives for an emergency appointment are to relieve our patient's pain or otherwise resolve their problem with efficient use of staff and doctor time. The extent of what we can accomplish in our treatment is often dictated by the amount of available doctor time – so time management is critical. Effective utilization of auxiliaries in the triage process provides more efficient use of available doctor time and therefore creates less stress and greater productivity. Triage is a team process.

Stress
When a patient is in pain, there is stress. When a front office team member answers the telephone and is confused by the patient's emergency problem or there doesn't seem to be any time available in the doctor's schedule, there is stress. When the clinical staff sees that an emergency patient has been squeezed into their busy schedule and no one seems to know what the patient is coming in for, there is stress. When the doctor examines the emergency patient and discovers that the patient's problem is not even close to what the front office had suggested and there is not adequate time to do what the patient needs, there is stress. Is there any wonder why in many dental offices emergency patients are considered inconveniences or worse?

The best-case scenario, in my opinion, for effective triage of an emergency dental patient would go something like this:

Front office: The initial conversation between the emergency patient and the front office staff person is the beginning of the triage process. This team member is responsible for a comprehensive assessment of the patient's problem that is provided in writing for the doctor's review. He or she is also responsible for scheduling the patient for an adequate amount of time for the clinical staff to either temporarily resolve the problem or make plans to do so by referral, etc. Inadequate or inaccurate information resulting from this dialogue will compromise the triage and treatment process.

Clinical staff: Upon the patient's arrival to the office, available clinical staff (either a clinical coordinator, hygienist or dental assistant) does a preliminary examination of the problem area and reviews and confirms the details of the initial triage report from the front office. He or she takes the necessary records including radiographs, intraoral photographs, etc.; prepares the treatment room for necessary clinical procedures and reports the clinical findings to the doctor.

Doctor: The doctor should have a detailed explanation of the patient's problem, including the results from radiographs and the preliminary exam before actually seeing the patient. The doctor determines the diagnosis and reviews treatment options with the patient. Clinical treatment will begin as time allows. Relief of any pain is accomplished by palliative treatment, prescribing medications or referral. If time allows, definitive restorations can be done. Otherwise, the patient is stabilized and appropriate follow-up appointments can be scheduled. Don't throw your whole day off trying to do more than is necessary!

The weak link in the triage process of most dental offices seems to be the information gathering from the initial emergency telephone call. Any miscommunication at this point can lead the team in the wrong direction and cause stress between the front office and the clinical staff. It is not uncommon for dental offices to "skip" the front office triage step because of a history of misinformation in handling past emergencies. If you have this problem, find out if it is due to lack of staff training or inadequate methods to record this important information or both.

If the dental office team is all on the same page, the emergency visit for the patient can be a very positive experience. It does take a coordinated effort by the entire staff to achieve the desired results… a win-win for the patient and the office. Successfully treated emergency patients are very appreciative and often become great referral sources.

Preferences in managing dental emergency patients vary considerably from office to office. There really is no one right way for all offices to handle such situations. However, if you want to lower the stress level in your office, pay attention to your triage process. It all starts when the telephone rings!
Author's Bio
Dr. Don Crumb has practiced general dentistry in Syracuse, New York since 1976. Dr. Crumb is the founder of Crumb's Cranium, LLC, a company that recently introduced the only intuitive dental triage software on the market that enables front office staff with or without dental experience to effectively manage and schedule dental emergencies. For more information go to www.crumbscranium.com or contact Dr. Crumb at drcrumb@crumbscranium.com.
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September 2025
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