AIM:To describe the pathways to care associated with acute dental infections in children. METHODS:Primary carers of children presenting with facial cellulitis completed a semistructured interview that sought to establish their pathway to the emergency department and definitive treatment. Descriptive statistics were used to describe the patterns of healthcare attendances, treatment received, medications prescribed and referrals made from the time the problem was first noted. RESULTS:Interviews were completed for 12 children presenting with acute cellulitis as a result of caries in the primary dentition (mean age of 6.8 + 2.6 years). The median time lapsed since carers first became aware of the problem was 15.5 days (range 3 to 63). The mean number of health service attendances made per child was 4.5 + 1.98. A total of 17 courses of oral antibiotics were prescribed prior to definitive treatment (mean 1.4 + 1.24, range 0 to 3). Half the teeth involved had been previously 'restored'. CONCLUSION:Children presenting with acute facial cellulitis represent the last stage in a pathway of failed clinical care that is associated with significant costs to both the individual family and the community. Further work is required to understand the barriers to children accessing timely and appropriate dental treatment.