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An analysis of dental emergency cases managed at BC Children's Hospital

University of British Columbia

Objective: To explore factors contributing to a reported increase in emergencies presenting to the Department of Dentistry at BCCH over recent years by investigating the “who, what, when and why” of their hospital management. Methods: A two-phase study incorporated quantitative (retrospective chart review) and qualitative (personal interview) elements. Phase 1- Records of 300 emergencies from 2009 to 2013 were systematically selected and reviewed. Patient demographics; source of referral; time/day of visit; nature, scope and management of emergency; and follow-up care were analyzed (Pearson’s Chi-squared Tests and Odds Ratios). Phase 2 - Twenty-five interviews with parents of children who recently experienced dental emergencies were recorded and analyzed for common themes in reported factors/circumstances. Results: Emergencies included dentoalveolar trauma (56.7%), pain of dental origin (20%), swelling from advanced dental disease (13.3%), and ‘other’, unrelated to trauma or caries (10%). Common patient characteristics were: healthy, male, young age (<7 years old), proximity of residence to the hospital and low socioeconomic status. Primary source of referral was the emergency department; emergencies presented equally throughout the week. No immediate intervention was necessary for the majority of cases and follow-up with a community dentist was advised. Factors contributing to a parent’s decision to seek emergent dental care in a hospital setting included: perception of urgency; concern for their child’s well being; desire for reliable care by a reputable institution; limited understanding of dental disease and consequences of poor oral care; and financial and access to care barriers. Conclusion: Dentoalveolar trauma and untreated advanced dental caries compel families to seek hospital-based dental emergency services. More aggressive efforts to improve awareness of the importance of early dental visits; development of curricula emphasizing management of anxious children and exposure to pediatric emergencies; and reinforcing the ethical responsibility of dentists to provide after-hours emergency care may help to reduce burden on hospital resources.

Text

2015-08-18

Attribution-NonCommercial-NoDerivs 2.5 Canada

http://hdl.handle.net/2429/54501

Craniofacial Science

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/2.5/ca/