Recommendations for Managing Endodontic Emergencies during Coronavirus Disease 2019 Outbreak

IntroductionThe management of endodontic emergencies has been particularly challenging during the coronavirus disease 2019 (COVID-19) outbreak because of the possible generation of airborne particles and aerosols. The aim of this report was to contribute to the practice of endodontics by proposing a general protocol for the management of emergencies showing the rationale for remote diagnosis, clinical procedures, and the use of personal protective equipment and barriers at the dental office during the COVID-19 outbreak.MethodsA review of the literature was conducted up to May 2020 on relevant institutional sites, aiming to retrieve the best updated evidence. The reporting considered the Reporting Tool for Practice Guidelines in Health Care statement.ResultsRecommendations from Cochrane Oral Health, the American Dental Association, and the Centers for Disease Control and Prevention were included along with the American Association of Endodontists resources and scientific articles that addressed the issue.ConclusionsThe proposed protocol could contribute to the management of endodontic emergencies at the dental office during the COVID-19 outbreak.     

To Drill or Not to Drill: Management of Endodontic Emergencies and In-Process Patients during the COVID-19 Pandemic

IntroductionDental professionals are at high risk of contracting coronavirus disease 2019 (COVID-19) infection because of their scope of practice with aerosol-generating procedures. Recommendation by the Centers for Disease Control and Prevention to suspend elective dental procedures and avoid aerosol-generating procedures posed significant challenges in the management of patients presenting with endodontic emergencies and uncertainty of outcomes for endodontic procedures initiated, but not completed, before shutdown. The purpose of this study was to evaluate the success of palliative care on endodontic emergencies during the COVID-19 pandemic and to evaluate the stability of teeth with long-term Ca(OH)₂ placement because of delays in treatment completion.MethodsPatients presenting for endodontic emergencies during COVID-19 Shelter-in-Place orders received palliative care, including pharmacologic therapy and/or non–aerosol-generating procedural interventions. Part I of the study evaluated the effectiveness of palliative care, and need for aerosol-generating procedures or extractions was quantified. Part II of the study evaluated survivability and rate of adverse events for teeth that received partial or full root canal debridement and placement of calcium hydroxide before shutdown.ResultsPart I: Twenty-one patients presented with endodontic emergencies in 25 teeth during statewide shutdown. At a follow-up rate of 96%, 83% of endodontic emergencies required no further treatment or intervention after palliative care. Part II: Thirty-one teeth had received partial or full root canal debridement before statewide shutdown. Mean time to complete treatment was 13 weeks. At a recall rate of 100%, 77% of teeth did not experience any adverse events due to delays in treatment completion. The most common adverse event was a fractured provisional restoration (13%), followed by painful and/or infectious flare-up (6.4%), which were managed appropriately and therefore seemed successful. Only 1 tooth was fractured and nonrestorable (3%), leading to a failed outcome of tooth extraction. The remaining 4 outcome failures (13%) were due to patient unwillingness to undergo school-mandated COVID testing or patient unwillingness to continue treatment because of perceived risk of COVID infection.ConclusionsPalliative care for management of endodontic emergencies is a successful option when aerosol-generating procedures are restricted. This treatment approach may be considered in an effort to reduce risk of transmission of COVID-19 infection during subsequent shutdowns. Prolonged Ca(OH)₂ medicament because of COVID-19 related delays in treatment completion appeared to have minimal effect on survival of teeth.     

Impact of covid-19 pandemic on characteristics of dental emergencies and treatment services at tertiary care centre

PurposeTo categorize and compare the dental emergencies along with status of health services received in the tertiary dental health care centre during the pre covid- 19 periods and period of the complete lockdown in COVID 19 pandemic. Methods: A retrospective cross-sectional observational survey was conducted. Four different groups period were studied on patients who visited for dental emergencies at tertiary care centre. April 14 to 13 May 2020 assigned and analyzed as a test period group or group IV. The control period group i.e. group III was 14 February 2020 to 17 March, pre lockdown COVID 19 month when there was no consideration of epidemic in India. Same as periods of group II and IV, group I and II from last year 2019 were also assigned and analyzed. The tertiary care centre provision of health services during this pandemic was also inquired and evaluated. The information was recorded regarding availability of health services like non-emergency dental treatments, emergency dental services, and online professional consultation. To compare four different time period of obtained data, Analysis of variance (ANOVA) and Chi square test were used. Results: The overall proportion and percentage of dental emergencies were raised. The reason for emergency visits to dental clinic were the main problem related with pulpal (46.0%) followed by abscess (16.6%), periapical lesions (15.0%), cellulitis (4.1%) or trauma (0.3%). In lockdown most of the dental emergencies 228(2 6 5) were endodontic related (86.1%) which managed mostly through ‘3A” approach (advise, analgesics and antibiotics) (60.1%) and remaining (26.0%) through extraction.     

Characteristics of Endodontic Emergencies during Coronavirus Disease 2019 Outbreak in Wuhan

IntroductionIn late 2019, an outbreak of a new coronavirus named severe acute respiratory syndrome coronavirus 2 was detected in Wuhan, China. A great percentage of patients with this disease developed symptoms of dry cough, malaise, and a high fever. During this time, several patients requiring assessment and treatment of endodontic emergencies were directed to the School and Hospital of Stomatology at Wuhan University, Wuhan, China. We examined the characteristics of these patients.MethodsA total of 96 patients with a mean age of 42.24 ± 18.32 years visited the general and emergency department of the School and Hospital of Stomatology at Wuhan University because of endodontic emergencies during the peak period of February 22 to March 2, 2020. Patient information was collected and organized by date of visit, sex, age, and systemic disease history. Body temperature was measured and acquired for each patient, a coronavirus disease 2019 (COVID-19) epidemiologic investigation questionnaire was given to each patient, an endodontic diagnosis was determined for the offending tooth, and a verbal numerical rating scale (VNRS) was used to record pain levels.ResultsOf the total patient visits during this period, 50.26% of visits were for endodontic treatment. No patients had a fever (>37.2°C). One patient with a confirmed COVID-19 history was admitted after recovery. Three admitted patients had been exposed to confirmed or suspected COVID-19 patients. Twelve admitted patients (12.5%) with a mean age of 62.42 ± 13.77 years had a history of systemic diseases. The most common age group for endodontic emergencies was 45–64 years (30.21%), and patients of this group showed a significantly higher mean VNRS score compared with that of the 6- to 19-year age group and the 20- to 34-year age group (P < .05). The majority of endodontic emergency diagnoses were diseases of symptomatic irreversible pulpitis (53.10%). Patients who were diagnosed with symptomatic irreversible pulpitis, symptomatic apical periodontitis, and acute apical abscess showed a significantly higher mean VNRS score than that of other groups (P < .05).ConclusionsEndodontic emergencies, with symptomatic irreversible pulpitis being the most common, consist of a much higher proportion of dental emergencies in a COVID-19 high-risk area than normally. Vital pulp therapy can advantageously reduce treatment time, resulting in a reduced risk of infection for vital pulp cases. Rubber dams, personal protective equipment, and patient screening are of great importance during the COVID-19 outbreak in protecting clinicians.     

2020 trends in dental office visits during the COVID-19 pandemic

BackgroundCOVID-19 has created barriers to the delivery of health care services, including dental care. This study sought to quantify the change in dental visits in 2020 compared with 2019.MethodsThis retrospective, observational study examined the percentage change in weekly visits to dental offices by state (inclusive of the District of Columbia), nationally, and by county-level COVID-19 incidence using geographic information from the mobile applications of 45 million smartphones during 2019 and 2020.ResultsFrom March through August 2020, weekly visits to dental offices were 33% lower, on average, than in 2019. Weekly visits were 34% lower, on average, in counties with the highest COVID-19 rates. The greatest decline was observed during the week of April 12, 2020, when there were 66% fewer weekly visits to dental offices. The 5 states (inclusive of the District of Columbia) with the greatest declines in weekly visits from 2019 through 2020, ranging from declines of 38% through 53%, were California, Connecticut, District of Columbia, Massachusetts, and New Jersey.ConclusionsWeekly visits to US dental offices declined drastically during the early phases of the COVID-19 pandemic. Although rates of weekly visits rebounded substantially by June 2020, rates remain about 20% lower than the prior year as of August 2020. These findings highlight the economic challenges faced by dentists owing to the pandemic.Practical ImplicationsStates exhibited widespread variation in rates of declining visits during the pandemic, suggesting that dental practices may need to consider different approaches to reopening and encouraging patients to return depending on location.     

Paediatric dental care during and post-COVID-19 era: Changes and challenges ahead

BackgroundCOVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus is transmitted through respiratory droplets and by physical contact from contaminated surfaces to the mucosa. Its route of transmission has caused a significant challenge in medical and dental healthcare.ObjectiveThis article aims to review the literature and information available on the provision of paediatric dental treatment during and post-pandemic and to provide specific recommendations on the safe provision of paediatric dental care.ResultsChildren infected by SARS-CoV-2 have no or milder COVID-19 symptoms and are potential vectors in spreading the disease. Routine dental treatment is suspended in many countries because of the increased risk of cross-infection in dental practices. Only emergency dental care is provided for urgent conditions. It is necessary to gradually reinstate regular dental care to paediatric patients and maintain their good oral health. To control the disease transmission and maintain the oral health of the population, minimally intervention techniques that minimise or eliminate aerosol generation, plus comprehensive oral health preventive measures should be practised to safeguard safety at dental practices in this unprecedented time.ConclusionsRobust infection control guidelines should be implemented in dental clinics to minimise the risk of infection and to ensure the safety of patients and staff during the pandemic. Three levels of preventive care should be practised to prevent oral diseases and improve children's oral health in this COVID-19 era. Treatment should be prioritized to patients in urgent needs and aerosol-generating procedures should be minimized.     

Changes in dental care use patterns due to COVID-19 among insured patients in the United States

BackgroundDemand for dental services has been known to be linked closely to dental insurance and disposable income. Widespread economic uncertainty and health systems changes due to COVID-19 thus may have a significant impact on dental care use.MethodsUsing deidentified dental practice management data from 2019 and 2020, the authors observed variations in dental care use among insured patients since the COVID-19 outbreak (during the period of practice closure and after the reopening) by patient age, procedure type, insurance type, practice size, geographic area, and reopening status. The authors examined whether the rebound in procedure volumes at dental practices can be explained by county-level characteristics using hierarchical regression models.ResultsAlthough dental care use among privately insured patients fully rebounded by August 2020, use still remained lower than the prepandemic level by 7.54% among the publicly insured population. Demand for teledentistry increased 60-fold during practice closure. Geographic characteristics—such as median household income, percentages of rural or Black populations, and dental care professional shortage designations—were associated significantly with the number of procedures performed at dental practices.ConclusionsAs a result of COVID-19, dental practices experienced substantial decreases in procedure volume, particularly among patients covered by public insurance or residing in underserved areas.Practical ImplicationsDuring economic downturns, state health officials should be encouraged to adopt policies to expand access to oral health care for vulnerable populations via oral health promotion strategies and increasing the supply of dentists or midlevel dental care providers in underserved areas.     

新型冠状病毒传播期间191例武汉口腔急诊患者临床特点

目的:分析新型冠状病毒传播期间武汉大学口腔医院口腔急诊患者特点,为新型冠状病毒传染疾病疫情防控期间,口腔急诊的处置对策提供资料。方法:收集2020年2月22日~2020年3月2日于武汉大学口腔医院就诊口腔急诊患者临床资料,收集分析患者年龄、性别、国籍、体温检测、流行病学调查结果、口腔专科疾病诊断结果等临床信息。结果:本研究纳入患者191例,其中男105例,女86例,性别比为1.22∶1,平均年龄(41.26±16.84)岁,65岁以上患者占12.04%。191例患者中非COVID-19发热患者1例;确诊COVID-19经治疗痊愈后患者2例,其中1例为外籍患者;近期与确诊或疑似COVID-19患者接触者3例。本研究中以牙髓炎和根尖周炎为主要诊断的病例占急诊就诊病例首位(48.17%),其次为牙周病(13.61%)和智齿冠周炎(13.09%)。结论:新型冠状病毒传播期间口腔急诊情况复杂,应关注患者特别是老年患者的健康状况,加强患者的体温检测与流行病学调查,包括外籍患者。口腔医务工作者应具备坚实的口腔全科专业知识,并做好个人防护,预防交叉感染,防止疫情扩散。     

The Impact of COVID-19 on Dentistry in Yichang,China, and Protective Suggestions for Normalisation of Epidemic Prevention

BackgroundCoronavirus disease 2019 (COVID-19) has been identified as a pandemic by the World Health Organization in March 2020, and it affects all aspects of life, including dental care.ObjectivesThe purpose of this article is to explore the impact of COVID-19 on the daily operations of the stomatology department and provide some guidance for dental health care personnel around the world in continuing to provide exemplary care while limiting the spread of COVID-19.Materials and methodsRetrospective analyses were performed on dental patients’ medical records from the stomatology department of the First People's Hospital of Yichang, China, which were collected in the pre-epidemic, epidemic, and post-epidemic periods. Hospital-wide triage and stomatology department–specific protocols were established in the hospital to prevent cross-infection during the COVID-19 pandemic.ResultsThe number of patients decreased and proportion of emergency cases increased during the epidemic period. With prevention protocols in place, the number of dental patients returned to the normal range with a slight elevation during the post-epidemic period. Thus far, there has not been a single documented case of COVID-19 related to dental treatment in the hospital.ConclusionsCOVID-19 has a major impact on daily life, including dental care services. Effective prevention and control measures including 3 levels of protection—zoning, instrumentation, and environmental disinfection—are needed for dental settings to provide care.     

A three-year retrospective study of emergency visits at an oral health clinic in south-east Queensland

Background: There is little information available regarding dental emergencies for children in Australia. The aim of this study was to investigate the reasons for dental emergency cases which were treated at a public oral health clinic in a low socioeconomic district in south‐east Queensland. Methods: From a register kept at a public oral health clinic, we analysed the monthly number of emergency visits for children over a three‐year period (January 2008 to August 2010) with respect to numbers treated, reasons for presentation and types of treatment rendered. Results: During the period 2008–2010, there was a mean of 196 ± 86 cases presenting for emergency care each month. The proportions of the various types of emergencies remained fairly consistent over the three‐year period, with the majority presenting for caries related problems (74–75%), followed by trauma (8–9%), orthodontic treatment related (2–5%) and other reasons (16–11%). Between 8–11% of cases were preschool children who were added to the waitlist for treatment for caries under general anaesthesia at the public hospital. Conclusions: Trends in the past three years at a public oral health clinic in a low socioeconomic district in south‐east Queensland show that dental caries constitute nearly three‐quarters of all paediatric emergency appointments.     

Effects of the COVID-19 pandemic on children’s oral health and oral health care use

BackgroundThe COVID-19 pandemic led to early restrictions on access to oral health care and social distancing requirements. The authors examined the early effects of the COVID-19 pandemic on children’s oral health and access to oral health care in the United States.MethodsUsing nationally representative data from the National Survey of Children’s Health, the authors compared several measures of children’s oral health and oral health care use early during the pandemic in 2020 with 1 year earlier. Logistic (multinomial or binary) regression models were estimated, adjusting for several child and household covariates and state fixed effects. Similar comparisons were estimated for 2019 relative to 2018 to evaluate prepandemic trends.ResultsChildren in 2020 were 16% (relative risk ratio, 0.84; 95% CI, 0.75 to 0.93) less likely to have excellent dental health as perceived by parents and 75% (relative risk ratio, 1.75; 95% CI, 1.14 to 2.67) more likely to have poor dental health than in 2019. In addition, children in 2020 had higher risk of bleeding gingivae (odds ratio, 1.46; 95% CI, 1.16 to 1.85). The likelihood of having a dental visit in the past 12 months was 27% (odds ratio, 0.73; 95% CI, 0.65 to 0.82) lower in 2020, including lower likelihood for preventive visits. The differences between 2020 and 2019 were observed across demographic and socioeconomic subgroups. There were no such differences between 2019 and 2018.ConclusionsThere was a widespread decline in children’s oral health status and access to oral health care early during the COVID-19 pandemic.Practical ImplicationsPrompt policies and oral health campaigns are needed to counter the pandemic effects and increase timely access to dental services.     

Willingness and ability of oral health care workers to work during the COVID-19 pandemic

BackgroundThe COVID-19 pandemic continues to disrupt dental practice in the United States. Oral health care workers play an integral role in societal health, yet little is known about their willingness and ability to work during a pandemic.MethodsOral health care workers completed a survey distributed on dental-specific Facebook groups during an 8-week period (May 1-June 30, 2020) about their willingness and ability to work during the COVID-19 pandemic, barriers to working, and willingness to receive a COVID-19 vaccine.ResultsFour hundred and fifty-nine surveys were returned. Only 53% of dentists, 33% of dental hygienists, 29% of dental assistants, and 48% of nonclinical staff members would be able to work a normal shift during the pandemic, and even fewer (50%, 18%, 17%, and 38%, respectively) would be willing to work a normal shift. Barriers included caring for family, a second job, and personal obligations, and these were faced by dental assistants and hygienists. Dentists were more likely than hygienists (P < .001), assistants (P < .001), and nonclinical staff members (P = .014) to receive a COVID-19 vaccine.ConclusionsOral health care workers have a decreased ability and willingness to report to work during a pandemic, and dentists are significantly more able and willing to work than hygienists and assistants. Dentists are more likely than staff to receive a COVID-19 vaccine.Practical ImplicationsThe results of this study may help inform future initiatives of dental workforce readiness during a pandemic. Dentists should be prepared to discuss alterations to standard operating procedures to allay staff members’ fears and improve retention rates during pandemics, allowing for improved access to oral health care.     

Caregiver acceptance of an anticipated COVID-19 vaccination

BackgroundThe world is hopeful a vaccine will help mitigate the COVID-19 pandemic. The authors conducted a hospital-based study using a questionnaire to examine parental acceptance of an anticipated COVID-19 vaccination.MethodsA 41-item questionnaire using the Health Belief Model was administered to caregivers of children receiving oral health care in a dental clinic in an urban pediatric teaching hospital. Demographic, health-seeking, and health-behavior questions were assessed.ResultsA total of 39.2% of caregivers would not allow their child to receive a COVID-19 vaccination. Whereas 27.8% of caregivers agreed that if their physician recommends a COVID-19 vaccination, they will allow their child to receive it, 52.2% said that a health care professional could influence this decision.ConclusionsDentists, intimately aware of the suggested risks of aerosol-generating procedures, can play a critical role in educating the public about the importance of accepting a COVID-19 vaccine.Practical ImplicationsDentists are in a unique position to discuss and advocate for vaccine acceptance. If a COVID-19 vaccine is not widely accepted, risks associated with performing aerosol-generating procedures will remain.     

A Retrospective Study of Oral Emergency Services During COVID-19

ObjectivesThis study was performed to examine changes in the number of patient visits and types of oral services in an oral emergency department from the beginning to the control stage of the coronavirus disease 2019 (COVID-19) outbreak in Beijing.MethodsThe numbers of daily oral emergency visits from January 20 to March 24, 2020, at a dental university hospital in Beijing and daily newly confirmed COVID-19 cases in Beijing during the same period were collected and analysed. All oral emergency patient information (including sex, age, and oral diagnosis) was also collected and analysed. Patients with incomplete medical data were excluded.ResultsIn total, 12,416 patients were included in this study. The number of daily emergency visits was negatively correlated with the number of newly confirmed local COVID-19 cases in Beijing (P < .001). The number of daily emergency visits during the COVID-19 stable period in Beijing was greater than that during the outbreak period (P < .001). Compared to those in the COVID-19 outbreak period, the percentages of females, children and adolescents, patients with acute toothache, and patients with nonurgent cases were higher in the stable period, and the numbers of patients with toothache, trauma, infection, and nonemergency conditions increased in the COVID-19 stable period (P < .001).ConclusionsCOVID-19 significantly influenced the number of patient visits and the percentages of patients with oral emergency situations in the oral emergency department. There were obvious differences in treatment seeking for oral emergencies between the COVID-19 periods in Beijing. There was an inverse relationship between daily oral emergency visits and daily confirmed COVID-19 cases in Beijing.     

A glimpse into the curricular format of comprehensive care clinics in Brazilian dental schools

Abstract

Objective. This study aimed to describe some curricular aspects of comprehensive dental care clinics in Brazil. Materials and methods. An email survey was sent to all academic affairs deans of Brazilian undergraduate dental programmes. It contained questions regarding the (1) curricular format and (2) characteristics of comprehensive dental care clinics. Results. Sixty-seven dental schools agreed to participate. It was observed that curricular changes have contributed to modify the structure of these clinics in 88.1% of the schools surveyed. The main alteration was related to an increase in credit hours and offer of this type of care at different levels of the dental curriculum. In 95.5% of the schools, clinical procedures were prioritized according to level of complexity. Inter-disciplinarity (37.3%) and teaching innovation (58.2%) were frequent challenges in the process of change. Progress in combining teaching and clinical services was reported by 50.8% of schools. In 32.8%, clinical procedures were still being performed intra-murally. Conclusions. Changes in the curriculum of Brazilian comprehensive dental care clinics were observed by this survey.     

What is the association between income loss during the COVID-19 pandemic and children’s dental care?

BackgroundThe degree to which children experience unmet need for dental care during the COVID-19 pandemic and its association with pandemic-related household job or income loss are unknown.MethodsThe authors performed a cross-sectional household survey of 348 families in Pittsburgh, Pennsylvania, from June 25 through July 2, 2020. Unmet need for child dental care and pandemic-related household job or income loss were assessed using caregiver self-report.ResultsCaregivers reported that the greatest unmet child health care need during the COVID-19 pandemic was dental care (16%), followed by medical care for a well visit or vaccination (5%). Approximately 40% of caregivers reported job loss or a decrease in household income due to the COVID-19 pandemic. The authors found a significant association between the probability of unmet child dental care and pandemic-related household job or income loss (P = .022). Losing a job or experiencing a decrease in income due to the COVID-19 pandemic was associated with unmet child dental care (relative risk, 1.77; 95% confidence interval, 1.08 to 2.88).ConclusionsIn this sample, 3 times as many households reported unmet dental care for a child compared with unmet medical care. Unmet child dental care was more common in households where pandemic-related job or income loss occurred.Practical ImplicationsIf unmet dental care continues as a result of the COVID-19 pandemic, nontraditional strategies for delivering dental care can be considered to improve access to dental care for children, such as teledentistry and oral health prevention services in primary care settings.     

Impact of COVID-19 on Oral Emergency Services

ObjectiveTo retrospectively review the impact of the outbreak of coronavirus disease 2019 (COVID-19) on services in the oral emergency room.Materials and methodsA statistical analysis of epidemiological characteristics and the patients’ diagnoses and treatments in the Emergency Department of Peking University Hospital of Stomatology during the outbreak of COVID-19 in 2020 compared with those in 2019 in Beijing, China.ResultsThere were fewer total visits in 2020 than in 2019 (P = 0.001), and the proportions of patients who were children, adolescents and elderly people were lower in 2020 than in 2019 (P < 0.001). The proportions of patients with acute toothache and infections were higher in 2020 than in 2019, and the proportions of patients with maxillofacial trauma and non-emergencies were lower in 2020 than in 2019 (P < 0.001). Drug treatment for acute pulpitis was used more often in 2020 than in 2019, and endodontic treatment and examination consultations were less common in 2020 than in 2019 (P = 0.022).ConclusionsThe outbreak of COVID-19 affected the patient population and structure of disease types and oral services in the emergency room. The number of visits to the oral emergency room and the proportions of the patients who were children, adolescents and elderly people were reduced, meanwhile the percentage of emergency cases, except trauma, and conservative treatments increased during the outbreak of COVID-19.     

What is the rate of COVID-19 infection in a population seeking oral health care?

BackgroundAlthough rates of COVID-19 have remained low among US dentists, the authors aimed to determine the risk of there being COVID-19 in patients seeking oral health care.MethodsThe authors performed a retrospective chart review of all emergency department consultations from June 1, 2020, through December 31, 2020. They used Pearson correlation coefficients to compare rates with citywide prevalence (P < .05).ResultsThe authors located 203 encounters with 149 tests and 10 cases of COVID-19. Cases were strongly correlated with the citywide positivity rate (r = 0.9147; P = .0039). All patients who tested positive were asymptomatic and afebrile, and one-half (50%) visited a dentist within a week of consultation.ConclusionsThe rate of COVID-19 in a population seeking oral health care reflects the community positivity rate. Asymptomatic or presymptomatic patients pose risks to providers, staff members, and other patients.Practical ImplicationsDentists should remain vigilant during the ongoing COVID-19 pandemic, even with vaccination rollout. The Centers for Disease Control and Prevention maintains an accessible website with easy access to each state’s positivity rate and caseload.     

Emergency protocol in the dental clinic: Assessing medical emergency training requirements and guidelines for dentists

BackgroundMedical emergencies are an unavoidable reality affecting dental practices. This review synthesizes and examines the guidelines offered by governmental and professional organizations.Types of Studies ReviewedLicensing agencies and professional associations were chosen as organizations of focus based on legal authority, high professional regard, or both. International and interprofessional organizational counterparts were chosen as points of comparison. In total, 11 organizations were examined. Guidelines reported were compiled by examination of documents published on official agency websites and in associated peer-reviewed journals.ResultsGuidelines for the handling of medical emergencies in the dental clinic vary in level of detail and scope among sources. Licensing agencies provide basic requirements for training, encouraging oral health care providers to develop and integrate their own emergency response plans. Professional associations provide extensive detail on instruction in medical emergency management. Both licensing agencies and professional associations provide lists of emergency medications and equipment, with varying levels of instruction on drug maintenance and organization. Professional associations emphasize regular review of training and office emergency drills.ConclusionOral health care professionals are provided with basic and required elements of medical emergency training by licensing agencies. They may seek out recommended, but not required, instruction from professional associations. Although guidance is provided, literature on protocol instituted in dental practices is limited. Further research is necessary to determine the oral health care community’s approach to emergency management.Practical ImplicationsProviders must be prepared to handle medical emergencies that they encounter. Accessible and understandable guidelines are crucial to safe dental practice.