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Sommacal A, Bingisser R, Filippi A, Bethke M, Thieringer FM, Jaquiéry C, Berg BI. Dental and Maxillofacial Emergency Algorithms in Swiss Emergency Departments. J Clin Med 2023; 12:jcm12082952. [PMID: 37109288 PMCID: PMC10144593 DOI: 10.3390/jcm12082952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/28/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
This study aimed to evaluate the availability and use of dental and maxillofacial emergency algorithms in Swiss hospitals. A survey was performed among physicians at Swiss emergency departments (ED) and participants of the "36th Annual Meeting of the Society for Oral and Cranio-Maxillofacial Surgery". Eighty-nine EDs in Switzerland were questioned about the availability and use of electronic algorithms in their hospitals. Eighty-one (91%) participated in the study. In 75 (93%) of the EDs, electronic algorithms are used, mainly "medStandards". Six have no available algorithms. Fifty-two (64%) use algorithms daily. Eight (10%) Swiss EDs have maxillofacial and dental algorithms, and 73 (90%) have no access to or do not know about them. For dental algorithms, 28 (38%) of the respondents would like to have access, and 16 (22%) do not desire access. For maxillofacial algorithms, 23 (32%) want to have access and 21 (29%) do not want it. Most (74%) of the participating maxillofacial surgeons did not know about the existence of ED algorithms regarding their specialty. Our study shows that the existence of specific algorithms is often not known. Furthermore, there is a demand for dental and maxillofacial algorithms in Swiss EDs.
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Affiliation(s)
- Adelita Sommacal
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
| | - Roland Bingisser
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
- Emergency Department, University Hospital Basel, 4031 Basel, Switzerland
| | - Andreas Filippi
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
- Clinic of Oral Surgery and Center of Dental Traumatology, University Center for Dental Medicine UZB, University of Basel, 4058 Basel, Switzerland
| | - Mascha Bethke
- Emergency Department, University Hospital Basel, 4031 Basel, Switzerland
| | - Florian M Thieringer
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
- Swiss MAM Research Group, Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
| | - Claude Jaquiéry
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
| | - Britt-Isabelle Berg
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
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Gallichan N, Albadri S, Watkins F, Jarad F, Messahel S, Hartshorn S, Gartshore L. Management of traumatic dental injuries: a survey of paediatric emergency department health professionals. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001740. [PMID: 36948508 PMCID: PMC10040074 DOI: 10.1136/bmjpo-2022-001740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/16/2023] [Indexed: 03/24/2023] Open
Abstract
OBJECTIVE To assess paediatric emergency department (PED) health professionals' confidence, experience and awareness in managing traumatic dental injuries (TDIs). DESIGN A cross-sectional online survey. SETTING PED at Alder Hey Children's Hospital and Birmingham Children's Hospital. RESULTS 94 ED health professionals responded. One-third of responders (n=26) encounter children with dental trauma daily or weekly. TDI teaching during undergraduate training was received by 13% (n=12) of responders, and 32% (n=30) had never received training. Responders thought they would benefit from online resources and regular teaching on paediatric TDIs, in addition to an easy-to-use decision-making tool to signpost families.ED health professionals' confidence in giving advice to families following a TDI, and in recognising types of TDIs, was notably low; -79 and -76 Net Promotor Score, respectively.Responders' awareness of how to recognise and manage TDIs was varied. Majority were aware of the need to attempt to reimplant an avulsed permanent tooth, and the need to refer a child presenting with a complex permanent tooth injury to the oncall dentist. However, very few responders commented on the importance of follow-up. Responders also raised concerns about the lack of dental services to treat TDIs in children. CONCLUSIONS There is a need to enhance dental trauma teaching for all ED health professionals who encounter TDIs to increase their confidence and enable them to triage and advise patients appropriately. Additionally, increased signposting for families to the appropriate service could in turn improve outcomes and experience for children who experience a TDI.
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Affiliation(s)
- Nathalie Gallichan
- Paediatric Dentistry Department, School of Dentistry, University of Liverpool, Liverpool, UK
- Paediatric Dentistry Department, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Sondos Albadri
- Paediatric Dentistry Department, School of Dentistry, University of Liverpool, Liverpool, UK
- Paediatric Dentistry Department, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Francine Watkins
- University of Liverpool Faculty of Health and Life Sciences, Liverpool, UK
| | - Fadi Jarad
- Restorative Department, School of Dentistry, University of Liverpool, Liverpool, UK
| | - Shrouk Messahel
- Paediatric Emergency Department, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Stuart Hartshorn
- Emergency Department, Birmingham Children's Hospital, Birmingham, UK
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Laura Gartshore
- Paediatric Dentistry Department, School of Dentistry, University of Liverpool, Liverpool, UK
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Currie C, Stone S, Pearce M, Landes D, Durham J. Urgent dental care use in the North East and Cumbria: predicting repeat attendance. Br Dent J 2022; 232:164-171. [PMID: 35149813 PMCID: PMC8837533 DOI: 10.1038/s41415-022-3886-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/05/2021] [Indexed: 12/29/2022]
Abstract
Introduction Around one-third of the UK population are 'problem-orientated dental attenders', only seeking care when suffering with dental pain and often on a repeated basis to secondary care. Little is known about attendance in primary care. The aim here was to examine the period prevalence of repeat urgent care attenders and establish predictors of repeat attendance in primary care. Methods Data on urgent and emergency dental care attendances in primary dental care in the North East and Cumbria were analysed from 2013-2019. Variables included: patient sex; ten-year age band; lower super output area; and Index of Multiple Deprivation. Period prevalence was calculated and data were considered year by year to identify trends in attendances. Analysis was with descriptive statistics and predictors of repeat attendance were identified using logistic regression modelling. Results Over the six-year period, there were 601,432 attendances for urgent primary dental care, equating to a period prevalence of 2.76% for the geographic population studied. In total, 16.15% of attendances were repeat attendances (period prevalence 0.45%) and predictors included being a woman and residence in deprived and rural areas. All urgent care attendances decreased over the six-year period, with one-off attendances beginning to increase again in 2019, while repeat attendances stabilised. Conclusion Interventions to encourage regular dental attendances should be targeted at patients from the most deprived and rural areas of the North East and Cumbria; however, a decrease in repeat attendance was noted in these areas. Predictors of being a repeat attender for urgent and emergency dental care included being a woman and living in the most deprived and rural areas of the North East and Cumbria. Over a six-year period (2013-2019), the number of one-off urgent and emergency dental care attenders to primary care in the North East and Cumbria decreased before beginning to increase. Over the same period, the number of repeat urgent and emergency dental care attenders to primary care in the North East and Cumbria decreased before stabilising.
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Yeng T, O'Sullivan AJ, Shulruf B. Dental trauma learning facilitators for medical doctors: A viewpoint. Dent Traumatol 2020; 36:212-214. [DOI: 10.1111/edt.12541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 12/29/2019] [Accepted: 12/30/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Thai Yeng
- Medical Education Faculty of Medicine University of New South Wales Sydney NSW Australia
| | - Anthony J. O'Sullivan
- St George and Sutherland Clinical Hospital University of New South Wales Sydney NSW Australia
| | - Boaz Shulruf
- Medical Education Faculty of Medicine University of New South Wales Sydney NSW Australia
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Yigit Y, Helvacioglu-Yigit D, Kan B, Ilgen C, Yilmaz S. Dentofacial traumatic injuries: A survey of knowledge and attitudes among emergency medicine physicians in Turkey. Dent Traumatol 2018; 35:20-26. [DOI: 10.1111/edt.12440] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/05/2018] [Accepted: 09/05/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Yavuz Yigit
- Department of Emergency Medicine; Kocaeli Derince Health Practice and Research Center; Kocaeli Turkey
| | | | | | - Cansu Ilgen
- MedicalPark Hospital Dental Clinic; Kocaeli Turkey
| | - Serkan Yilmaz
- Department of Emergency Medicine; Faculty of Medicine; Kocaeli University; Kocaeli Turkey
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Abbott B, Zybutz C, Scott KM, Eberhard J, Widmer R. A review of the hours dedicated to oral health education in medical programmes across Australia. Intern Med J 2018; 48:1035-1040. [DOI: 10.1111/imj.14021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/07/2018] [Accepted: 03/16/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Bronwyn Abbott
- Discipline of Child and Adolescent Health; The University of Sydney; New South Wales Australia
| | - Cian Zybutz
- Discipline of Child and Adolescent Health; The University of Sydney; New South Wales Australia
| | - Karen M. Scott
- Discipline of Child and Adolescent Health; The University of Sydney; New South Wales Australia
| | - Joerg Eberhard
- Sydney Dental School; The University of Sydney; New South Wales Australia
| | - Richard Widmer
- Discipline of Child and Adolescent Health; The University of Sydney; New South Wales Australia
- Dental Department; The Children's Hospital at Westmead; Sydney New South Wales Australia
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Carpenter CR, Lewis L, Jotte RS, Schwarz ES. A Bridge to Nowhere? Challenging Outpatient Transitions of Care for Acute Pain Patients in the Opioid Epidemic Era. Mo Med 2018; 115:241-246. [PMID: 30228730 PMCID: PMC6140146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Opioid misuse is reducing Americans' life expectancy, thereby catalyzing professional societies and legislators to action. Efforts to combat the opioid epidemic must work hand-in-hand with appropriate efforts to reduce the severity and duration of suffering. Pharmacologic analgesia is temporizing. Current opioid prescribing guidelines focus on reducing the frequency and quantity of narcotics prescribed, but lack attention to alleviation of the source of pain. Conditions eliciting acute pain sometimes require additional specialist management following discharge from the emergency department. Patients frequently lack timely access to these specialists, particularly if underinsured. This essay explores acute dental pain, extremity fractures, and back pain as three common examples whereby complex healthcare systems must efficiently adapt in order to serve the dual objectives of reducing the risk of opioid-related adverse consequences and minimizing the duration of patient suffering.
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Affiliation(s)
- Christopher R Carpenter
- Christopher R. Carpenter, MD, MSc, MSMA member since 2016, Associate Professor, is in the Division of Emergency Medicine, Washington University School of Medicine, St. Louis, Mo
| | - Lawrence Lewis
- Lawrence Lewis, MD, Professor, is in the Division of Emergency Medicine, Washington University School of Medicine, St. Louis, Mo
| | - Randall S Jotte
- Randall S. Jotte, MD, MSMA member since 2016, Associate Professor, is in the Division of Emergency Medicine, Washington University School of Medicine, St. Louis, Mo
| | - Evan S Schwarz
- Evan S. Schwarz, MD, MSMA member since 2014, Associate Professor, is in the Division of Emergency Medicine, Washington University School of Medicine, St. Louis, Mo
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Currie CC, Stone SJ, Connolly J, Durham J. Dental pain in the medical emergency department: a cross-sectional study. J Oral Rehabil 2016; 44:105-111. [DOI: 10.1111/joor.12462] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2016] [Indexed: 11/30/2022]
Affiliation(s)
- C. C. Currie
- Centre for Oral Health Research; School of Dental Sciences; Newcastle University; Newcastle Upon Tyne UK
| | - S. J. Stone
- Centre for Oral Health Research; School of Dental Sciences; Newcastle University; Newcastle Upon Tyne UK
| | - J. Connolly
- Emergency Department; Royal Victoria Infirmary; Newcastle Upon Tyne UK
| | - J. Durham
- Institute of Health and Society and Centre for Oral Health Research; Level 5, School of Dental Sciences; Newcastle University; Newcastle Upon Tyne UK
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Carter AE, Carter G, Abbey R. A Focus Group on Dental Pain Complaints with General Medical Practitioners: Developing a Treatment Algorithm. Int J Family Med 2016; 2016:4760672. [PMID: 27462469 PMCID: PMC4947654 DOI: 10.1155/2016/4760672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 06/04/2016] [Accepted: 06/08/2016] [Indexed: 06/06/2023]
Abstract
Objective. The differential diagnosis of pain in the mouth can be challenging for general medical practitioners (GMPs) as many different dental problems can present with similar signs and symptoms. This study aimed to create a treatment algorithm for GMPs to effectively and appropriately refer the patients and prescribe antibiotics. Design. The study design is comprised of qualitative focus group discussions. Setting and Subjects. Groups of GMPs within the Gold Coast and Brisbane urban and city regions. Outcome Measures. Content thematically analysed and treatment algorithm developed. Results. There were 5 focus groups with 8-9 participants per group. Addressing whether antibiotics should be given to patients with dental pain was considered very important to GMPs to prevent overtreatment and creating antibiotic resistance. Many practitioners were unsure of what the different forms of dental pains represent. 90% of the practitioners involved agreed that the treatment algorithm was useful to daily practice. Conclusion. Common dental complaints and infections are seldom surgical emergencies but can result in prolonged appointments for those GMPs who do not regularly deal with these issues. The treatment algorithm for referral processes and prescriptions was deemed easily downloadable and simple to interpret and detailed but succinct enough for clinical use by GMPs.
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Affiliation(s)
| | - Geoff Carter
- Department of Employment and Human Relations, Parklands Drive, Southport, QLD 4215, Australia
| | - Robyn Abbey
- Griffith University, Parklands Drive, Southport, QLD 4215, Australia
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Deeb GR, Johnson A, Bondarew M, Carrico C, Laskin D, Deeb JG. How Effective is a Dental Workshop at Improving the Knowledge and Confidence of Medical Students in the Management of Dental Emergencies? J Med Educ Curric Dev 2016; 3:10.4137_JMECD.S39992. [PMID: 29349314 PMCID: PMC5736274 DOI: 10.4137/jmecd.s39992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/07/2016] [Accepted: 06/09/2016] [Indexed: 06/07/2023]
Abstract
The purpose of this study was to evaluate the effect of a three-hour hands-on workshop for medical students and residents on their pre- and postcourse knowledge and confidence in managing dental emergencies. A 1-hour lecture followed by four 20-minute "hands-on" skill stations on dental mannequins was administered to a group of 30 medical students and residents. Pre- and postworkshop questionnaire surveys were conducted. There was a significant increase in the percent of attendees who responded correctly to three of the four knowledge questions following the workshop (P-value < 0.005). Confidence, as expressed in various statements, about treating dental emergencies was significantly improved after the lecture for eight of the nine statements. These findings indicate that dental knowledge is generally not provided during medical training. Our interactive workshop appeared to be effective in increasing this knowledge and self-reported confidence in handling dental emergencies. These findings clearly indicate the need for additional dental education during medical school. The use of a hands-on workshop may be one model for achieving this goal.
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Affiliation(s)
- George R. Deeb
- Department of Oral and Maxillofacial Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Amber Johnson
- Department of Oral and Maxillofacial Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Mikhail Bondarew
- Department of General Dentistry, Virginia Commonwealth University, Richmond, VA, USA
| | - Caroline Carrico
- Department of Research Administration, Virginia Commonwealth University, Richmond, VA, USA
| | - Daniel Laskin
- Department of Oral and Maxillofacial Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Janina Golob Deeb
- Department of Periodontics, Virginia Commonwealth University, Richmond, VA, USA
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Manzie T, Rich W. Dental presentations to an emergency department in a regional centre: prescribing practices for analgesia. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Alotaibi N, Cloutier L, Khaldoun E, Bois E, Chirat M, Salvan D. Criteria for admission of odontogenic infections at high risk of deep neck space infection. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:261-4. [PMID: 26347337 DOI: 10.1016/j.anorl.2015.08.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Many patients with odontogenic infections are hospitalised because of the risk of deep neck space infection. The objective of this study was to identify risk factors allowing more reliable selection of patients requiring hospitalisation for both specialists and emergency physicians. MATERIAL AND METHODS This retrospective study was based on a cohort of 97 patients hospitalised for odontogenic infection in the Department of Otorhinolaryngology and Head and Neck Surgery of Centre hospitalier Sud Francilien, Île-de-France, from January 2008 to June 2012. RESULTS The majority of patients presented with dental abscess (66 patients; 68%). Nineteen patients (20%) presented with deep neck space infection. The frequency of deep neck space infection was significantly higher in patients with mandibular odontogenic infection (16/55 patients (29%) than in those with maxillary odontogenic infection (3/42 (7%); P ≤ 0.009). The incidence of deep neck space infection was significantly higher in patients with dental abscess (17/66, (26%) than in those without dental abscess (2/31 (6%); P ≤ 0.03). CONCLUSION In addition to the well-known classical criteria (fever, neck swelling, dyspnoea, dysphagia, trismus, leukocytosis, elevated C reactive protein (CRP)), the criteria for admission for odontogenic infection should include mandibular odontogenic infection and/or the presence of dental abscess.
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Affiliation(s)
- N Alotaibi
- Service d'ORL et de chirurgie cervico-maxillo-faciale, centre hospitalier Sud Francilien, 116, boulevard Jean-Jaurès, 91100 Corbeil-Essonnes, France.
| | - L Cloutier
- Service d'ORL et de chirurgie cervico-maxillo-faciale, centre hospitalier Sud Francilien, 116, boulevard Jean-Jaurès, 91100 Corbeil-Essonnes, France
| | - E Khaldoun
- Service d'ORL et de chirurgie cervico-maxillo-faciale, centre hospitalier Sud Francilien, 116, boulevard Jean-Jaurès, 91100 Corbeil-Essonnes, France
| | - E Bois
- Service d'ORL et de chirurgie cervico-maxillo-faciale, centre hospitalier Sud Francilien, 116, boulevard Jean-Jaurès, 91100 Corbeil-Essonnes, France
| | - M Chirat
- Service d'ORL et de chirurgie cervico-maxillo-faciale, centre hospitalier Sud Francilien, 116, boulevard Jean-Jaurès, 91100 Corbeil-Essonnes, France
| | - D Salvan
- Service d'ORL et de chirurgie cervico-maxillo-faciale, centre hospitalier Sud Francilien, 116, boulevard Jean-Jaurès, 91100 Corbeil-Essonnes, France
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DeAngelis AF, Barrowman RA, Harrod R, Nastri AL. Review article: Maxillofacial emergencies: oral pain and odontogenic infections. Emerg Med Australas 2015; 26:336-42. [PMID: 25065769 DOI: 10.1111/1742-6723.12266] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2014] [Indexed: 11/30/2022]
Abstract
Oral pain and odontogenic infections are common reasons for patients to present to EDs and general medical practice in Australia. Although most odontogenic infections can be managed on an outpatient basis, because of their proximity to the airway, infections in this region can be life threatening, requiring urgent surgical intervention and ICU management. This article focuses on the emergency assessment, triage and non-specialist management of oral pain and odontogenic infections.
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Affiliation(s)
- Adrian F DeAngelis
- Maxillofacial Surgery Unit, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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15
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Samaei H, Weiland TJ, Dilley S, Jelinek GA. Knowledge and confidence of a convenience sample of australasian emergency doctors in managing dental emergencies: results of a survey. Emerg Med Int 2015; 2015:148384. [PMID: 25821600 PMCID: PMC4364295 DOI: 10.1155/2015/148384] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 01/28/2015] [Accepted: 01/29/2015] [Indexed: 11/23/2022] Open
Abstract
Background. We aimed to determine Australasian Specialist Emergency Physicians' and Emergency Physicians in Training (Trainees') level of knowledge of common dental emergencies. We also explored confidence in managing dental emergencies; predictors of confidence and knowledge; and preferences for further dental education. Methods. A questionnaire was distributed electronically (September 2011) and directly (November 2011) to Fellows and Trainees of the Australasian College for Emergency Medicine. It explored demographics, confidence, knowledge of dental emergencies, and educational preferences. Results. Response rate was 13.6% (464/3405) and college members were proportionally represented by region. Fewer than half (186/446; 42%) had received dental training. Sixty-two percent (244/391, 95% CI 57.5-67.1) passed (>50%) a knowledge test. More than 60% incorrectly answered questions on dental fracture, periodontal abscess, tooth eruption dates, and ulcerative gingivitis. Forty percent (166/416) incorrectly answered a question about Ludwig's Angina. Eighty-three percent (360/433) were confident in the pharmacological management of toothache but only 26% (112/434) confident in recognizing periodontal disease. Knowledge was correlated with confidence (r = 0.488). Interactive workshops were preferred by most (386/415, 93%). Conclusions. The knowledge and confidence of Australasian Emergency Physicians and Trainees in managing dental emergencies are varied, yet correlated. Interactive training sessions in dental emergencies are warranted.
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Affiliation(s)
- Hossein Samaei
- Department of Emergency Medicine, St. Vincent's Hospital, Melbourne, VIC 3065, Australia
| | - Tracey Joy Weiland
- Emergency Practice Innovation Centre, St. Vincent's Hospital, Melbourne, VIC 3065, Australia
- Department of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Stuart Dilley
- Department of Emergency Medicine, St. Vincent's Hospital, Melbourne, VIC 3065, Australia
- Department of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - George Alexander Jelinek
- Emergency Practice Innovation Centre, St. Vincent's Hospital, Melbourne, VIC 3065, Australia
- Department of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3010, Australia
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Abstract
Fractures of the facial skeleton are a common reason for patients to present to EDs and general medical practice in Australia. Trauma to the maxillofacial region can lead to airway obstruction, intracranial injuries, loss of vision or long term cosmetic and functional deficits. This article focuses on the emergency assessment, triage and non-specialist management of traumatic injuries of the orbit and facial skeleton.
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Affiliation(s)
- Adrian F DeAngelis
- Maxillofacial Surgery Unit, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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DeAngelis AF, Barrowman RA, Harrod R, Nastri AL. Review article: Maxillofacial emergencies: Dentoalveolar and temporomandibular joint trauma. Emerg Med Australas 2014; 26:439-45. [DOI: 10.1111/1742-6723.12267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Adrian F DeAngelis
- Maxillofacial Surgery Unit; Royal Melbourne Hospital; Melbourne Victoria Australia
| | - Roland A Barrowman
- Maxillofacial Surgery Unit; Royal Melbourne Hospital; Melbourne Victoria Australia
| | - Richard Harrod
- Emergency Medicine Department; Royal Melbourne Hospital; Melbourne Victoria Australia
| | - Alf L Nastri
- Maxillofacial Surgery Unit; Royal Melbourne Hospital; Melbourne Victoria Australia
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18
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Skapetis T, Gerzina T, Hu W. Managing dental emergencies: a descriptive study of the effects of a multimodal educational intervention for primary care providers at six months. BMC Med Educ 2012; 12:103. [PMID: 23110579 PMCID: PMC3534540 DOI: 10.1186/1472-6920-12-103] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 10/14/2012] [Indexed: 05/30/2023]
Abstract
BACKGROUND Clinicians providing primary emergency medical care often receive little training in the management of dental emergencies. A multimodal educational intervention was designed to address this lack of training. Sustained competency in managing dental emergencies and thus the confidence to provide this care well after an educational intervention is of particular importance for remote and rural healthcare providers where access to professional development training may be lacking. METHODS A descriptive study design with a survey instrument was used to evaluate the effectiveness of a brief educational intervention for primary care clinicians. The survey was offered immediately before and at six months following the intervention. A Wilcoxon signed rank test was performed on pre and six month post-workshop matched pair responses, measuring self-reported proficiency in managing dental emergencies. The level of significance was set at p < 0.001. Confidence intervals (CI) were calculated for participants who scored an improved proficiency. RESULTS The educational intervention was associated with a significant and sustained increase in proficiency and confidence to treat, especially in oral local anaesthesia, management of avulsed teeth and dental trauma, as reported by clinicians at six months after the education. This was associated with a greater number of cases where dental local anaesthesia was utilised by the participants. Comments from participants before the intervention, noted the lack of dental topics in professional training. CONCLUSIONS The sustained effects of a brief multimodal educational intervention in managing dental emergencies on practice confidence and proficiency demonstrates its value as an educational model that could be applied to other settings and health professional groups providing emergency primary care, particularly in rural and remote settings.
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Affiliation(s)
- Tony Skapetis
- Clinical Director of Education Westmead Centre for Oral Health, Western Sydney Local Health District, University of Sydney faculty of Dentistry, PO Box 533, Wentworthville, NSW 2145, Australia
| | - Tania Gerzina
- Jaw Function and Orofacial Pain Unit, Faculty of Dentistry, Division of Health, Westmead Centre for Oral Health, University of Sydney, Westmead Australia 2145, Australia
| | - Wendy Hu
- University of Western Sydney School of Medicine, Locked Bag 1797, Penrith, NSW 2751, Australia
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Skapetis T, Gerzina T, Hu W. Can a four-hour interactive workshop on the management of dental emergencies be effective in improving self reported levels of clinician proficiency? ACTA ACUST UNITED AC 2012; 15:14-22. [DOI: 10.1016/j.aenj.2011.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Revised: 12/13/2011] [Accepted: 12/13/2011] [Indexed: 11/29/2022]
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Trivedy C, Kodate N, Ross A, Al-Rawi H, Jaiganesh T, Harris T, Anderson JE. The attitudes and awareness of emergency department (ED) physicians towards the management of common dentofacial emergencies. Dent Traumatol 2011; 28:121-6. [DOI: 10.1111/j.1600-9657.2011.01050.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Skapetis T, Gerzina T, Hu W. Review article: Management of dental emergencies by medical practitioners: Recommendations for Australian education and training. Emerg Med Australas 2011; 23:142-52. [DOI: 10.1111/j.1742-6723.2011.01384.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Burnham R, Bhandari R, Bridle C. Changes in admission rates for spreading odontogenic infection resulting from changes in government policy about the dental schedule and remunerations. Br J Oral Maxillofac Surg 2010; 49:26-8. [PMID: 20083328 DOI: 10.1016/j.bjoms.2009.10.033] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Accepted: 10/28/2009] [Indexed: 11/28/2022]
Abstract
The government changed the system of payment to general dental practitioners on 1 April 2005 from a fee/item to a banding system. The figures collected have shown that there has been a 62% increase in the number of patients who require admission for surgical treatment of spreading odontogenic infections compared with the 3-year period before this date.
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Affiliation(s)
- Richard Burnham
- Barts and the London NHS Trust, Oral and Maxillofacial Surgery Centre, The Royal London Hospital, John Harrison House, Philpot Street, Whitechapel, London, E1 1BB, United Kingdom.
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Abstract
OBJECTIVE To determine the prevalence, types, and treatment of nontraumatic dental emergencies that present to a tertiary care pediatric emergency department (ED). METHODS A retrospective chart review of all children coming to a tertiary care pediatric emergency department with nontraumatic dental complaints from January 2005 to December 2005 was conducted. Demographic information, the time and day of presentation, presenting complaints, history of previous dental treatment, interventions, and disposition details were collected and analyzed. RESULTS The 247 visits for nontraumatic dental complaints comprise 0.5% of all patients who presented to the ED in 2005. Fifty-nine percent were younger than 5 years (primary dentition), with males representing 52% of the children. Half of the visits were during normal dental office hours, and more than half presented during the weekday. Fifty-three percent complained of pain. Twenty-eight percent were referred to the dental clinic after being seen by an ED physician. Eight percent of children required hospitalization for intravenous antibiotics. Most children (82%) were discharged from the ED with oral antibiotics. CONCLUSIONS The ED is an important point of care for nontraumatic pediatric dental complaints, and about 60% of these children are younger than 5 years. Only 8% of them had severe infections requiring hospitalization, and most patients could have been treated in the community.
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Abstract
INTRODUCTION We determined the compliance rates of orthopaedic trauma team members in applying universal precautions in major trauma resuscitation scenarios and the availability of universal precautions in accident and emergency (A&E) departments throughout England. MATERIALS AND METHODS A national telephone survey was implemented contacting the first on-call orthopaedic surgeon and A&E departments in hospital trusts accepting major trauma throughout England. A questionnaire was employed to ascertain current practice, experience and availability of universal precautions when managing a major trauma patient. RESULTS Overall, 112 first on-call orthopaedic surgeons and 99 A&E departments responded. There was good compliance for using gloves (99%) and aprons (86%). There was poor compliance in using eye protectors (21%), face masks (18%), shoe covers (4%) and head caps (4%). Trainees applied universal precautions according to the level of risk they subjectively perceived. All A&E departments had gloves and aprons but the availability of the other universal precautions was less. Of trainees, 76 reported that all universal precautions were not readily available in the A&E department. CONCLUSION Orthopaedic trauma team members are very compliant in using gloves and aprons, but should be more compliant in using eye protectors. It is questionable whether face masks, head caps and shoe covers need to be used in all trauma scenarios. In general, universal precautions should be more available in the A&E departments. There should be better communication between A&E departments and the trauma team regarding the availability of universal precautions.
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Affiliation(s)
- R O Sundaram
- Department of Orthopaedics, Arrowe Park Hospital, Upton, Wirral, UK.
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