Association between pulp and periapical conditions and dental emergency visits involving pain relief: epidemiological profile and risk indicators in private practice in Australia

Abstract

Aim To assess the prevalence of dental emergency visits (DEV) involving pain relief and their relationship with socio‐economic and clinical factors in an Australian representative sample in the primary care setting. Methodology Data on reason for visit and patient characteristics were collected from a representative random sample of Australian dentists in private practice surveyed in 2009–2010. Information regarding socio‐economic (gender, age, health insurance) and clinical factors (number of teeth, number of decayed teeth, diagnosis and reason for visit [DEV, check‐up, other reasons not involving pain relief]) were retrieved from compiled questionnaires. Descriptive statistics were reported, and Poisson regression models were used to assess the association between socio‐economic and clinical factors and DEV. Prevalence ratio (PR) and 95% confidence interval (CI) were calculated. Results A total of 1148 dentists responded (67%), resulting in records from 6504 patients. The overall prevalence of DEV was 20.8%. The unadjusted analysis, according to the reason of visit, revealed the following predictors for DEV: male gender (PR = 1.18; 95% CI = 1.08–1.29), age 18–64 years (PR = 2.70; 95% CI = 2.19–3.33) and over 65 years (PR = 2.64, 95% CI = 2.10–3.32), uninsured patients (PR = 1.36; 95% CI = 1.24–1.49), patients with <20 teeth (PR = 1.19; 95% CI = 1.06–1.33), decayed teeth (PR = 1.64; 95% CI = 1.48–1.81). After adjustment for confounding factors (gender, age, insurance status, number of teeth and decayed teeth) apart from ‘dental trauma’ (PR = 1.37), all remaining diagnoses had lower PR (‘other’ PR = 0.19, ‘decay’ PR = 0.34, ‘periodontal’ PR = 0.51, ‘failed restoration’ PR = 0.45) compared with ‘pulp/periapical disease’. Conclusions In the primary care setting, the diagnoses ‘pulp/periapical’ and ‘dental trauma’ had a stronger association with DEV compared with visits not involving relief of pain. Both socio‐economic (male gender, older age and uninsured individuals) and clinical factors (tooth loss, decayed teeth, endodontic diseases and dental trauma) were identified as independent risk indicators for DEV in this population. Future public health policies should include specific preventive strategies addressing these factors, aiming to reduce the need for DEV.

Tratamientos endodónticos en el contexto de la pandemia por COVID-19 Tratamientos endodónticos en el contexto de la pandemia por COVID-19

“…(22)(23)33) La causa más frecuente de inflamación de los tejidos perirradiculares es de origen microbiano y se encuentra asociado a una pulpa necrótica. (34)(35) La resolución de estas consultas de urgencia consiste en: a) la evaluación clínico-radiográfica b) anestesia (opcional) c) aislación absoluta d) apertura coronaria e) es fundamental neutralizar el contenido tóxico-microbiano de cámara y conductos irrigando con solución de hipoclorito de sodio (2,5%), remover contenido orgánico cameral con instrumentos manuales f) ingresar al sistema de conductos, removiendo su contenido por tercios con limas acordes a la anatomía canalicular, procurando no impulsarlo hacia la zona apical, intercalando el desbridamiento mecánico con profusa irrigación/aspiración con aguja de irrigación fina g) luego de esta maniobra también se podría permeabilizar la zona foraminal con instrumentos manuales finos, especialmente si se sospecha que se encuentra en transición hacia la fase siguiente h) colocar medicación antiséptica y realizar el doble sellado de la cavidad de acceso. i) si la pieza lo requiere se puede realizar el alivio de la oclusión.…”

Changes in the characteristics of dental emergencies under the influence of SARS-CoV-2 ： A retrospective study

“…Emergency dental patients often need emergency treatment because of acute facial or dental pain,bleeding,trauma and other conditions [1].Dental emergencies progress quickly because of the acute and complex nature of the conditions in patients.The composition and epidemiological characteristics of dental diseases in the emergency center vary from region to region [1,2],Previous studies have summarized the characteristics of visits to emergency dental patients.For example,in terms of time distribution,the number of visits to emergency dental patients at weekends is more than that in weeks [3],and night is the peak of visits to emergency dental patients [3,4].Gender and age show different features in all kinds of emergency visits [3,4,5],and the main reasons for visits are Pulpitis, trauma and bleeding [5].…”

“…The composition and characteristics of emergency dental care are in uenced by environmental changes,lifestyle,economic and sociocultural in uences [6].With the spread of SARS-COV-2 around the world,people adopt home isolation to reduce going out and gathering,resulting in changes in the living environment,psychological status and lifestyle of the population [7].The composition of dental emergency diseases also presents different changes and characteristics.Most of the risk factors associated with dental emergencies are considered to be preventable [6,8].Characteristics of dental emergency patients under the in uence of SARS-COV-2 have been reported,There is a lack of comparison with the situation before the SARS-COV-2 [9].To analyze the incompleteness of the types of emergency diseases [1,9]. Hospitals and clinics choose to reduce or stop visits in order to ensure the safety of doctors and patients under the impact of the SARS-COV-2,At the same time,the dental treatment process has also changed accordingly [1,9,10],dental protection needs to be strengthened during treatment,reduced use of some dental appliances that cause spatter,changes in treatment choices and drug use all in uence the effective operation of dental emergencies [10,11].So master dental emergency diseases distribution and the change law of demographic characteristics for dental emergency center in the face of strong public health emergencies of infectious respiratory disease,can not only improve the e ciency of treatment of dental emergency patients,at the same time can provide dental emergency personnel,supplies, and emergency technical expertise to provide important reference data [12].…”

Changes in the characteristics of dental emergencies under the influence of SARS-CoV-2 pandemic: A retrospective study

“…The characteristics of dental emergency patients with SARS-COV-2 have been reported. There is a lack of comparison with the situation before the SARS-COV-2 pandemic [9] to analyze changes in emergency diseases' classi cation [1,9]. Hospitals and clinics try to reduce or stop visits to ensure doctors' and patients' safety under the impact of the SARS-COV-2 pandemic.…”

“…Hospitals and clinics try to reduce or stop visits to ensure doctors' and patients' safety under the impact of the SARS-COV-2 pandemic. At the same time, the dental treatment process has changed accordingly [1,9,10], and dental protection needs to be strengthened during treatment, reduce the use of some dental appliances that cause spatter, change treatment options and drug use, and improve dental emergency care [10,11]. Therefore, knowledge about the dental emergency diseases' classi cation and changes in the demographic characteristics of the dental emergency center in the face of intense public health emergencies of respiratory infectious disease can improve the e ciency of treatment of dental emergency patients and provide dental emergency personnel, supplies, and emergency technical expertise to supply important reference data [12].…”