Brazilian Dentists’ Attitudes About Medical Emergencies During Dental Treatment

Abstract

The main objective of this study was to evaluate the prevalence of emergencies in dental practices and the preparedness and the training experience in cardiopulmonary resuscitation (CPR) of Brazilian dentists in dealing with emergencies. The volunteer participants in the study were 498 Brazilian dentists who were present at the 27th International Congress of Dentistry in São Paulo. The most prevalent emergency was presyncope (reported by 54.20 percent of respondents), followed by orthostatic hypotension (44.37 percent), moderate allergic reactions (16.86 percent), hypertensive crisis (15.06 percent), asthma (15.06 percent), syncope (12.65 percent), angina (6.82 percent), convulsion (6.22 percent), hypoglycemia (5.62 percent), hyperventilation crisis (5.22 percent), choking (2.20 percent), and cerebrovascular accident (0.8 percent). Anaphylaxis, myocardial infarction, and cardiac arrest were the rarest emergencies, reported by only 0.4, 0.2, and 0.2 percent of dentists, respectively. Only 41 percent of the dentists judged themselves capable to diagnose the cause of an emergency during a dental visit. The majority responded that they would be capable of performing initial treatment of presyncope, syncope, orthostatic hypotension, convulsion, and choking. However, most of them felt unable to treat anaphylaxis, myocardial infarction, or cardiac arrest. Further, the majority felt unable to perform CPR or undertake an intravenous injection. It was concluded that the most prevalent medical emergencies in dental practice of Brazilian dentists are presyncope and orthostatic hypotension. The occurrence of life-threatening medical emergencies like anaphylaxis, myocardial infarction, cardiac arrest, and cerebrovascular accident is rare. Brazilian dentists are not fully prepared to manage medical emergencies and have insufficient experience training in CPR

The knowledge of and attitudes toward anaphylaxis emergency management among Polish dentists

“…In Brasil, Arsati et al [23] studied dentists' attitude toward medical emergencies in the dental office. They revealed that 16.86% of the surveyed dentists had faced moderate allergic reactions within the previous 12 months, and anaphylaxis was reported by 0.40%.…”

Die häufigsten medizinischen Notfälle in der Zahnarztpraxis – Teil 1: Grundsätze, Medikamente, Ausrüstung

“…Nach einer Grundausbildung in lebensrettenden Sofortmaßnahmen (Reanimationstraining/BLS-Basic Life Support) erfolgen jährlich Trainings zur Auffrischung, idealerweise in der eigenen Zahnarztpraxis, um die erworbene Kompetenz und Handlungssicherheit zu erhalten. Es besteht für viele Zahnarztpraxen Handlungsbedarf, denn etliche Zahnärzte stufen sich selbst als schlecht vorbereitet ein und nur 41 % geben an, dass sie in der Lage wären, einen Notfall korrekt zu diagnostizieren [3].…”

Anaphylaxis: an update for dental practitioners

“…Dentists must be capable of recognizing and initiating management of anaphylaxis. Despite this, numerous surveys in different countries indicate that the majority of dentists are not adequately able to identify and treat anaphylaxis . This article will provide an update of anaphylaxis recognition and treatment for dentists, and document six new case histories of anaphylaxis arising out of dental oral maxillofacial surgery practice.…”

“…In the USA, conservative estimations suggest that 25 000 cases of anaphylaxis occur each year . The incidence of anaphylaxis in dental practice is said to be between 0.004 to 0.015 cases/dentist/year . In comparison, the incidence during general anaesthesia is between 1 in 4000 to 1 in 25 000 .…”

“…At this stage, if not already done by another staff member, retrieval via ambulance to a medical facility should be arranged by contacting the relevant emergency number (000 in Australia). Early retrieval is suggested for a few reasons: firstly, to limit the delay in obtaining IV access and receiving IV therapy if warranted (as the majority of dentists indicate they are unable to secure IV access); secondly, to receive medical review and appropriate further monitoring and management; and thirdly, to allow for biochemical testing to support the diagnosis.…”