Dental Emergencies Management in COVID-19 Pandemic Peak: A Cohort Study

Abstract

Due to the global coronavirus disease 2019 pandemic, the high risk of cross-contamination and the overload of hospital facilities have resulted in a real urgency for restricting dental emergency patient flow. In this context, the objectives of the current work were to 1) measure the ability of a triage-based management strategy to limit patient admission and 2) evaluate the success rate of both on-site and remote emergency management regarding symptom relief and pain control over a 1-mo period. We included all patients contacting the dental medicine department for an emergency consultation during the lockdown, between April 1 and April 30, 2020 ( N = 570). Following a telephone consultation and based on preestablished admission guidelines, a decision was made at baseline (T0) to either admit the patient for treatment or perform remote management by providing advice and/or drug prescription. Patients were then followed up systematically at 1 wk and 1 mo. Management failure was defined as the need for emergency admission for patients managed remotely since T0 and for new emergency admission for those admitted at T0. The global follow-up rate of patients with a complete data set was 91.4% ( N = 521). Of included patients, 49.3% could be managed without admission for emergency reasons for 1 mo. The proportion of successful management was 71.8% and 90.2% at 1 mo for remote and on-site management, respectively. To conclude, the proposed triage-based emergency management strategy with systematic follow-up was a good compromise between limiting patient admission and ensuring effective symptom relief and pain control. The strategy can be useful in situations where regulation of the emergency patient flow is required.

Impact of COVID-19 on Dental Care during a National Lockdown: A Retrospective Observational Study

“…Interestingly, the peak of registered patients with positive/suspected COVID-19 infections in the urgent dental care unit of our department coincided with the peak of infection numbers in Munich during the first wave, indicating the effectiveness and importance of such screening methods. In addition, telephone screening has been evaluated to reduce the number of dispensable dental visits effectively [29].…”

Endodontic Emergencies Encountered in a Tertiary Dental Hospital during the Periods of Prelockdown, Lockdown, and Sequential Unlock Phases of the First Wave of COVID-19 in Ahmedabad City, India

“…49.3% of patients were treated remotely without the need of urgent hospitalisation through teledentistry. [ 14 ] Similarly, Jessica et al conducted a study in Tufts University School of Dental Medicine, USA, from March 30, 2020, to May 8, 2020, where there were a total of 466 patients out of which 199 were treated through teledentistry, and the rest were clinically encountered [ 8 ]. It was not undertaken at our hospital as it is the only hospital working and treating patients in person and the other dental healthcare clinics and hospitals were nonfunctional and performing teledentistry.…”

Endodontics Specialists’ Practice during the Initial Outbreak of Coronavirus Disease 2019

“…Dental clinics and institutions reported changes in the presentation and management of endodontic/dental emergencies during the initial outbreak of COVID-19. There were changes in policies at these institutions that limited their patient flow to those with true emergencies (e.g., severe pain and/or swelling; life threatening infections) that could not be managed remotely ( 3 , 4 , 5 , 6 ). Centreville Endodontics and Capitol Endodontics, two private offices in Washington DC and Northern Virginia area, that are about 25 miles apart and serve similar population of patients and are operated by one team of endodontists, stayed fully operational during the period of March 16 to May 31, 2020.…”