Incidence and characteristics of medical emergencies related to dental treatment: a retrospective single‐center study

Abstract

Although uncommon, medical emergencies arise in general dental practice. Inadequate data on their severity and frequency makes targeting medical education for general dental practitioners difficult. This also makes planning for unexpected events challenging for practitioners and makes collaborating with emergency physicians burdensome. We aimed to clarify the incidence and characteristics of a dental outpatient department's medical emergencies.Methods: This single-center, retrospective, observational study was undertaken with patients who visited the dental outpatient department of Okayama University Hospital during the 8-year period. The primary outcome of the study was to identify the incidence and characteristics of medical emergencies in the dental outpatient department. Then we examined the timing of medical emergencies, administered medications, and final disposition (home/admission).Results: During the period, 1,146,929 patients were enrolled. Forty-two patients (0.0037%) were consulted as medical emergencies.More than 60% of the incidents were vasovagal syncope, and dehydration and hypoglycemia were the second most prevalent at 9.5%. The most common types of dental treatments were tooth extraction (45.2%), followed by general dental treatment (28.6%), and other dental surgery such as implant placement (14.3%). Types of medical emergencies occurred equally before, during, and after dental treatment. Antihypertensive agents, sedatives, or glucose were used. For patients with emergencies, 90.5% recovered during the day and returned home, and 9.5% were hospitalized. Conclusion:The incidence of medical emergencies was low in our dental outpatient department. Knowledge of basic management principles, regular education for emergency care, and practicing first aid skills are mandatory for safe patient management.

Frequency and characteristics of medical emergencies in an Australian dental school: A retrospective study

“…Within this study, the medical emergency frequency rate of 0.037% was considered to be higher compared to other retrospective international studies. 6,[14][15][16] Based on the number of dental visits, Obata et al reported 0.0037% over an 8-year period, Anders et al reported 0.016% over an 8-year period, and Sorenson et al reported 0.0079% over a 7-year period. The most likely reason for a higher occurrence within this study is due to the variances in the inclusion criteria from previous studies.…”

“…Some studies only reported medical emergencies that resulted in a dispatch of a medical team, or when the establishment of an intravenous line was required for the patient. 15,16 Other reasons include varying definitions in what was classified as a medical emergency between the studies as well as the acknowledgment of under-reporting of minor events by other authors into the incident reporting system database. 16 Incidents tend to go unreported or unnoticed if they are being managed without a medical emergency team or assistance by paramedics.…”

“…6,[14][15][16] Although there are some data available regarding the nature and frequency of medical emergencies in dental practices or dental hospitals, the majority of these studies have collected data from self-administered surveys and are often subject to the limitations of recall by dental practitioners and sampling bias which may result in under or over reporting. 6,[14][15][16] Retrospective studies of documented medical emergencies are considered a more accurate reflection, produce more meaningful information, and appear to report a lower frequency of such emergencies. 6,[14][15][16] Currently there are limited published retrospective studies (n = 4) on the occurrence and types of medical emergencies occurring within dental settings in England, Japan, and United States of America.…”

“…6,[14][15][16] Retrospective studies of documented medical emergencies are considered a more accurate reflection, produce more meaningful information, and appear to report a lower frequency of such emergencies. 6,[14][15][16] Currently there are limited published retrospective studies (n = 4) on the occurrence and types of medical emergencies occurring within dental settings in England, Japan, and United States of America. 6,[14][15][16] Therefore, the current study was undertaken to establish baseline data for Australia over a 6-year period at the Griffith University Dental Clinic.…”

“…6,[14][15][16] Currently there are limited published retrospective studies (n = 4) on the occurrence and types of medical emergencies occurring within dental settings in England, Japan, and United States of America. 6,[14][15][16] Therefore, the current study was undertaken to establish baseline data for Australia over a 6-year period at the Griffith University Dental Clinic. The aim of this study was to determine the frequency and characteristics of medical emergencies within an Australian dental school setting.…”