Medical emergencies in dental practice

Abstract

-Introduction:Dentistry is a clinical activity potentially at risk of medical emergencies and dental practitioners need to be prepared to handle them effectively. Materials and methods: We have contacted 25535 French and Belgian dentists through an online survey which included 37 questions about emergency situations they have experienced, emergency equipment at their disposal, training and self-evaluation of competence in the management of medical emergencies. Results: 1344 were included. The incidence of medical emergencies was 2.1 events per dentists per year, mostly vasovagal syncope, orthostatic hypotension or hypoglycemia. Life-threatening emergencies and cardiac arrests are rare but occur (0.003 cardiac arrests per dentist per year of practice). Nearly one out of five dentists had no emergency equipment at all. While many practitioners are equipped with oxygen (66.8%), few possess a defibrillator (7.7%). Nearly 10% of practitioners report never being trained for medical emergencies. Conclusions: Dental practitioners encounter medical emergencies, mostly benign ones but also, more rarely, life-threatening emergencies. Efforts should be made in the education of dental practitioners regarding the management of medical emergencies during initial and continuing education. The recommended emergency equipment for dental practices should be kept to the minimum necessary in order to increase the number of offices properly equipped.Résumé -Urgences médiales au cabinet dentaire. Introduction : La chirurgie dentaire est une activité clinique au cours de laquelle une urgence médicale peut survenir. Les chirurgiens-dentistes doivent se préparer à les gérer efficacement. Méthodes : Nous avons contacté 25535 dentistes français et belges par le biais d'un sondage en ligne qui comprenait 37 questions. Ce questionnaire portait sur les urgences médicales auxquelles ils ont été confrontés, l'équipement d'urgence à leur disposition, leur formation et une auto-évaluation de leurs compétences dans la gestion des urgences médicales. Résultats : 1344 ont été inclus. L'incidence des urgences médicales était de 2,1 événements par dentiste par an, principalement des malaises vagaux, des hypotensions orthostatiques ou des hypoglycémies. Les urgences vitales et les arrêts cardiaques sont rares, mais ils se rencontrent néanmoins (0,003 arrêt cardiaque par dentiste par année de pratique). Près d'un dentiste sur cinq n'avait pas de matériel d'urgence. Alors que de nombreux praticiens sont équipés d'oxygène (66,8 %) ou d'un tensiomètre (64,5 %), peu possèdent un défibrillateur (7,7 %). Près de 10 % des praticiens déclarent ne jamais avoir été formés pour la prise en charge des urgences médicales. Pour 40 % des praticiens formés, la dernière formation a eu lieu il y a plus de 4 ans. Une large majorité des praticiens se sentent capables de gérer un malaise, tandis que moins de la moitié se sentent en mesure de gérer un arrêt cardiaque. Conclusions : Les chirurgiens-dentistes rencontrent des urgences médicales dans leur pratique, la p...

A Pilot Study of Preparedness for Medical Emergencies in Urban Private Dental Practices in Malaysia

“…Only 10% of dentists in South Africa were found to have at least half of the emergency equipment recommended and even a smaller percentage of 1% of its respondents stated to have all the equipments required (Qwen and Mizra, 2015). These findings were in accordance with the previous report from France where 19.2% of the dentists declared of not having any emergency equipment available in their clinics (Laurent et al, 2014).…”

“…Among the respondents who had received training for medical emergencies after they graduated, 51.1% claimed to be fairly well in competency or preparedness and 48.9% felt to be moderately competent in medical emergencies management. In the present study, syncope was the commonest emergency event which was favourable with results of other studies done in Great Britain (Atherton et al, 1999a;Girdler and Smith, 1999), Fiji (Morse and Murthi, 2004), India (Jodalli and Ankola, 2012), France (Laurent et al, 2014), South Africa (Qwen and Mizra, 2015), Nepal (Joshi and Acharya, 2015) and Saudi Arabia (Al-Turki et al, 2017). Although syncope was not considered strictly as an 'emergency', it still requires prompt and correct treatment, or otherwise it can lead to a more adverse sequelae such as cerebral ischaemia (Girdler and Smith, 1999).…”

“…Similarly in Fiji Island, 226 emergency events were recorded giving a mean of 3.42 events per respondent, per 10 years (Morse and Murthi, 2004). In a study involving 1,344 dentists in France, the emergencies incidences were 2.1 events per dentist per year (Laurent et al, 2014). Meanwhile, in South Africa and Slovenia, it was reported that their dentists had experienced medical emergencies as 19% and 93.4% respectively (Qwen and Mizra, 2015;Umek and Šoštarič, 2018).…”

“…On the other hand, a study in South Africa reported only 1% of its practitioners had all the equipment required to deal with medical emergencies in their practice (Qwen and Mizra, 2015). In France, 19.2% dentists declared of not having any emergency equipment available in their clinics (Laurent et al, 2014).…”

Medical Emergencies in Dental Clinics: A Survey of 2013 Dentists in China

“…[8] Study from other country reported that dentists encountered medical emergencies twice annually. [9] In our survey, dentist annually encountered 1.45 emergent events in average. Interestingly, we found dentists with the longest practicing time had the highest frequency of medical emergency, which probably indicated that patients with complicated conditions or those need longer time or more complicated dental procedures intend to visit senior dentists.…”