Medical emergency department attendance of under 16‐year‐olds with dental problems

Abstract

Summary Background Medical emergency departments (MED) are under increasing pressure in the UK with suggestions that unnecessary attendances to MED, which may include dental problems, are to blame. Objectives The aim of this cross‐sectional study was to examine the period prevalence of under 16‐year‐olds attendance to medical emergency departments (MED) with oral and dental problems over a 5‐year period and investigate reason for attendance. This cross‐sectional study was carried out as part of a service evaluation at the Newcastle upon Tyne Hospitals NHS Foundation Trust. Methods Retrospective data were collected between 1 January 2012 and 31 December 2016 from the MED database using coding and a free text search of all paediatric attendances. The data were then analysed using descriptive statistics. Results Over the 5‐year period, 135 760 under 16‐year‐olds attended the MED. Of these, 868 (0.6%) attended for dental problems. The most common dental reasons for attendance were as follows: Candida accounted for 22.6% of the 0‐ to 5‐year‐olds; dental trauma accounted for 29.5% of 6‐ to 11‐year‐olds; and mandibular fractures accounted for 18.9% of the 12‐ to 16‐year‐olds. Of those who attended the MED for dental problems, 28.5% resided in areas with an Index of Multiple Deprivation decile of 1, the areas of highest deprivation in the UK. Conclusion Many of the diagnoses may have been appropriately managed elsewhere in the community, which may result in improved treatment provision and tailored care pathways, as well as reducing strain on the MED. Further research is needed to investigate why patients attend MED with dental problems.

Traumatic and non‐traumatic dental presentations to the paediatric emergency departments of two UK children's hospitals: A multi‐centre evaluation

“…The finding that children from more deprived areas more frequently access PEDs is in line with the existing literature. 4,13 Our findings also support the limited body of evidence that children attending the PED with TDIs are more likely to come from less deprived areas compared with children attending with NTDCs who are more likely to reside in more deprived areas. 14 Although it is known that children from more deprived areas suffer more preventable dental disease, 6 there has been limited research to explore the demographic of children attending with TDIs.…”

“…The combined number of dental attendances at the units observed within a 1-year period was 667. This figure is proportionally higher than the 868 attendances over a 5-year period in a comparative study in Newcastle, UK, which included maxillofacial and oro-mucosal conditions 13 and proportionately lower than the 687 attendances observed in Sheffield, UK, in 2012-2013, given that our data are derived from two sites. 14 Additionally, we found that NTDCs accounted for 64.9% of all dental attendances, which contrasts existing evidence that TDI is the most common cause for presentation.…”

“…Our findings are in line with other studies based in EDs, with over half of attenders being aged less than 4-5 years. 13,14 A notable variation in the ethnicity of attenders was observed between AHCH and BCH with 79.8% (n = 317) of attenders identifying as White British compared with 29.5% (n = 74) at BCH. This, however, correlates with census data, with only 13.8% (n = 64 201) of Liverpool residents identifying as an ethnicity other than White British or Irish in 2011 compared with 44.8% (n = 480 807) in Birmingham.…”

Primary Care Dentists’ management of permanent dentition traumatic dental injuries in 7‐ to 16‐year‐olds: A sequential mixed‐methods study

“…Alternatively, some patients with TDIs may present to a hospital Accident and Emergency department. A recent north‐east England study reported that the most common dental reason for attendance in 6‐ to 11‐year‐olds was dental trauma 8 . Thus, the provision and delivery of care for patients with TDIs can be disjointed.…”