Paediatric dental pain and infection during the COVID period

Abstract

Background During the coronavirus pandemic, paediatric patients will still likely present with dental pain and infection. In order to streamline care at King's College Hospital (KCH), Paediatric Dentistry and Oral and Maxillofacial Surgery (OMFS) have developed a collaborative working approach allowing patients to be treated effectively and to streamline patient care in the absence of easy access to general anaesthetic facilities. Method Presenting complaints, treatment need and the treatment received were recorded for all paediatric patients presenting with dental pain and infection in the “lockdown” period (23rd March- 14th June) during “normal” working hours and “out of hours” to either paediatric dentistry or OMFS. Results 420 calls were triaged which converted to 67 patients seen face-to-face for oro-facial pain and infection. 41% of children were treated successfully under Local anaesthetic alone, only 13% required a general anaesthetic (GA) in the “lockdown” period. The vast majority of patients had antibiotics prescribed prior to attendance (80%). Conclusion We have demonstrated the demographic, presenting complaints and treatment need of patients who presented to KCH during the lockdown period with dental pain and infection. The majority were able to be treated without needing for GA facilities. This paper highlights how a collaborative approach between paediatric dentistry and OMFS can help streamline patient care and is a model which can be adopted by other units in the event of further “lockdowns”.

Impact of Covid-19 pandemic on children with special needs requiring general anaesthesia for the treatment of dental disease: the experience of the Brescia Children’s Hospital, Lombardy, Italy

“…One of the limitations of the current study is that it was difficult to quantify the clinical impact of missed or delayed treatments by evaluating the access to the emergency room only. In case of dental pain or infections, parents of paediatric patients with special needs during the lockdown may had contacted by telephone the family paediatrician or private dentist for any urgent oral/dental related problems, as described by other authors (Ilyas et al 2021 ). However, the poor cooperation often observed in children makes the remote diagnosis of dental pain or infections challenging even with the help of teledentistry (Kumar Mallineni et al 2021 ; Saccomanno et al 2020 ).…”

“…As for many other non-essential healthcare related services, routine paediatric dental treatment was suspended in many countries because of the increased risk of cross-infection in dental practices. Dental care was provided only on an emergency basis, for urgent conditions (Ilyas et al 2020 ; Alzahrani et al 2021 ), or in cases of children with special needs because of their higher risk of oral health problems (Luo et al 2021 ). Despite falling into the categories of “frailty with urgency,” children with special needs and their families were highly penalised by the Covid-19 pandemic, due to the limited possibility of accessing routine care.…”

Evaluation of Post-Translation Control Mechanisms (Mirnas) In Type 1 Diabetic Patients with and Without Cardiac Autonomic Neuropathy

“…Nevertheless, providing paediatric dental treatment became increasingly challenging in Covid-19 milieu and all guidelines issued in this regard revolved around minimizing aerosol generation procedures (AGP) in providing regular dental treatment among paediatric patients [7]. Consequently, triaging and treating only emergency and urgent cases were emphasized and use of non-invasive or minimally invasive caries management techniques were recommended [7][8][9][10], remained preferable choices for clinical practice of post Covid-19 period as well [11]. In contrast, aerosol generating procedures, extractions and use of general anaesthesia or sedation became common procedures in the post lock-down period by some paediatric dentists [12].…”

Prácticas y actitudes sobre salud bucal en madres de familia de estudiantes del nivel inicial de la institución educativa 106 Carmen Alto, durante la pandemia COVID-19, Ayacucho 2021

“…Distribución de las frecuencias y porcentajews de las variables sociodemográficas de madres de familia de estudiantes del nivel inicial evaluadas de la Institución Edcuativa 106 Carmen Alto , durante la pandemia COVID- Reportando el aumento de muertes a nivel mundial por COVID-19 complicando los tratamientos ya que muchos de los lugares de atención han colapsado por casos de pacientes con coronavirus, teniendo que priorizar las áreas especializadas más urgentes. 2 Así mismo debido a la naturaleza del tratamiento dental que incluye procedimientos que producen aerosoles y salpicaduras que contienen grandes cantidades de saliva o sangre de pacientes que conllevaría al riesgo de transmisión a gran escala del virus. 3 La salud bucal es un buen indicador de la salud general que se ha visto afectada por la emergencia de salud pública, que puede ocasionar enfermedades sistémicas, como aterosclerosis, enfermedad pulmonar, diabetes, embarazo, bajo peso al nacer, osteoporosis y enfermedad renal ya que el periodonto y la biopelícula pueden servir como reservorios de patógenos que facilitarían la aspiración a los pulmones, inclusive en individuos sanos.…”