Incidence of emergencies and equipment to treat emergencies in dental practices: A statewide survey

Abstract

Purpose of the study: Dental practice teams have to manage medical emergencies adequately to provide optimal patient safety. The German Society of Dental, Oral and Craniomandibular Sciences recommends ECG monitoring and readiness for defibrillation during electrosurgery in patients with pacemakers. Guidelines published by the Association of the Scientific Medical Societies in Germany demand adequate equipment to treat medical emergencies in all patients treated under analgesia or sedation. Objective on the study was to evaluate the incidence of emergencies as well as available equipment in dental practices in the state Saxonia (Germany). Materials and methods: A survey was mailed to all 3000 dentists who were registered with the state dentist board of Saxonia in January 2005. It contained questions on medical emergencies during a 12 months period (01/2004–12/2004) and on emergency equipment which is provided actually in the respective practice. The survey was completely anonymous, all questionnaires which had been returned within 4 weeks were evaluated. Results: We received 573 questionnaires. 21% of the dentists provide treatment under sedation. During the evaluated 12 months 1435 emergencies occurred. The most frequent emergencies were vasovagal syncope (1208), hypertensive crisis (67), grand mal seizure (44), hypoglycaemia (30) and acute coronary syndrome (22). Two cardiac arrests were reported. 83% of the dentists who had responded have an emergency bag. Eighty eight percent have an airway device and 71% oxygen in their practice. Only 1.7% have an automated external defibrillator, 17% plan to buy an AED. Five percent of the dentists do not provide any equipment to treat emergencies. Thirty-five percent of the responding dentists had invested in emergency equipment in 2004 and 22% plan to buy new equipment in 2005. Conclusions: Emergencies occur frequently in dental practices. There are deficits as some dentists do not provide any emergency equipment and AED are not standard in dental practices.