Management of medical emergencies in orthodontic practice

M Amiri Bavandpour,R E G Jonkman,C Livas

doi:10.1186/s40510-020-00327-3

M Amiri Bavandpour, R E G Jonkman + Show 1 more

Open Access

https://doi.org/10.1186/s40510-020-00327-3

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Abstract

BackgroundThe aims of this study were to survey the occurrence of acute medical situations in Dutch orthodontic practice and to examine the self-perceived competence of orthodontists in managing acute medical emergencies.MethodsA self-designed questionnaire was distributed among all 149 Dutch orthodontists attending the spring meeting of the Dutch Society for Orthodontists. The questionnaire was divided into three parts, addressing background information of the orthodontist, precautions against and experiences in acute medical situations, and self-perceived competence of nine common medical emergencies. The statistical analysis was performed using the chi-square test and a multiple logistic regression analysis.ResultsThe response rate was 74.5% (105 out of 149). The male to female ratio in this population was 55:50. Mean age of all participants was 46.9 years (SD 10.4 years) with on average 16.7 years of working experience (SD 10.6 years). The most common medical emergency reported by Dutch orthodontists was vasovagal collapse (n = 219), followed by acute allergic reaction (n = 163) and hyperventilation (n = 83). On average, 75% (n = 79) of the orthodontists felt competent to handle any acute medical situation with an average occurrence of 0.36 acute medical emergencies per orthodontist per year. Male participants were more likely to send patients towards the emergency department (p = 0.049). Moreover, a statistically significant negative correlation was observed between self-perceived competence handling hypoglycemia and years of clinical experience. The longer orthodontists were clinically active, the less competent they felt when encountered with a hypoglycemia (p = 0.031).ConclusionsMedical emergencies may be rare but challenging occurrences in the orthodontic practice. It is strongly recommended for all orthodontists and supporting staff to be trained regularly in the management of medical emergencies and to possess up-to-date evidence-based knowledge. Familiarity with and availability of appropriate drugs and equipment are deemed essential to the management of acute medical emergencies that may arise in the orthodontic practice.

Highlights

The aims of this study were to survey the occurrence of acute medical situations in Dutch orthodontic practice and to examine the self-perceived competence of orthodontists in managing acute medical emergencies
Life-threatening medical emergencies are rare in dental practice, according to Collange et al, approximately 5% of general practitioners have to cope with cardiopulmonary resuscitation (CPR) at least once during their career [4]
The third part of the questionnaire was based on nine common medical emergencies seen in Dental practice, which included vasovagal collapse, hyperventilation, angina pectoris (AP), myocardial infarct (MI), cardiac arrest, aspiration, asthma, hypoglycemia, epilepsy, and an acute allergic reaction [16,17,18]

Summary

Introduction

The aims of this study were to survey the occurrence of acute medical situations in Dutch orthodontic practice and to examine the self-perceived competence of orthodontists in managing acute medical emergencies. A Dutch study reported an occurrence of 0.75 medical emergencies per dentist per year [2]. In a scoping review on medical emergencies in dental practice, it is reported that 43.6 to 75% of dentists will be required to perform some form of medical emergency management throughout their career [3]. Members of the dental and orthodontic team are expected to adequately manage common acute medical emergencies that might occur. Only 69% of dentists feel comfortable managing medical emergencies in a dental setting [7]

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