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

Abstract

Dental attendances to paediatric emergency departments (PEDs) represent suboptimal use of resources of an unknown scale. To evaluate dental attendances at two PEDs in the UK and compare traumatic dental injury (TDI) and non-traumatic dental conditions (NTDCs). Retrospective data were collected for a 12-month period including demographics, attendance pattern, assessment, and management. Maxillofacial conditions were excluded, and attendances were grouped as TDI and NTDC. Of 667 attendances, 35.1% (n=234) were TDI and 64.9% (n=433) NTDC. Nineteen children reattended. Proportionately, more TDI attenders were male, White British, of lower mean age, and resided in less deprived areas than NTDCs. Over half (52.3%, n=339) of attendees resided in the 10% most deprived UK areas. Saturday and Monday were modal attendance days; attendance peaked in summer. Over half (56.4%, n=376) attended out of hours. A majority (74.8%, n=499) self-referred and half accessed no other service prior to PED attendance. No PED dental input was received for 38.7% (n=258), and dental treatment was received for 12.4% (n=83). Antibiotics were provided for 42.1% (n=281), and 15.4% (n=103) were admitted. Dental abscesses and toothache accounted for half of attendances, many of these children may be managed in primary care. Improved signposting to alternative dental services for non-urgent conditions may better allocate resources to those with urgent need.