Emergencies In Dental Practice Research Articles

Knowledge and attitudes toward anaphylaxis to local anesthetics in dental practice

Objective/aimThe absence of a comprehensive understanding of potential anaphylactic reactions to local anesthetics (LAs) and management can result in grave consequences. For this reason we aim to assess Latin American dentists’ knowledge, preparedness, and competency in managing anaphylactic reactions to LAs.Materials and MethodsDesign: A cross-sectional study was conducted from November 2021 to February 2022. Board-certified dentists answered a survey comprising 26 structured questions. Chi-square tests and logistic regression models were performed in Stata 17.0. Setting: Argentina, Brazil, Colombia, Costa Rica, Ecuador, Honduras, Mexico, Peru, Venezuela, and other Latin American countries.ResultsOf 507 respondents, lidocaine was the most frequently used LA (88.1%). While 85.2% could identify dyspnea as a symptom of anaphylaxis, only 50.1% knew the correct route for epinephrine administration, and just 43.5% had epinephrine in their emergency kits. Confidence in managing anaphylactic reactions was low (9.6%). Older age was inversely related to both knowledge of anaphylaxis management and the possession of epinephrine (P = 0.003 and P = 0.0001, respectively).DiscussionOur study highlights a concerning discrepancy between the practical readiness of Latin American dentists in handling anaphylaxis.ConclusionThe study’s findings underscore the need for educational interventions to improve the readiness to identify and handle anaphylactic emergencies in dental practice.

MEDICAL EMERGENCIES PREPAREDNESS IN DENTAL CLINIC AMONG POSTGRADUATE RESIDENTS IN NEPAL

Background: Serious medical emergencies in dental practices are generally rare (one in 3-5 years) but if it happens it is life threatening to the patient. Adequate knowledge and competency, training of the dental practitioners is necessary to avoid such life-threatening conditions. The study was conducted to assess the preparedness of medical emergencies among postgraduate dental students of Nepal. Methods: An online questionnaire based cross-sectional study was conducted among all post graduate dental students from all the dental colleges of Nepal. Pretested, validated, close ended questionnaire was used. Questionnaire consisted of twenty medical emergency situations and five questions regarding self-evaluation of training regarding the management of medical emergencies. Chi-square test was used to assess association between competency in managing medical emergency situations and years of academic experience during post-graduation. P- value <0.05 was considered statistically significant. Results: More than 70% participants answered correct management of medical emergency situations. Almost 20% disagreed and 20% don’t know about the management of such situations. Only 28% received training in the management of medical emergencies during undergraduate dental program. More than 50% were moderately satisfied with their knowledge about medical emergencies. Conclusions: The results of the study showed that knowledge to handle commonly occurring medical emergencies was higher. Most of the participants did not attend any training regarding medical emergencies. And those who attended felt there is need for further training in the management of emergency medical cases in the dental chair.

Interdisciplinary management of horizontal root fracture in middle third with osseous bone defect – A clinical report

Dental trauma are the main cause of emergencies in dental practice. Amongst these, root fractures are relatively uncommon but comprises about 0.5 to 7% of all injuries affecting permanent dentition. Most commonly, root fracture occurs from a horizontal impact mostly in oblique direction. The incidence is more common at the mid-third of the root rather at the apical and cervical thirds. Such hideous injury must be restored to normal as early as possible to retain the dental health and appearance. This report records the case of horizontal root fracture of upper anterior tooth, treated with Mineral Trioxide Aggregate (MTA) and fractured root fragments were unified with the aid of a stainless steel reamer after an endodontic treatment. Alloplastic bone graft and GTR membrane were used for osseous bone defect. Mineral trioxide aggregate (MTA) has several impending & forthcomin clinical applications owing to its grander sealing property and biocompatibility. A 12 months follow-up revealed a well stabilized assembly of the root fragments and periodontal healing.

Management of specific medical emergencies in dental practice.

In this paper, the actions needed to manage specific medical emergencies are discussed. Each emergency requires a correct diagnosis to be made for effective and safe management. The basis of management in contemporary dental practice avoids the intravenous route where drugs are required to treat the emergency.

Letters to the editor

Dental UpdateVol. 50, No. 6 LettersLetters to the editorNg Yue Myng, Lim Zhi Yin Joan, Phrabhakaran NambiarNg Yue MyngDepartment of Restorative Dentistry, Faculty of Dentistry, MAHSA University, Selangor, MalaysiaSearch for more papers by this author, Lim Zhi Yin JoanDepartment of Restorative Dentistry, Faculty of Dentistry, MAHSA University, Selangor, MalaysiaSearch for more papers by this author, Phrabhakaran NambiarDepartment of Oral Biology and Biomedical Sciences, Faculty of Dentistry, MAHSA University, Selangor, Malaysia; Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, MalaysiaSearch for more papers by this authorNg Yue Myng; Lim Zhi Yin Joan; Phrabhakaran NambiarPublished Online:13 Jun 2023https://doi.org/10.12968/denu.2023.50.6.536aAboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View article References Greenwood M, Meechan JG. General medicine and surgery for dental practitioners: part 2. Medical emergencies in dental practice: the drug box, equipment and basic principles of management. Br Dent J 2014; 216: 633–667. https://doi.org/10.1038/sj.bdj.2014.447 Medline, Google ScholarQuigley EM, Locke GR, Mueller-Lissner S et al.. Prevalence and management of abdominal cramping and pain: a multinational survey. Aliment Pharmacol Ther 2006; 24: 411–419. https://doi.org/10.1111/j.1365-2036.2006.02989.x Medline, Google ScholarOladosu FA, Tu FF, Farhan S et al.. Abdominal skeletal muscle activity precedes spontaneous menstrual cramping pain in primary dysmenorrhea. Am J Obstet Gynecol 2018; 219: 91.e1–91.e7. https://doi.org/10.1016/j.ajog.2018.04.050 Medline, Google ScholarSandler RS, Stewart WF, Liberman JN et al.. Abdominal pain, bloating, and diarrhea in the United States: prevalence and impact. Dig Dis Sci 2000; 45: 1166–1171. https://doi.org/10.1023/a:1005554103531 Medline, Google ScholarBommelaer G, Poynard T, Le Pen C et al.. Prevalence of irritable bowel syndrome (IBS) and variability of diagnostic criteria. Gastroenterol Clin Biol 2004; 28: 554–561. https://doi.org/10.1016/s0399-8320(04)95011-7 Medline, Google Scholar FiguresReferencesRelatedDetails 2 June 2023Volume 50Issue 6ISSN (print): 0305-5000ISSN (online): 2515-589X Metrics History Published online 13 June 2023 Published in print 2 June 2023 Information© MA Dentistry Media LimitedPDF download

Medical emergencies in dental practice: A nationwide web-based survey of Italian dentists

ObjectiveDentists must be prepared to manage medical emergencies, which are arisen during dental practice together with the increase of age population and medically compromised patients. This study aims at assessing the occurrence of medical emergencies in a cohort of Italian dentists, to ascertain their level of confidence in the management of these conditions, also based on their educational training and type of medical graduation, and, finally, to know their educational needs, in order to plan appropriate institutional interventions for specific training. MethodsA national-based cross-sectional study was carried out by means of an online survey sent to all dentists working in Italy. ResultsThe survey included 6818 questionnaires. Most of the respondents (n = 4443; 65.2%) reported the occurrence of at least one medical emergency during their professional life. The events rarely resulted in death as declared by only 62 (0.9%) of respondents. The commonest medical emergency was the vasovagal syndrome. Most medical emergencies occurred during the dental procedure (n = 4883; 71.6%). An average degree of satisfaction about the ability to diagnose and manage medical emergencies was reported by most of respondents, with high level of confidence in treating vasovagal syndrome, while a lack in preparedness about the management of myocardial infarction or transient ischemic attack (TIA) and stroke. Medical doctors were more confident in managing the emergencies than dentistry graduates (p < .01). Considering the educational needs, almost all of participants (n = 6721; 98.6%) declared the need to improve their training and expressed their interest in theoretical-practical institutional courses as well as in the establishment of an official national register for medical emergencies occurred in dental practice. ConclusionsMedical emergencies are not negligible and the dentist should receive adequate training and continuing education to be updated and ready for their correct management. Clinical significanceThe dentist should be ready to deal with medical emergencies and provide first aid to the patient. The dentist is not always prepared to manage the most complex emergencies; therefore, there is the need to organize post-graduate courses and to set up an emergency register.

Different types of medical emergencies in dental practice: A review

Fortunately medical emergencies rarely occurs in daily dental practice. The risk of any serious complications can be reduced by ensuring that the basic life supporting drugs are in the appropriate place and the whole dental team should be well trained in basic life support measures. It is important for a dental practioner to have a thorough knowledge in recognizing and carrying out its initial management.

Knowledge, Attitude and Perceived Confidence of USIM Dental Graduates Towards Management of Medical Emergencies

Medical emergencies can be alarming to any clinicians, but these situations can be managed well if proper preparation has been made. The objectives of this study are to evaluate USIM dental graduate’s knowledge in dealing with medical emergencies in dental practice, to assess perceived level of competency of USIM dental graduate’s in dealing with medical emergencies in dental practice and to determine the need for further improvement in medical emergencies undergraduate training. A standardised questionnaire form consisting of demographic data, experience, knowledge and perceived level of competency of dental practitioner in dealing with medical emergencies were distributed to USIM dental graduate.123 respondents answered the online questionnaire. Around 58.5% of them had experienced medical emergencies during dental treatment. All of them answered correctly on management of hypoglycaemia but only 44.7% answered correctly on management of unresponsive patient and 65% answered correctly on position of syncope patient. Most of the respondents were not confident in administrating intravenous medication (46.3%), handling foreign body aspiration (24.4%) and using Automated External Defibrillator (AED) (38.2%). This study can be used to guide further improvement in medical emergency training for undergraduates and enhancing the proficiency level of the USIM dental graduates.

Knowledge, Attitude and Perceived Confidence of USIM Dental Graduates Towards Management of Medical Emergencies

Medical emergencies can be alarming to any clinicians, but these situations can be managed well if proper preparation has been made. The objectives of this study are to evaluate USIM dental graduate’s knowledge in dealing with medical emergencies in dental practice, to assess perceived level of competency of USIM dental graduate’s in dealing with medical emergencies in dental practice and to determine the need for further improvement in medical emergencies undergraduate training. A standardised questionnaire form consisting of demographic data, experience, knowledge and perceived level of competency of dental practitioner in dealing with medical emergencies were distributed to USIM dental graduate.123 respondents answered the online questionnaire. Around 58.5% of them had experienced medical emergencies during dental treatment. All of them answered correctly on management of hypoglycaemia but only 44.7% answered correctly on management of unresponsive patient and 65% answered correctly on position of syncope patient. Most of the respondents were not confident in administrating intravenous medication (46.3%), handling foreign body aspiration (24.4%) and using Automated External Defibrillator (AED) (38.2%). This study can be used to guide further improvement in medical emergency training for undergraduates and enhancing the proficiency level of the USIM dental graduates.

Rehabilitation of the Breached Tooth, Fragment– A Minimal Invasive Cosmetic Approach: An Original Case Series

Tooth fractures are often reported as emergencies in dental practice. Coronal fractures of the anterior teeth are a prevalent cause of dental trauma in children and teenagers. It's a tragic situation that necessitates prompt care and quick functional and esthetic repair. The clinician's main difficulty when dealing with these types of dental injuries is to re-establish the natural esthetics of the traumatized anterior tooth. There are several therapeutic options for this condition, one of which is reattachment of the fractured component itself. Because of its simplicity, natural esthetics, and preservation of tooth structure, reattachment of a tooth fragment should be the first choice and a feasible alternative to conventional approaches. For a successful prognosis, the patient's cooperation and comprehension of the treatment's limitations is essential. This paper presents a report of two clinical cases on managing complicated crown fractures, where the restoration of the fractured anterior teeth using the residual tooth fragment was supported by fiber post system.&#x0D; Keywords: Complicated Crown Fracture, Fiber post, Fractured Tooth Fragment, Internal grooving.

UK Dental Medicines Advisory Service: questions asked by dentists - part 2: drugs used for medical emergencies in dental practice.

The UK Dental Medicines Advisory Service (UKDMAS) provides advice to dentists and other dental healthcare professionals concerning the use of medicines and medical devices in dentistry. The commonly asked questions posed to the UKDMAS concerning the prescribing and administering of dental emergency drugs in dental practice are discussed, with answers supplemented by relevant information from clinicians. These include the drugs that need to be stocked in the emergency drugs kit in dental practice, their formats and storage, and the restrictions on which members of the dental team can administer the drugs.

Medical emergencies in the dental school setting

An aging population with an increasing chronic disease burden may make management of medical emergencies in dental practice more common. Previous research has differed significantly in the reported frequency of medical emergencies in a dental setting, often relying on survey-based protocols. This study examines the incidence and type of emergencies encountered in a dental school setting. Additional examination of contributing medical co-morbidities is provided. A retrospective study was designed to review 121 incident reports at the Ohio State University College of Dentistry (OSU CoD) from July 1, 2013 to January 24, 2019. Sixty-five of the recorded events were classified as medical emergencies and were further analyzed. The most common emergency encountered was syncope, followed by cardiac events, seizures, and diabetic complications. Emergencies most commonly occurred in the pre-doctoral general dentistry clinics. Many of the affected patients had no significant medical history. Identifying emergencies most encountered by dentists is critical for process improvement, awareness, and targeted educational initiatives. This may reduce the frequency of medical emergencies in dental practices and allow for more efficient management should they occur.

A brief review on medical emergencies in dental practise

Medical emergencies in dental practice are those adverse medical events that may present in the course of dental treatment. Each of those events requires a correct diagnosis for effective and safe management. Medical emergencies in dental practice are uncommon but could occur at any time. Dentist should be able enough to handle the emergency.

Medical emergencies in dental practice - management requirements and international practitioner proficiency. A scoping review.

The management of medical emergencies is widely considered a requisite skill for all dentists. Timely intervention of an emergency can significantly alter the outcome for a patient's morbidity and possible mortality. This scoping review examines the prevalence of medical emergencies in dental practice, as well as dentists' attitude, confidence, and competence, of medical emergency management within a dental setting. Key findings include a lack of preparedness towards medical emergencies, despite a universal recognition of the importance and desire to improve key medical skills.

The Emergency Dental Appointment: Restorative Emergencies Part 1 - Tooth Related Problems.

Dental emergencies affect a large proportion of the population. While there is ample information in the literature on how to manage medical emergencies in dental practice, there is little information on common dental emergencies and how to manage them. In the UK, the 2009 Adult Dental Health Survey reported 9% of dentate adults reporting pain at their clinical examination. 1 The prevalence of non-pain related restorative dental emergencies is estimated to be higher, and will be a common presenting situation in the dental clinic. Often these unplanned events cause difficulties for dental practitioners, who are already constrained by time, to fit in these patients and manage them. Over and above this, the increasing life spans, retention of teeth into later life and finite life of dental restorations all add to the challenges encountered by the dental practitioner. Prompt and effective management of these conditions often leads to optimising patient experience, but also offers better outcomes. This two-part series provides an overview of the more common dental emergencies encountered by the dental practitioner and their management. Paper 1 focuses on the management of common tooth-related emergencies and includes non-odontogenic and odontogenic pain. Paper 2 focuses on the management of osseointegrated dental implant related emergencies.

An Update on Current Resuscitation Council (UK) Guidelines.

On 15 October 2015, The Resuscitation Council (UK) published new resuscitation guidelines following the review of resuscitation science by the International Liaison Committee on Resuscitation (ILCOR). The 2015 guidelines emphasize the importance of interactions between the emergency medical dispatcher, the bystander who provides cardiopulmonary resuscitation (CPR) and the prompt deployment of an automated external defibrillator (AED); the co-ordination of these three elements is crucial to improving out-of-hospital cardiac arrest survival. Medical emergencies in dental practices are thought to occur on average once every 3−4 years per dentist in primary care. The GDC consider medical emergencies as a highly recommended topic for Continuing Professional Development (CPD) and recommend at least 10 hours in every CPD cycle. Clinical relevance: The publication of the updated guidelines serves as a reminder to the clinical team of the importance of being up to date with recognition and treatment of cardiac arrest and choking and how seamless interaction between members of both the dental and medical teams improves long-term outcomes for patients.

Experience, awareness, and perceptions about medical emergencies among dental interns of Chennai city, India

Introduction: Every dental health professional should have the essential knowledge to identify, assess and manage a potentially life-threatening situation. Aim: To assess the experience, awareness, and perceptions about medical emergencies among dental interns in Chennai city, India. Materials and Methods: A cross-sectional study carried out in four randomly selected dental colleges of Chennai city. Data were collected using a self-administered, structured, closed-ended 20-item questionnaire. It consists of questions on experience of medical emergencies encountered by interns during their graduation, awareness of the essential drugs and equipment, the amount of medical emergencies training undertaken by participants, preparedness of interns in handling medical emergencies. Descriptive statistics, independent sample t-test, were used. Results: Out of 335 interns, 157 (47%) said that syncope was the most common medical emergency event encountered by the interns. Regarding awareness about essential drugs, about 161 (48%) study participants answered oxygen, epinephrine, nitroglycerin, antihistamine, salbutamol, and aspirin as emergency drugs. About half of the study participants, 187 (56%) were aware that pressure should be given to the affected site, with or without suturing if the greater palatine artery is inadvertently cut. The majority of the interns (93%) preferred to have a specified training on the handling of medical emergencies in dental practice. Conclusions: Syncope was the most common medical emergency event. Awareness about the essential drugs, equipment, and preparedness of dental interns in handling medical emergencies was low.

Formulation of guidelines to resolve medical emergencies in dental practice: An overview

Dentists are prone to face unpredictable medical emergency crises in their patients during dental practice. These seldom but usually occurring events require diagnosis for safe and effective management. Therefore, dental care professionals are required to be equipped with information and training on how to manage medical emergencies (MEs) including drug administration. An outline of what essential basic life support equipment and medications require in dental clinics to manage MEs are provided with recommendation for training to handle those medical events. Effective and safe dental practice require to providing graduate and undergraduate dentistry students with updated information and training on medical emergencies and how to handle different equipment and drugs associated with such events.

Medical Emergencies in Dental Practice - A Nepalese study

Introduction: Medical emergencies can occur in dental practice anytime. Changing demographics in the population and increased life expectancy have resulted in more people having medical conditions which predispose to a medical emergency.Objective: To find the prevalence of medical emergencies in dental practice in Nepal, to assess the preparedness of dentists to manage emergency situation, to find out the ways to improve their preparedness, and to determine the factors affecting the occurrence of medical emergency.Materials &amp; Method: A cross-sectional study using self-administered questionnaire was done among one hundred and twenty four participants present at the 16th Annual Dental Conference. The questionnaire consisted of 15 questions. The data were analyzed using chi-square test and cross tabulation was performed to evaluate categorical variables at a significant level of p&lt; 0.05.Result: The percentage of respondents who reported at least one emergency situation was 37.1%. Majority of the events occurred during oral surgical treatment. According to the survey, the most frequently encountered emergency condition was vasovagal syncope followed by hypoglycemia and seizures. The emergency events were managed by the respondents through various modalities. The dental graduates despite BLS training were found to feel incompetent to manage emergency events.Conclusion: Medical emergencies in dental practice in Nepal are frequent and not as rare as anticipated. Thus periodic training should be provided to improve necessary clinical skills.

The Effect of Basic Life Support Workshop on Performance Skills of Iranian Undergraduate Dental Students

Background: Considering the occurrence of medical emergencies in dental practice, and the essential need of acquiring competency in Basic life support (BLS), the aim of the present study was to evaluate the effect of BLS workshop on the skills of dental students in the cardiopulmonary resuscitation. Methods: In this switching replication experimental study, students in the 5th year of Mashhad dental school (Iran) in 2013 participated in the study. All participants completed a baseline assessment at the skill lab (pre-test). To evaluate the practical skills of students in the cardiopulmonary resuscitation, a scenario was presented, and the students were asked to demonstrate all the actions that are necessary to rescue the patient on a manikin. A trained instructor scored their skills according to a standard checklist. Then; the participants were randomly divided into two groups. The first group took BLS workshop and was assessed immediately after the workshop (immediate post-test), while final examination was conducted one month after the course. The same scenario was used for all participants at each testing point. In the second group, the second pretest was taken within one month of the first pretest. Immediately after taking the second pretest, the students participated in workshop, and were assessed immediately after the course. To compare the score of competency in BLS in the two groups, t-test or Mann-Whitney U-test was used. Results: Primary skills of the two groups were almost similar (P= 0.77). Considerable increase in the skills of the two groups was observed after taking the workshop. One month interval between the two pretests in the second group did not cause any significant difference in the students' skills (P = 0.12). A decrease was observed in the skills of first group one month after the first exam (P = 0.003). Conclusions: BLS workshops can significantly increase dental students’ competency in life support. However, considering the retention time of skills, refreshing courses are strictly recommended.