Emergencies In Dental Practice Research Articles

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 & 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< 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.

Facebook as a learning environment for teaching medical emergencies in dental practice.

Social media can be part of the formal education of health professsionals and in their lifelong learning activities. The effectiveness of Facebook, an online social medium, application for educational purposes was evaluated in this study. It was used to serve as a teaching medium of a course in medical emergencies in dental practice (MEDP). Syrian dental students were invited to join a Facebook group "Medical emergencies in dental practice" during the second semester of the academic year 2013-2014. The group privacy settings were changed from an open group to a closed group after the registration period. Administrators of the group published 61 posts during the course period, which extended for one month. Students' progress in learning was evaluated using self-assessment questionnaires administered to the students before and after the course. These questionnaires also queried their opinions regarding the use of Facebook as an educational modality. Qualitative statistics, Wilcoxon signed ranks and Mann-Whitney U-tests were used to analyze the data. Out of 388 students registered in this course, 184 completed it. Two-third of students agreed that Facebook was useful in education. Their impressions of this course were 17.4% as excellent, 52.2% as very good. P values of the self-assessment questions of Wilcoxon signed ranks test were <0.001, indicating self-assessed improvement in MEDP skills. Facebook as a social medium provides a unique learning environment. It allows students to discuss topics more openly in a flexible setting with less rigid time and place constraints. In the light of this study it was found that Facebook may be useful in teaching medical emergencies in dental practice in its theoretical aspect.

The ability of oral & maxillofacial surgeons to perform basic life resuscitation in chattisgarh.

This study was conducted to assess the ability of oral & maxillofacial surgeons regarding basic life resuscitation in case of medical emergencies. This cross-sectional study was conducted among oral & maxillofacial surgeons through a mailed questionnaire. The sample size was finalized to 152 including 108 - males and 44 - females with mean age of the subjects as 30.65 y. The Statistical software namely SPSS version 16.0 was used for data analysis. The student's t-test, ANOVA test and post-hoc test were used as tests of significance for statistical evaluation at p ≤ 0.05. The study revealed that most of the participants were aware about the administration of drugs. Around half of the surgeons (52.4%) were able to understand correct reading of ECG. It has been seen that, 66.8% were properly knowing, how to maintain the airway and 77.4% were experienced in the administration of oxygen in case of emergencies. Overall the knowledge was more among experienced dental surgeons. It was found that most of the participants were aware to handle the medical emergencies in dental practice and the awareness was higher among senior surgeons. Still the surgeon should have more knowledge for initial stabilization in a patient with risk happening at dental office.

General medicine and surgery for dental practitioners: part 3. 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. Contemporary management in dental practice avoids the intravenous route when drugs are required to treat the emergency.

Medical emergencies in dental practice: the five P's

Medical emergencies in dental practice: the five P's

General medicine and surgery for dental practitioners: part 2. Medical emergencies in dental practice: the drug box, equipment and basic principles of management.

Dental practitioners need knowledge of the diagnosis and management of medical emergencies. This paper deals with the general aspects of emergency treatment including basic management principles which are applicable to all emergencies. The next paper in this series, part 3, deals with more specific aspects of medical emergency management.

Medical emergencies in dental practice

Introduction : Dentistry is a clinical activity potentially at risk of medical emergencies and dental practitioners need to be prepared to handle them effectively. Materials and methods : We have contacted 25535 French and Belgian dentists through an online survey which included 37 questions about emergency situations they have experienced, emergency equipment at their disposal, training and self-evaluation of competence in the management of medical emergencies. Results : 1344 were included. The incidence of medical emergencies was 2.1 events per dentists per year, mostly vasovagal syncope, orthostatic hypotension or hypoglycemia. Life-threatening emergencies and cardiac arrests are rare but occur (0.003 cardiac arrests per dentist per year of practice). Nearly one out of five dentists had no emergency equipment at all. While many practitioners are equipped with oxygen (66.8%), few possess a defibrillator (7.7%). Nearly 10% of practitioners report never being trained for medical emergencies. Conclusions : Dental practitioners encounter medical emergencies, mostly benign ones but also, more rarely, life-threatening emergencies. Efforts should be made in the education of dental practitioners regarding the management of medical emergencies during initial and continuing education. The recommended emergency equipment for dental practices should be kept to the minimum necessary in order to increase the number of offices properly equipped.

Awareness of Dental Office Medical Emergencies Among Dental Interns in Southern India: An Analytical Study

Medical emergencies in dental practices are common, and specific training and skills are needed to manage the situations. Dental curricula provide training in basic life support in medical emergency management. In India, the internship is the final stage before graduation, and the interns are future practitioners. Managing emergency situations increases the confidence level among new graduates. Training and skill improvement through various training programs on medical emergencies will improve the quality of dental practice, and it is beneficial to the patients. Knowledge of medical emergencies by dental interns is important since they go for practice without supervision. This study was conducted to assess the awareness and knowledge of medical emergencies among dental interns in the southern part of India. Based on the results, dental curricula need to include more rigorous training in emergency management.

Avoiding medical emergencies

Medical emergencies can occur at any time in any location. This article and associated presentation at the forthcoming British Dental Conference Exhibition provide key advice on avoiding medical emergencies in dental practice; including advice on risk assessing all patients, understanding the importance of a checklist, and using a National Early Warning Score (NEWS).

Medical emergencies in dental practice: case studies

Following on from the series of articles outlining the identification and management of medical emergencies, this article presents two reflective case studies for practitioners to work through in order to appreciate the knowledge and skills required

Emergências médicas em medicina dentária: prevalência e experiência dos médicos dentistas

Medical emergencies in dental practice are generally perceived as being rare but when an emergency does occur it can be life-threatening. The aim of this study was to evaluate the prevalence of emergencies in dental practices and their training experience. An anonymous questionnaire survey was submitted by phone call to the 240 clinics and hospitals from Oporto city listed in the Health Control Institution during 6 months. The most frequently reported emergency was syncope, hypoglycemia, asthma, hypertensive crisis, epileptic fit and anaphylaxis. Most of dentists felt competent to treat syncope however 90% felt unable to manage a cardiac arrest. Medical emergencies are not rare in dental practice, although most of them are not life- threatening. Future postgraduate training in emergency care for dentists needs to be more accurately targeted to the known prevalence of emergencies and deficiencies in dentist́s emergency skills.

Practical skills training influences knowledge and attitude of dental students towards emergency medical care

Medical emergencies in dental practice are generally perceived as being rare. Nonetheless, recent studies have shown that incidents occur on a regular basis. Therefore, patients have the right to expect necessary skills to manage life-threatening situations from every dentist. To observe students' attitude and self-assessment towards emergency medical care (EMC) and its practical appliance. Students of dentistry took part in small group sessions for adult and paediatric basic life support. Participants filled out pre-post questionnaires regarding knowledge and attitude towards EMC (6, respectively, 10-point Likert scale). Additionally, feedback was asked for the quality of course and tutors. Forty dental students in their last 2 years of study registered for the EMC courses. The majority had never attended any first-aid course; the mean age was 25% and 75% were women. A comparison between pre- and post-evaluation showed that the participation in practical training easily enhances the students' awareness of EMC importance as well as self-confidence in managing emergencies. After the course, 71% shared the opinion that retraining should be obligatory for all medical personnel. At the same time, students' self-assessment of confidence for specific tasks got significant upgrades in every aspect. The evaluation data clearly show the participants' needs to deal with topics of EMC within the curriculum of dentistry. The proposed course is able to change participants' attitudes towards EMC and its importance for their daily practice. The considerable enhancement of self-confidence in performing EMC-techniques might also lead to more willingness to manage emergency situations.

Management of medical emergencies in dental practice

Medical emergencies can happen. If they do take place in a dental practice, there should be staff that are adequately trained to deal with the problem quickly and correctly. This article advises on managing some of the medical emergencies that can arise when treating patients in general practice

Use of emergency intravenous injection in dental practice

Medical emergencies can occur in dental practice and dental surgeons have to be able to handle them effectively. The intravenous route has long been advocated for dental surgeon in emergency. Since 2006, recommendations from the British Resuscitation Council tend to discourage this route of administration for dental practitioners in emergency. In France there is no consensus on this subject and most French dental schools still teach intravenous route in case of medical emergency. We reviewed international literature regarding medical emergencies in dental practice since 2006 and identified those dealing with intravenous access. Half of the publications suggest or encourage the use of intravenous access. Nevertheless, most of dental surgeons do not feel confident in realizing an urgent intravenous injection. Indeed, this technique requires an intensive phase of learning and regular practice to be performed in safety and effectively. Thus, this technique is difficult to realize in a context of stress and of under-training. Dental surgeons should be familiar with other methods of administration to manage medical emergencies encountered in dental practice such as intramuscular, inhalatal, sublingual, buccal and oral. It seems necessary to encourage an European consensus on this subject in order to improve the management of medical emergencies. Mots cles : urgence medicale / chirurgie dentaire / cabinet dentaire / dentiste / injection intraveineuse / etudiant en chirurgie dentaire

Simulation of medical emergencies in dental practice: development and evaluation of an undergraduate training programme

The evidence available suggests that many dentists on graduation do not feel competent managing medical emergencies; a problem requiring improved undergraduate training. This study developed a comprehensive simulation based training programme for final year undergraduate dental students and assessed student attitudes towards training. Final year dental students (n = 52) from The University of Melbourne were required to complete simulation training incorporating an interactive tutorial and realistic, simulated emergency scenarios conducted in the students' real clinical environment. A post-participation questionnaire utilizing a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree) assessed student attitudes. Student responses supported simulation training, evidenced by the following selected questionnaire responses: achieved greater confidence in managing emergencies 4.65 ± 0.48 (n = 52); prefer lecture to simulation 1.46 ± 0.74 (n = 52); simulation training is important in undergraduate teaching 4.86 ± 0.35 (n = 43). Realistic simulation training in management of medical emergencies for dental students is an effective adjunct to traditional lecture style teaching. Given the importance of this subject, this mode of training would benefit students if incorporated into undergraduate dental courses.

Prevalence of emergency events in dental practice and emergency management of dentists

Purpose of the study: Medical emergencies in dental practice are generally perceived as being rare but when an emergency does occur it can be life-threatening. The ability of the dentist to initiate management is the key to minimizing morbidity and mortality. Few studies exist about the occurrence of emergencies in dental practice and the training experience of dental practice teams in life support. The aim of this study was to evaluate the prevalence of emergencies in dental practices and their training experience.Material and methods: An anonymous questionnaire survey was submitted by phone call to the 240 clinics and hospitals from Oporto city listed in the Health Control Institution during 6 months. This questionnaire was performed by three Anesthesiologists from our institution.Results: We had a response rate of 25%. 66% of the responders were male and 34% female. 42% work in a dental office, 52% in a clinical and 6% in a hospital. 67% reported an emergency during their practice and only 33% did not have any emergency situation. The most frequently reported emergency was syncope (59%), followed by hypoglycemia (53%), asthma (34%), hypertensive crisis (34%), epileptic fit (30%) and anaphylaxis (21%). 58% of dentists felt competent to treat syncope and 46% to treat a hypoglycemia. However 90% felt unable to manage a cardiac arrest, 95% a hypertensive crisis and 96% asthma. 97% underwent training in medical emergencies. 77% of the dentists considered important to have more emergency training.Conclusion: Medical emergencies are not rare in dental practice, although most of them are not life-threatening. Future postgraduate training in emergency care for dentists needs to be more accurately targeted to the known prevalence of emergencies and deficiencies in dentist's emergency skills. Purpose of the study: Medical emergencies in dental practice are generally perceived as being rare but when an emergency does occur it can be life-threatening. The ability of the dentist to initiate management is the key to minimizing morbidity and mortality. Few studies exist about the occurrence of emergencies in dental practice and the training experience of dental practice teams in life support. The aim of this study was to evaluate the prevalence of emergencies in dental practices and their training experience. Material and methods: An anonymous questionnaire survey was submitted by phone call to the 240 clinics and hospitals from Oporto city listed in the Health Control Institution during 6 months. This questionnaire was performed by three Anesthesiologists from our institution. Results: We had a response rate of 25%. 66% of the responders were male and 34% female. 42% work in a dental office, 52% in a clinical and 6% in a hospital. 67% reported an emergency during their practice and only 33% did not have any emergency situation. The most frequently reported emergency was syncope (59%), followed by hypoglycemia (53%), asthma (34%), hypertensive crisis (34%), epileptic fit (30%) and anaphylaxis (21%). 58% of dentists felt competent to treat syncope and 46% to treat a hypoglycemia. However 90% felt unable to manage a cardiac arrest, 95% a hypertensive crisis and 96% asthma. 97% underwent training in medical emergencies. 77% of the dentists considered important to have more emergency training. Conclusion: Medical emergencies are not rare in dental practice, although most of them are not life-threatening. Future postgraduate training in emergency care for dentists needs to be more accurately targeted to the known prevalence of emergencies and deficiencies in dentist's emergency skills.

Medical emergencies in dental practices

Medical emergencies in dental practices

Brazilian Dentists’ Attitudes About Medical Emergencies During Dental Treatment

The main objective of this study was to evaluate the prevalence of emergencies in dental practices and the prepared-ness and the training experience in cardiopulmonary resuscitation (CPR) of Brazilian dentists in dealing with emergencies. The volunteer participants in the study were 498 Brazilian dentists who were present at the 27th International Congress of Dentistry in São Paulo. The most prevalent emergency was presyncope (reported by 54.20 percent of respondents), followed by orthostatic hypotension (44.37 percent), moderate allergic reactions (16.86 percent), hypertensive crisis (15.06 percent), asthma (15.06 percent), syncope (12.65 percent), angina (6.82 percent), convulsion (6.22 percent), hypoglycemia (5.62 percent), hyperventilation crisis (5.22 percent), choking (2.20 percent), and cerebrovascular accident (0.8 percent). Anaphylaxis, myocardial infarction, and cardiac arrest were the rarest emergencies, reported by only 0.4, 0.2, and 0.2 percent of dentists, respectively. Only 41 percent of the dentists judged themselves capable to diagnose the cause of an emergency during a dental visit. The majority responded that they would be capable of performing initial treatment of presyncope, syncope, orthostatic hypotension, convulsion, and choking. However, most of them felt unable to treat anaphylaxis, myocardial infarction, or cardiac arrest. Further, the majority felt unable to perform CPR or undertake an intravenous injection. It was concluded that the most prevalent medical emergencies in dental practice of Brazilian dentists are presyncope and orthostatic hypotension. The occurrence of life-threatening medical emergencies like anaphylaxis, myocardial infarction, cardiac arrest, and cerebrovascular accident is rare. Brazilian dentists are not fully prepared to manage medical emergencies and have insufficient experience training in CPR.