Department of Paediatric Dentistry, Charles Clifford Dental Hospital, Wellesley Road, Sheffield, S10 2SZ.
Br Dent J. 2010 Mar 27;208(6):E11; discussion 254-5. doi: 10.1038/sj.bdj.2010.254.
To investigate the time lapse prior to provision of emergency dental care and appropriateness of earliest treatment provided for children with dental trauma.
A multi-regional prospective and cross-sectional survey.
Paediatric dental departments of Liverpool, Manchester and Sheffield.
One hundred and fifty referred or emergency paediatric patients with trauma to the permanent incisors.
One hundred and fifty subjects were recruited. Mean age of the subjects was 11.1 years (SD = 2.6; range = 6.2-16.6); 100 were male and 50 were female. The mean time interval from injury until initial presentation to a health care professional was 22.6 hours (SD = 76.1; range = 0-672). Thirty-six percent of children (n = 54) first presented to a general dental practitioner whilst 30% (n = 45) presented to accident and emergency medical staff. Following initial assessment, a further mean time lapse of 8.1 hours (SD = 43.7; range = 0-504) was incurred in 25% of cases prior to dental referral. In 39% of subjects (n = 58/150), treatment was considered inappropriate. The most frequent example of inadequate management was failure to protect exposed dentine, which was found for 71% (n = 24/34) of complicated crown fractures and 40% (n = 25/62) of uncomplicated crown fractures.
This study identified marked delays in the management of some paediatric dental trauma to permanent incisor teeth which, in itself, could be suboptimal. Greater educational and clinical support would seem to be warranted in this area of service provision.
调查为牙外伤儿童提供紧急牙科护理的时间延迟以及提供的最早治疗的适宜性。
多区域前瞻性和横断面调查。
利物浦、曼彻斯特和谢菲尔德的儿科牙科部门。
150 名转诊或急诊的恒切牙外伤患儿。
共纳入 150 名受试者。受试者的平均年龄为 11.1 岁（标准差=2.6；范围=6.2-16.6）；100 名男性，50 名女性。从受伤到首次向医疗保健专业人员就诊的平均时间间隔为 22.6 小时（标准差=76.1；范围=0-672）。36%（n=54）的儿童首次就诊于普通牙科医生，30%（n=45）就诊于急症医疗人员。在初步评估后，25%的病例在转诊前又平均延迟 8.1 小时（标准差=43.7；范围=0-504）。在 39%的病例（n=58/150）中，治疗被认为是不合适的。管理不当最常见的例子是未能保护暴露的牙本质，在复杂冠折的 71%（n=24/34）和简单冠折的 40%（n=25/62）病例中发现。
本研究发现，一些儿童恒切牙外伤的处理存在明显延迟，这本身可能并不理想。在这一服务提供领域，似乎需要更多的教育和临床支持。
