Brecher Erica A, Keels Martha Ann, Best Al M, Quiñonez Rocio B, Roberts Michael W
Assistant professor, Department of Pediatric Dentistry, at the Virginia Commonwealth University, Richmond, Va., USA;, Email:
Adjunct associate professor, Department of Pediatrics, Duke University, Durham; and an adjuct professor, Department of Pediatric Dentistry, University of North Carolina School of Dentistry, Chapel Hill, N.C., USA.
Pediatr Dent. 2018 Sep 15;40(5):352-358.
Assess how pediatric dentists (PD) and general practitioners (GP) manage after-hours pediatric dental emergencies according to perceived urgency. A survey was e-mailed to PD and GP in North Carolina. Participants responded to management of 18 cases (primary and permanent dentition) according to perceived urgency. Repeated-measures logistic regression was used to analyze factors influencing perception of clinical scenarios. Response rates for PD and GP were 45.5% and 36.3%, respectively. Perceived urgency varied by clinical scenarios, dentition (primary vs. permanent), and practitioner (PD vs. GP) (P<.001). Practitioners with fewer years in practice or seeing fewer pediatric patients managed more cases as urgent. Traumatic injuries in primary dentition (intrusion, pulp exposure, palatal displacement, avulsion) were managed as more urgent by GP than PD (P<.001). Emergencies related to infection and permanent dentition were perceived similarly by PD and GP. Conclusions: Clinical scenarios highlighted disagreement in the management of after-hours pediatric dental emergencies between GP and PD, especially trauma in primary dentition. General practitioners tended to refer to an ED or see urgently, and PD tended to defer care. By identifying needs for improved education in dental trauma management, we can increase utilization of the dental home, avoiding use of overburdened EDs.
评估儿科牙医(PD)和全科医生(GP)如何根据感知到的紧迫性处理非工作时间的儿科牙科急诊。向北卡罗来纳州的儿科牙医和全科医生发送了一份电子邮件调查问卷。参与者根据感知到的紧迫性对18例病例(乳牙列和恒牙列)的处理情况进行了回应。采用重复测量逻辑回归分析影响对临床场景感知的因素。儿科牙医和全科医生的回复率分别为45.5%和36.3%。感知到的紧迫性因临床场景、牙列(乳牙列与恒牙列)和从业者(儿科牙医与全科医生)而异(P<0.001)。从业年限较少或看儿科患者较少的从业者将更多病例视为紧急情况。全科医生比儿科牙医更将乳牙列的创伤性损伤(嵌入、牙髓暴露、腭侧移位、脱位)视为紧急情况(P<0.001)。儿科牙医和全科医生对与感染及恒牙列相关的急诊的感知相似。结论:临床场景凸显了全科医生和儿科牙医在处理非工作时间的儿科牙科急诊方面存在分歧,尤其是乳牙列的创伤。全科医生倾向于转诊至急诊科或紧急接诊,而儿科牙医则倾向于推迟治疗。通过确定在牙科创伤管理方面改进教育的需求,我们可以提高牙科之家的利用率,避免使用不堪重负的急诊科。