Dental Core Trainee 1 in Oral Surgery, Kingston Hospital.
Specialty Doctor in Oral and Maxillofacial Surgery, Kingston Hospital.
Prim Dent J. 2021 Mar;10(1):40-45. doi: 10.1177/2050168420980961.
The COVID-19 pandemic enforced the cessation of routine dentistry and the creation of local urgent dental care systems in the UK. General dental practices are obligated by NHS guidance to remain open and provide remote consultation and referral where appropriate to patients having pain or problems.
To compare two urgent dental centres with different triage and referral systems with regard to quality and appropriateness of referrals, and patient management outcomes.
110 consecutive referrals received by a primary care urgent dental centre and a secondary care urgent dental centre were assessed. It was considered whether the patients referred had access to remote primary care dental services, fulfilled the criteria required to be deemed a dental emergency as mandated by NHS guidance, and what the outcomes of referrals were.
At the primary care centre, 100% of patients were referred by general dental practitioners and had access to remote primary care dental services. 95.5% of referrals were deemed appropriate and were seen for treatment. At the secondary care site, 94.5% of referrals were direct from the patient by contacting NHS 111. 40% had received triaging to include 'advice, analgesia and antimicrobial' from a general dental practitioner, and 25.5% were deemed appropriate and resulted in treatment.
Urgent dental centres face many issues, and it would seem that easy access to primary care services, collaboration between primary care clinicians and urgent dental centres, and training of triaging staff are important in operating a successful system.
COVID-19 大流行迫使英国停止常规牙科治疗,并建立当地紧急牙科护理系统。国民保健制度指导方针要求普通牙科诊所保持开放,并为有疼痛或问题的患者提供远程咨询和转诊服务。
比较两家具有不同分诊和转诊系统的紧急牙科中心,评估其转诊的质量和适宜性,以及患者管理结果。
评估初级保健紧急牙科中心和二级保健紧急牙科中心收到的 110 例连续转诊病例。评估标准为:转诊患者是否能够获得远程初级保健牙科服务,是否符合国民保健制度指导方针规定的视为牙科急症的标准,以及转诊的结果如何。
在初级保健中心,100%的患者由普通牙科医生转诊,并且可以获得远程初级保健牙科服务。95.5%的转诊被认为是合适的,并接受了治疗。在二级保健中心,94.5%的转诊是通过联系 NHS 111 直接来自患者。其中 40%接受了普通牙科医生的分诊,包括“建议、镇痛和抗菌治疗”,25.5%被认为是合适的,并进行了治疗。
紧急牙科中心面临许多问题,似乎容易获得初级保健服务、初级保健临床医生与紧急牙科中心之间的合作,以及分诊人员的培训,对于成功运作系统很重要。