Senior Research Fellow, Department of Public Health, University of Otago, Wellington.
BSc, BDS, Faculty of Dentistry, University of Otago.
N Z Med J. 2021 Oct 22;134(1544):99-112.
Many low-income New Zealanders attend emergency departments (EDs) for relief of dental pain and infection. This places a substantial burden on EDs. Better understanding of non-traumatic dental presentations (NTDPs) will aid the development of relevant health policy and clinical management strategies.
To explore the nature, context and impact of NTDPs on New Zealand EDs.
A mixed-methods approach was used. Routinely collected data on NTDPs to ED at four New Zealand hospitals were analysed descriptively, and semi-structured interviews with ED and dental personnel (n=20) from the four hospitals were conducted and analysed thematically.
Young adults (20-39 years), and Māori and Pacific people, were frequent ED attenders for NTDPs; repeat visits were common. Most were seen by non-dental health practitioners. Cost and access were identified as barriers to dental care. Management of NTDPs generally involved analgesics for relief of pain and antibiotics for infection management. All participants said definitive care pathways for NTDPs were lacking. There is potential to improve staff training in diagnosis and anaesthetic administration. However, participants were more interested in referral pathways and public funding for dental care.
Accessible and equitable dental care pathways and policies are urgently required to enable timely and appropriate care for NTDPs.
许多新西兰低收入者因牙痛和感染前往急诊部(ED)寻求缓解。这给 ED 带来了巨大的负担。更好地了解非创伤性牙科表现(NTDP)将有助于制定相关的卫生政策和临床管理策略。
探讨新西兰 ED 中非创伤性牙科表现(NTDP)的性质、背景和影响。
采用混合方法。对四家新西兰医院 ED 中 NTDP 的常规收集数据进行描述性分析,并对四家医院的 ED 和牙科人员(n=20)进行半结构化访谈,并进行主题分析。
年轻人(20-39 岁)、毛利人和太平洋岛民经常因 NTDP 前往 ED;重复就诊很常见。大多数人由非牙科卫生从业者接诊。费用和获得途径被认为是牙科护理的障碍。NTDP 的管理通常包括镇痛药缓解疼痛和抗生素管理感染。所有参与者均表示缺乏明确的 NTDP 治疗途径。有潜力改善员工在诊断和麻醉管理方面的培训。然而,参与者更感兴趣的是转诊途径和公共资金用于牙科护理。
迫切需要可及和公平的牙科护理途径和政策,以便为 NTDP 提供及时和适当的护理。