School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK.
Newcastle Dental Hospital, Newcastle Hospitals NHS Foundation Trust, Richardson Road, Newcastle upon Tyne, NE2 4AZ, UK.
Int Endod J. 2023 Jun;56(6):697-709. doi: 10.1111/iej.13917. Epub 2023 Apr 4.
This study aimed to: (i) calculate personal financial costs associated with urgent dental attendance; and (ii) investigate the pain-related disability and quality of life impact of dental conditions which result in urgent dental attendance.
Data were collected from those presenting with urgent dental conditions to an out-of-hours dental service, a dental emergency clinic (DEC) and five primary care general dental practices across North-East England. A pre-operative questionnaire explored the impact of urgent dental conditions on oral health-related quality of life (OHRQoL) using Oral Health Impact Profile-14 (OHIP-14) and a modified Graded Chronic Pain Scale (GCPS). OHIP-14 yields a maximum score of 56, with a higher score indicating a lower OHRQoL. Personal financial costs were summed to provide a total. These included travel, appointment fees, childcare costs, medication use and time away from work. Data were analysed using one-way anova and multivariable modelling.
In total, 714 participants were recruited. The mean OHIP-14 score was 25.73; 95% CI [24.67, 26.79], GCPS CPI was 71.69; 95% CI [70.09, 73.28] and GCPS interference was 49.56; 95% CI [47.24, 51.87]. Symptomatic irreversible pulpitis was the most frequently managed dental emergency and was associated with the highest mean OHIP-14 score (31.67; 95% CI [30.20, 33.15]). The mean personal financial cost of urgent dental care (UDC) was £85.81; 95% CI [73.29, 98.33]. Differences in travel time (F[2, 691] = 10.24, p < .001), transport costs (F[2, 698] = 4.92, p = .004), and appointment time (F[2, 74] = 9.40, p < .001) were significant between patients attending an out-of-hours dental service, DEC and dental practices for emergency care, with a DEC being associated with the highest costs and dental practices the lowest.
Diseases of the pulp and associated periapical disease were the most common reason for patients to present for UDC and were the most impactful in terms of OHRQoL and pain in the present sample. Personal financial costs are significant from urgent dental conditions, with centralized services increasing the burden to patients of attending appointments.
本研究旨在：（i）计算与紧急牙科就诊相关的个人经济成本；（ii）调查导致紧急牙科就诊的牙科状况对疼痛相关残疾和生活质量的影响。
本研究的数据来自于英格兰东北部的一家非营业时间牙科服务机构、一家牙科急诊诊所（DEC）和五家初级保健普通牙科诊所，这些患者因紧急牙科状况就诊。术前问卷调查采用口腔健康影响量表-14（OHIP-14）和改良的慢性疼痛分级量表（GCPS）评估了紧急牙科状况对口腔健康相关生活质量（OHRQoL）的影响。OHIP-14 的最高得分为 56 分，得分越高表明 OHRQoL 越低。个人经济成本总计。这些费用包括旅行、预约费、儿童保育费、药物使用和旷工时间。使用单因素方差分析和多变量模型进行数据分析。
共有 714 名参与者被招募。OHIP-14 的平均得分为 25.73；95%CI[24.67,26.79]，GCPS CPI 为 71.69；95%CI[70.09,73.28]，GCPS 干扰为 49.56；95%CI[47.24,51.87]。可复性不可逆行牙髓炎是最常见的牙科急症，其 OHIP-14 平均得分最高（31.67；95%CI[30.20,33.15]）。紧急牙科护理（UDC）的个人经济成本平均为 85.81 英镑；95%CI[73.29,98.33]。在旅行时间（F[2,691]=10.24，p<0.001）、交通成本（F[2,698]=4.92，p=0.004）和预约时间（F[2,74]=9.40，p<0.001）方面，在接受非营业时间牙科服务、DEC 和牙科诊所急诊护理的患者之间存在差异，DEC 相关费用最高，而牙科诊所相关费用最低。
牙髓疾病和相关根尖周疾病是患者接受 UDC 的最常见原因，在本样本中，它们在 OHRQoL 和疼痛方面的影响最大。个人经济成本因紧急牙科状况而显著增加，集中服务增加了患者就诊的负担。
