COVID-19 pandemic: the first wave - an audit and guidance for paediatric dentistry

Ilyas, Nabeel; Agel, Mona; Mitchell, Julie L.; Sood, Sanjeev

doi:10.1038/s41415-020-1702-8

Cited by 24 publications

(25 citation statements)

References 13 publications

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“…This reduced the ability of UDCs to obtain adequate PPE supplies which hindered their ability to deliver essential urgent treatment. Furthermore, despite advice, patients have struggled to access to UDCs, with some centres receiving an average of 200 telephone calls a day from those unable to find alternatives for treatment 7 .…”

Section: Introductionmentioning

confidence: 99%

Impacts of lockdown during the SARS-CoV-2 pandemic on patients presenting with cervicofacial infection of odontogenic origin: a comparative study

Dawoud

Kent

2021

British Journal of Oral and Maxillofacial Surgery

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Introduction The SARS-CoV-2 pandemic caused unprecedented disruption to primary and secondary healthcare services. Our aim was to explore whether the pandemic had any impact on patients presenting with cervicofacial infections (CFI) of odontogenic origin to the secondary care and their management. Methods Comparative analysis was carried out evaluating prospective and retrospective consecutively admitted patients with a diagnosis of CFI of odontogenic origin in the COVID-19 lockdown period from 15 th March to 15 th June 2020 and pre COVID-19 during the same period of the previous year. Data included patient demographics, co-morbidities, systemic inflammatory response syndrome (SIRS) status on admission, clinical features, prior treatment in primary care, source of referral, SARS-CoV-2 antigen status, treatment received in secondary care, intra-operative findings, and whether escalation of the level of care was required. Results Across both cohorts there were one hundred and twenty-five (125) patients admitted with CFI of odontogenic origin, with a 33% reduction ((n = 75 (2019) vs. n = 50 (2020)) in number of patients admitted during COVID-19 lockdown. There was no difference between the cohorts in terms of age (p = 0.192), gender (p = 0.609) or major co-morbidities (p = 0.654). Proportionally more patients in the COVID-19 group presented with SIRS (p = 0.004). This group of patients persisted with symptoms for longer before presenting to secondary care (p = 0.003), more delay from hospital admission to surgical intervention (p < 0.005) and had longer length of hospital stay (p = 0.001). More patients required extra-oral surgical drainage during COVID-19 (p = 0.056). Conclusions This study suggests that the COVID-19 lockdown has had adverse effects on the presentation of CFI of odontogenic origin and its management within a Regional Acute Maxillofacial Service. Commissioners and clinicians should endeavour to plan for adequate primary and secondary care provision during any future local lockdowns to ensure that patient care is optimised.

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Section: Introductionmentioning

confidence: 99%

Impacts of lockdown during the SARS-CoV-2 pandemic on patients presenting with cervicofacial infection of odontogenic origin: a comparative study

Dawoud

Kent

2021

British Journal of Oral and Maxillofacial Surgery

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“…COVID-19 has had a profound impact on the dental profession. Everyday dental treatment involves the generation of splatter and aerosols of bodily fluids including blood and saliva, which increases the likelihood of transmission of viruses such as SARS-CoV-2 (Ilyas et al 2020 ). The use of dental equipment such as high-speed handpieces, 3-in-1 air–water syringes, and suction aspirators initiates an aerosol generating procedure (AGP) which form part of everyday dental care.…”

Section: Introductionmentioning

confidence: 99%

Paediatric dental A&E service during the COVID-19 pandemic in the Greater London area

Patel

Viswanathan

Lee

et al. 2021

Eur Arch Paediatr Dent

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Purpose The UK government introduced a nationwide lockdown on the 23rd March 2020 to prevent the spread of COVID-19. All elective hospital and dental practice assessments and procedures were mandated to stop. Key hospital dental workers were required to work, and Guy's and St Thomas' NHS Foundation Trust became a designated Urgent Dental Care Centre (UDC) for the greater London area. The paediatric dental emergency walk-in service was suspended and replaced with a telephone triage system and evaluation of digital images sent by parents/carers when needed. The aim of this paper is to describe the emergency service provided by staff in the department of Paediatric Dentistry at St Thomas' Hospital during the first lockdown. Methods A prospective service evaluation of the modified paediatric dental emergency service was carried out between 25th March and 29th May 2020. Results Four-hundred and sixty-four patients accessed the paediatric dental emergency service via telephone during the service evaluation period. Of these, 192 (41%) had dental pain, 121 (26%) had pain and swelling of dental origin, and 89 (19%) had trauma. Conclusions Remote telephone consultations and digital photographs were useful to screen emergency paediatric dental patients, but lack of face-to-face consultations with radiographic assessment and access to general anaesthetic services were major limiting factors.

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“…This inevitably led to some compromise in treatment—for example normal follow‐ups regarding splint removal and radiographs may have been delayed and instead conducted virtually. Many units treating acute dental trauma therefore developed their own local policies designed to safeguard the well‐being of staff and patients, whilst still ensuring those with the most acute need could be seen and treated 8 . King's College Hospital (KCH) operated an initial telephone triage and ‘virtual’ service, to ensure that patients were not being seen face to face unnecessarily.…”

Section: Introductionmentioning

confidence: 99%

Demographics and management of paediatric dental‐facial trauma in the ‘lockdown’ period: A UK perspective

Ilyas

Green

Karia

et al. 2021

Dental Traumatology

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Background The United Kingdom entered ‘lockdown’ on the 23 March 2020 due to the COVID‐19 pandemic. This resulted in school closures forcing children to remain at home. Dental‐facial trauma was still likely to be common place due to falls and injuries exercising. The aim of this study was to explore the impact of the COVID‐19 pandemic on clinical practice in a paediatric population in a tertiary care hospital and a linked Dental Institute. Method A proforma was designed to capture the demographics, presenting complaints, type of dental‐facial injury, treatment need and the treatment received for all paediatric patients presenting face to face with dental‐facial trauma to King's College Hospital during the ‘lockdown’ period (23 March‐ 14 June 2020). Results Four hundred and twenty calls were triaged, converting to 102 patients seen face‐to‐face for dental‐facial trauma. The remainder were able to be triaged ‘virtually’. Injuries seen included 56 (54.9%) dentoalveolar injuries, 37 (36.2%) lacerations, five (4.9%) suspected facial fractures and four (3.9%) dog bites. Males and females were equally affected. The majority of incidents occurred in the home environment (n = 60, 58.8%), with the remainder (n = 42, 41.2%) occurring outside the home environment. The main causes of dental‐facial trauma were falls (n = 47, 46.1%) and bicycles/scooters (n = 29, 28.4%). The most common type of dentoalveolar injury was lateral luxation (n = 15, 26.7%), followed by avulsion (n = 12, 21.4%). Only one child required treatment under general anaesthesia (GA). Conclusion The demographic, presenting complaints and treatment needs of patients who presented during the lockdown period with dental‐facial trauma were unusual. The overwhelming majority were able to be treated without the use of GA. The attendance protocol in a tertiary care setting and the use of ‘teledentistry’ ensured only the most severe trauma cases were seen. This highlights how more complex trauma can still occur during ‘lockdown’ and requires immediate management.

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COVID-19 pandemic: the first wave - an audit and guidance for paediatric dentistry

Cited by 24 publications

References 13 publications

Impacts of lockdown during the SARS-CoV-2 pandemic on patients presenting with cervicofacial infection of odontogenic origin: a comparative study

Impacts of lockdown during the SARS-CoV-2 pandemic on patients presenting with cervicofacial infection of odontogenic origin: a comparative study

Paediatric dental A&E service during the COVID-19 pandemic in the Greater London area

Demographics and management of paediatric dental‐facial trauma in the ‘lockdown’ period: A UK perspective

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