Dental Emergencies in an Italian Pediatric Hospital during the COVID-19 Pandemic

Abstract

Emergency rooms (ER) are largely used by patients with oral complaints, who choose the ER over private or public dental offices for oral prevention and treatment. During the COVID-19 pandemic, the activity of most dental facilities was limited, and most hospitals and ERs were dedicated to the treatment of COVID-19 patients. The present study analyzed the number of and reason for visits at the emergency room (ER) of Ospedale dei Bambini “Vittore Buzzi”, the main pediatric hospital in Milano, Italy, between 2019 and 2020, with a particular focus on oral emergencies. In 2019, 25,435 children turned to the ER, compared to 16,750 in 2020. About 10% of the children were eventually admitted to the hospital in both years. The number of admissions for infectious diseases, other than COVID-19, signed an important decrease in 2020, while trauma/injuries decreased slightly in number but increased in proportion. The number and proportion of ER visits for oral complaints decreased in 2020 compared to 2019. Stomatitis was the most frequent condition, followed by traumatic injuries, which decreased in number and percentage between 2019 and 2020. Oral infections and painful caries accounted for about 15% of the cases in both 2019 and 2020. These data highlight the need to promote territorial services for the prevention and treatment of oral health complaints, including dental emergencies.

COVID-19 Related Information on Pediatric Dental Care including the Use of Teledentistry: A Narrative Review

“…Emergency pedodontic procedures and underlying oral and dental needs recorded during 2020 and compared to 2019 showed disparate trends worldwide [ 5 ]. Indeed, registered admissions for emergency dental procedures proportionally increased from 2% in 2019 to 3% in 2020 at the emergency department of the Alfred I DuPont Hospital for Children in Wilmington (North Carolina, USA) [ 9 ], and similarly raise to 20.8% in South India, while decreased in 2020 compared to 2019 at Children’s Hospital Vittore Buzzi (Milan, Italy) [ 10 ].…”

“…The availability of treatment in private practices and hospitals was significantly reduced [ 16 ] as all medical resources were used to combat the then-unknown infection. In addition, during the curfew, emergency and urgent dental care were the prominent cases admitted to hospitals and facilities, which experienced an increase in admissions for early childhood caries, dental pain, facial swelling, and dental trauma worldwide, largely due to the unavailability of private and outpatient structures [ 8 , 9 , 10 , 11 , 12 ]. The restriction of dental care was justified to contain the spread of SARS-CoV-2 and to limit the consumption of personal protective equipment, which was initially in short supply.…”

Disasters in pediatric dentistry: a systematic review

“…The most common treatments offered were extractions, pulpotomies, and fillings. These studies also revealed some of the challenges and barriers to providing pediatric emergency dental care during the pandemic, such as a lack of personal protective equipment (PPE), limited access to general anesthesia, delayed referrals, and parental fear of infection [ 26 – 28 , 30 ].…”

Experience and Prevalence of Dental Caries in Migrant and Nonmigrant Low-SES Families’ Children Aged 3 to 5 Years in Italy

“…During the first spread of the COVID-19 pandemic, most public and private territorial health facilities in most countries were closed; the consequences of the suspension of routine dental care and the delay in the management of oral hygiene have led an increase in dental emergencies, especially in the pediatric population [ 38 ], which was followed by higher access to first-aid facilities for dental emergencies, especially in the most disadvantaged categories of the population.…”