Does Restriction of Public Health Care Dental Benefits Affect the Volume, Severity, or Cost of Dental-Related Hospital Visits?

Salomon, David; Heidel, R. Eric; Kolokythas, Antonia; Miloro, Michael; Schlieve, Thomas

doi:10.1016/j.joms.2016.10.019

Cited by 35 publications

(30 citation statements)

References 13 publications

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“…This comparative study showed that during the COVID-19 lockdown patients persisted with symptoms of CFI of odontogenic origin longer and presented later compared to patients in the pre-COVID-19 era. Studies have shown that patients who do not seek treatment early in CFIs risk a deterioration of their clinical condition 9 , 11 , 12 , 13 . Chen et.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, other studies have shown how limiting access to essential primary medical/dental services lead to an increase demand on secondary care 12 . Salomon et al found that patients with limited access to primary healthcare were significantly more likely (OR = 1.48; 95% CI, 1.13-1.94), to require incision and drainage upon admission and had longer hospital admissions (p = 0.004) than those with adequate access 12 . An increase in patients requiring secondary care treatment leads to higher costs, stretching resources in hospitals which could potentially be deployed in the management COVID-19 and ultimately be of further detriment from a health-economics perspective.…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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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“…The number of patients presenting to emergency departments (EDs) with odontogenic infections is increasing (16)(17)(18)(19)(20), which is likely due to a number of factors including cost, fear, mental illness, substance abuse, health literacy and perceptions that oral disease is of low importance (21,22). While some of these patients can be discharged safely from ED for treatment in outpatient clinics, others will require inpatient admission for more urgent incision and drainage of their abscess.…”

Section: Introductionmentioning

confidence: 99%

Increasing Use of Intensive Care Unit for Odontogenic Infection Over One Decade: Incidence and Predictors

McGowan

Sun

et al. 2018

Journal of Oral and Maxillofacial Surgery

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The use of the ICU in the management of odontogenic infection has increased significantly at the Royal Brisbane and Women's Hospital over 1 decade. The demographic data and clinical presentation of the patients admitted to the ICU did not change significantly. However, the length of ICU stay and the total length of stay have both increased. A significant increase in CT usage for odontogenic infections also occurred. Third molar infections, dysphagia, and elevated CRP might be relevant clinical predictors of a more complicated course of care requiring ICU admission. More judicious use of CT scanning, combined with prompt surgical consultation and intervention, might reduce the rate of ICU admissions for odontogenic infections.

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“…You can freely access the chapter at the Web Viewer here. surgical cares increased 100%, and the related healthcare cost skyrockets [175]. The reported data show that opportunistic species and/or ARIA infections are nearby and expected to increase in dental setting [21-26, 29, 81, 82, 85, 91-99, 101-105, 109-114, 120-124, 136-141, 145-149, 153-155, 159, 160, 165] due to the overuse of antibiotics in dentistry and the limited awareness on infection prevention guidelines and the lapses and errors during infection prevention [176].…”

Section: Resultsmentioning

confidence: 99%

Infection Control in Dentistry and Drug-Resistant Infectious Agents: A Burning Issue. Part 1

Barenghi¹,

Barenghi²,

Blasio³

2020

Surgical Infections - Some Facts

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Using molecular biological methods and retrospective investigations, some outbreaks in dental settings have been proven to be caused by mainly blood-borne viruses and water-borne bacteria. Nowadays, drug-resistant bacteria seem further hazards taking into account the worldwide overuse of antibiotics in dentistry, the limited awareness on infection prevention guidelines, and the lapses and errors during infection prevention (reported in more detail in Part 2). We chose MRSA and VRE as markers since they are considered prioritized bacteria according antibiotic resistance threats. Antibiotic-resistant bacterial infections inside of dental setting are relevant, and we argue about some hazards in dentistry, including dedicated surgeries. MRSA has a key role for its colonization in patients and dental workers, presence on gloves, resistance (days-months on dry inanimate surfaces), the contamination of different clinical contact surfaces in dental settings, the ability of some strains to produce biofilm, and finally its estimated low infective dose. For better dental patient and healthcare personnel safety, we need evidence-based guidelines to improve education and training initiatives in surgery.

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Does Restriction of Public Health Care Dental Benefits Affect the Volume, Severity, or Cost of Dental-Related Hospital Visits?

Cited by 35 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

Increasing Use of Intensive Care Unit for Odontogenic Infection Over One Decade: Incidence and Predictors

Infection Control in Dentistry and Drug-Resistant Infectious Agents: A Burning Issue. Part 1

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