The financial and quality of life impact of urgent dental presentations: A cross‐sectional study

Abstract

Aim 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. Methodology 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. Results 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. Conclusions 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.

Oral health knowledge is associated with oral health-related quality of life: a survey of first-year undergraduate students enrolled in an American university

“…On the other hand, oral health knowledge was not related to patients’ history of seeking urgent care for dental problems [ 25 ]. As the most common conditions requiring urgent dental care included infection, pain, trauma and restoration fractures which are all pain or function-related issues [ 26 ], it is understandable that oral health knowledge is a strong determinant for the psychosocial dimension but weaker for other dimensions of OHRQoL.…”

The use of medicaments in the management of symptomatic irreversible pulpitis: A community‐based cohort study

“…No previously published data exist which would enable a power calculation, and no pilot study was undertaken. Participants were recruited for a wider study exploring the impact of urgent dental conditions on quality of life (n = 713), of which participants in the present study represent a cohort of patients diagnosed with symptomatic irreversible pulpitis who received operative intervention in the form of a pulpotomy or pulpectomy (Edwards et al, 2023). Once the power calculation of the wider study was satisfied, the recruitment for the present study was stopped.…”

“…However, they offer further insight to the impact that symptomatic irreversible pulpitis can have on our patients. The present study represents a cohort of participants from a wider study investigating the impact of urgent dental conditions on patients (Edwards et al, 2023). This highlighted that symptomatic irreversible pulpitis is one of the most painful and impactful urgent dental conditions.…”

“…This included medication use (92.3%) and inability to work (38.8), which remained high in the present study, even 5-day post-operatively (33.3% and 24.0% respectively). This, in addition to the need for further treatment increases the financial burden of urgent dental conditions on both the individual and society where care is accessed through state funded healthcare systems (Edwards et al, 2023). Other studies have also highlighted the challenges of attending dental appointments due to work commitments (Currie, 2022;Harris et al, 2017;van der Zande et al, 2021).…”

“…Globally, the problem may be even more significant, with reports ranging from 12% to 24% per annum (McMillan et al, 2006;Peres et al, 2019). The most frequently encountered urgent dental condition is reported to be symptomatic irreversible pulpitis, contributing to up to one in three presentations (Currie et al, 2015;Edwards et al, 2023;Huang et al, 2019). Furthermore, symptomatic irreversible pulpitis has been found to have the biggest impact on oral health-related quality of life (OHRQoL) and to be the most painful of all urgent dental presentations (Cimilli et al, 2012;Currie et al, 2015;Edwards et al, 2023).…”