Managing dental emergencies

What is a dental emergency?

If a patient requires emergency dental care, they are likely to need immediate attention so as to minimise any serious risks to their medical or dental health, and to prevent further complications. Depending on the type and severity of their condition, patients are likely to present either to the practice, or to the accident and emergency department with bleeding, swelling, or trauma.[i]

There are a number of common dental emergencies which you might come across in practice. For example, a patient may have had an injury, which has resulted in the avulsion of a permanent tooth, and will require an emergency appointment as, in some cases, the tooth may be able to be re-planted. Or, patients may be experiencing significant swelling which requires investigation and treatment. Patients may also have uncontrolled bleeding post-dental extraction, as well as dental infections with a systemic effect, and severe trismus. These conditions are usually considered dental emergencies, and patients should receive treatment as soon as possible.[ii]

There are a number of other conditions which might be considered urgent, and should be treated quickly. These may include infections of the dental and soft tissues, severe dental pain which cannot be controlled by the patient, or a dental fracture which exposes the pulp.[iii]

Different advice in different cases

Depending on the condition and its severity, clinicians will need to provide patients with different advice and appointment types. For example, if a patient presents with a broken or fractured tooth, test the tooth for sensitivity to heat and cold to help determine whether dentine has been exposed, and treat the tooth accordingly to avoid infection. If the

dentine has not been exposed, the case is unlikely to be considered an emergency, but a routine appointment should be arranged to restore dental aesthetics.[iv] By making an a

ssessment about the urgency of the patient’s situation, the dental team will be able to judge how best toproceed.

Keeping accurate records

Maintaining thorough clinical notes is vital in all cases, including in an emergency sit

uation. When a patient’s condition is urgent, the risk of missing out more routine informati

on might be higher, which makes it important to carry out a systematic examination[v] in order to avoid incomplete clinical notes. Additionally, in some cases, the emergency patient may also be a new patient, making it even more crucial to gather and include all of their information.

During an emergency appointment, it is likely that patients will be more distressed and anxious than usual, so you should aim to be more attentive, and work with your dental team to keep them calm. When assessing a patient in an emergency, it is important to take clear and accurate notes to ensure that the patient is receiving the most appropriate care for them. You should recount any assessments you undertake, including any radiographs taken, and be sure to record any conversations had with the patient regarding their oral health. This should include advice given for maintaining their oral health following their appointment.[vi]

Kiroku, the digital note taking platform, provides you with the dynamic templates you need to take complete, accurate, and contemporaneous notes during any emergency dental appointment. The emergency template from Kiroku allows the user to record the most common dental emergencies from start to finish – this includes the patient complaint, through to the examination, special tests, diagnosis, and treatment. The template provides the user with helpful prompts relevant to each case to easily take notes in just a few clicks, eliminating the worry of missing out any important information. Plus, Kiroku makes it easy to tailor your notes, so they will always be unique to you and your patients.

When faced with an emergency, it is important that the whole dental team know how best to respond. Each case in unique, so making an assessment, and deciding how to proceed is essential for the best outcome, especially when conditions are so time sensitive. During these appointments, it’s important to ensure that your clinical notes are complete and accurate, as this will ensure that you have a comprehensive record of the appointment, and are protected against litigation.

To find out more about Kiroku, or to start your free trial, please visit trykiroku.com

[i] NHS England. Unscheduled dental care. Accessed April 23. file:///Users/officeone/Desktop/74-dental-definitions.pdf

[ii] Scottish Dental Clinical Effectiveness Programme. Emergency Dental Care. Accessed April 23. https://www.sdcep.org.uk/media/wfrjkqax/edc-guidance.pdf

[iii] Scottish Dental Clinical Effectiveness Programme. Emergency Dental Care. Accessed April 23. https://www.sdcep.org.uk/media/wfrjkqax/edc-guidance.pdf

[iv] Scottish Dental Clinical Effectiveness Programme. Emergency Dental Care. Accessed April 23. https://www.sdcep.org.uk/media/wfrjkqax/edc-guidance.pdf

[v] Pocket Dentistry. History Taking and Clinical Examination of Patients on a Dental Emergency Clinic. Accessed April 23. https://pocketdentistry.com/2-history-taking-and-clinical-examination-of-patients-on-a-dental-emergency-clinic/

[vi] NHS England. Dental Record Keeping Standards: a consensus approach. Accessed April 23. https://www.england.nhs.uk/wp-content/uploads/2019/10/dental-record-keeping-standards-a-consensus-approach.pdf