Post-surgical emergency after-hours calls: Prevalence, concerns, and management.
after-hours care
dental health services
emergencies
implantology
oral and maxillofacial surgery
pain
patient care management
periodontics
postoperative
postoperative complications
Journal
Journal of dental education
ISSN: 1930-7837
Titre abrégé: J Dent Educ
Pays: United States
ID NLM: 8000150
Informations de publication
Date de publication:
Jul 2022
Jul 2022
Historique:
received:
24
08
2021
accepted:
08
01
2022
pubmed:
5
2
2022
medline:
23
7
2022
entrez:
4
2
2022
Statut:
ppublish
Résumé
The purpose of this study was to investigate the prevalence, nature, and management of post-surgical emergency after-hours calls in a dental school setting with predoctoral students, graduate students/residents, and faculty providers. A patient chart review (March 2018-February 2020) for post-surgical calls through the emergency after-hours pager system was conducted at the Marquette University School of Dentistry. The total number of surgical procedures, procedure type, the timing of call, operator experience, concern, and recommendation given during the call were documented. During the review period, 83 calls (from 75 patients) were recorded after 8,487 surgical procedures (1% of procedures). Patients called 5.4 ± 0.8 days postoperatively. Procedure type affected call prevalence (p = 0.04), with most calls made after extractions (69.9% of all calls; 1% of extractions; 58/5,725), implant placement (6%; 0.9% of implant placements; 5/530) and periodontal plastic surgery (6%; 3.1% of all plastic surgeries; 5/161). The most common concern was pain (72.3%), then swelling (36.1%), bleeding (12%), and infection (9.6%). Operator experience did not affect call prevalence. Recommendations given were next business day follow-up (79.5%), reinforcement of already given postoperative instructions (51.8%), prescription (15.7%), and hospital emergency department (ED) visit (7.2%). Post-surgical emergency after-hours calls in a dental school setting occur within the first postoperative week and are rare, unrelated to operator experience, typically prompted by pain, and rarely resulting in referral to hospital ED. The use of a pager system is adequate for the management of after-hours emergencies and may reduce self-referrals to the hospital ED.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
814-822Informations de copyright
© 2022 American Dental Education Association.
Références
Wall T, Kamyar Nasseh, Vujicic Marko. Emergency department use for dental conditions continues to increase. Am Dent Assoc. 2014. Available from: http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0814_1.ashx. Accessed February 17, 2015.
Kelekar U, Naavaal S. Dental visits and associated emergency department-charges in the United States. JADA. 2019;150(4):305-312.
Bassey O, Csikar J, Hallam J, Sandoe J, Thompson W, Douglas G. Non-traumatic dental presentations at accident and emergency departments in the UK: a systematic review. Br Dent J. 2020;228(3):171-176.
Huang SM, Huang JY, Yu HC, Su NY, Chang YC. Trends, demographics, and conditions of emergency dental visits in Taiwan 1997-2013: a nationwide population-based retrospective study. J Formos Med Assoc. 2019;118(2):582-587.
Bae J-H, Kim Y-K, Choi Y-H. Clinical characteristics of dental emergencies and prevalence of dental trauma at a university hospital emergency center in Korea: clinical characteristics of dental emergencies and prevalence of dental trauma. Dent Traumatol. 2011;27(5):374-378.
Topping GVA. Out-of-hours emergency dental services - evaluation of the first year of a pilot project in FIFE. Br Dent J. 2005;198(4):193-197.
Allareddy V, Rampa S, Lee MK, Nalliah RP. Hospital-based emergency department visits involving dental conditions. JADA. 2014;145(4):331-337.
Roberts RM, Hersh AL, Shapiro DJ, Fleming-Dutra KE, Hicks LA. Antibiotic prescriptions associated with dental-related emergency department visits. Ann Emerg Med. 2019;74(1):45-49.
Okunseri C, Okunseri E, Thorpe JM, Xiang Q, Szabo A. Medications prescribed in emergency departments for nontraumatic dental condition visits in the United States. Med Care. 2012;50(6):508-512.
Quiñonez C, Gibson D, Jokovic A. Locker D. Emergency department visits for dental care of nontraumatic origin. Community Dent Oral Epidemiol. 2009;37(4):366-371.
Austin R, Jones K, Wright D, Donaldson N, Gallagher JE. Use of the out-of-hours emergency dental service at two south-east London hospitals. BMC Oral Health. 2009;9(1):19.
Vallerand WP, Vallerand AH, Heft M. The effects of postoperative preparatory information on the clinical course following third molar extraction. J Oral and Maxillofac Surg. 1994;52(11):1165-1170.
Aravena PC, Astudillo P, Manterola C. Design of a scale for measuring post-surgical complications in third molar surgery. Int J Oral and Maxillofac Surg. 2014;43(8):1008-1014.
Curtis JW, McLain JB, Hutchinson RA. The incidence and severity of complications and pain following periodontal surgery. J Periodontol. 1985;56(10):597-601.
Pilalas I, Tsalikis L, Tatakis DN. Pre-restorative crown lengthening surgery outcomes: a systematic review. J Clin Periodontol. 2016;43(12):1094-1108.
Langer B, Langer L. Subepithelial connective tissue graft technique for root coverage. J Periodontol. 1985;56(12):715-720.
Griffin TJ, Cheung WS, Zavras AI, Damoulis PD. Postoperative complications following gingival augmentation procedures. J Periodontol. 2006;77(12):2070-2079.
Wessel JR, Tatakis DN. Patient outcomes following subepithelial connective tissue graft and free gingival graft procedures. J Periodontol. 2008;79(3):425-430.
Chambrone L, Tatakis DN. Periodontal soft tissue root coverage procedures: a systematic review from the AAP regeneration workshop. J Periodontol. 2015;86(2-s):S8-S51.
Rotenberg SA, Tatakis DN. Dimensional changes during early healing after a subepithelial connective tissue graft procedure. J Periodontol. 2014;85(7):884-889.
Tan WC, Krishnaswamy G, Ong MMA, Lang NP. Patient-reported outcome measures after routine periodontal and implant surgical procedures. J Clin Periodontol. 2014;41(6):618-624.
Mei C-C, Lee F-Y, Yeh H-C. Assessment of pain perception following periodontal and implant surgeries. J Clin Periodontol. 2016;43(12):1151-1159.
Yao J, Lee KK, McGrath C, Wu YN, Li KY, Mattheos N. Comparison of patient-centered outcomes after routine implant placement, teeth extraction, and periodontal surgical procedures. Clin Oral Impl Res. 2017;28(4):373-380.
Kuroi R, Minakuchi H, Hara ES, et al. A risk factor analysis of accumulated postoperative pain and swelling sensation after dental implant surgery using a cellular phone-based real-time assessment. J Pros Res. 2015;59(3):194-198.
Capuzzi P, Montebugnoli L, Vaccaro MA. Extraction of impacted third molars. Oral Surg Oral Med Oral Pathol. 1994;77(4):341-343.
Al-Khabbaz AK, Griffin TJ, Al-Shammari KF. Assessment of pain associated with the surgical placement of dental implants. J Periodontol. 2007;78(2):239-246.
Momin M, Albright T, Leikin J, Miloro M, Markiewicz MR. Patient morbidity among residents extracting third molars: does experience matter? Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125(5):415-422.
Zoghbi SA, de Lima LAPA, Saraiva L, Romito GA. Surgical experience influences 2-stage implant osseointegration. J Oral Maxillofac Surg. 2011;69(11):2771-2776.
Lambert PM, Morris HF, Ochi S. Positive effect of surgical experience with implants on second-stage implant survival. J Oral Maxillofac Surg. 1997;55(12):12-18.
Powell CA, Mealey BL, Deas DE, McDonnell HT, Moritz AJ. Post-surgical infections: prevalence associated with various periodontal surgical procedures. J Periodontol. 2005;76(3):329-333.
Conrad SM, Blakey GH, Shugars DA, Marciani RD, Phillips C, Jr WhiteRP. Patients’ perception of recovery after third molar surgery. J Oral Maxilliofac Surg. 1999;57(11):1288-1294.
Mardinger O, Poliakov H, Beitlitum I, Nissan J, Chaushu G. The patient's perception of recovery after maxillary sinus augmentation: a prospective study. J Periodontol. 2009;80(4):572-576.
Tramini P, Al Qadi Nassar B, Valcarcel J, Gibert P. Factors associated with the use of emergency dental care facilities in a French public hospital. Spec Care Dentist. 2010;30(2):66-71.
Gibson GB, Blasberg B, Hill SJ. A prospective survey of hospital ambulatory dental emergencies Part 1: patient and emergency characteristics. Spec Care Dentist. 1993;13(2):61-65.
Wells JP, Roked Z, Moore SC, Sivarajasingam V. Telephone review after minor oral surgery. Br J Oral Maxillofac Surg. 2016;54(5):526-530.
Portman-Lewis S. An analysis of the out-of-hours demand and treatment provided by a general dental practice rota over a five-year period. Prim Dent Care. 2007;os14(3):98-104.
Blinder D, Rotenberg L, Peleg M, Taicher S. Patient compliance to instructions after oral surgical procedures. Int J Oral Maxillofac Surg. 2001;30(3):216-219.
Lewis C, Lynch H, Johnston B. Dental complaints in emergency departments: a national perspective. Ann Emerg Med. 2003;42(1):93-99.