Medical emergency department attendance of under 16-year-olds with dental problems

Medical emergency departments (MED) are under increasing pressure in the UK with suggestions that unnecessary attendances to MED, which may include dental problems, are to blame.

The aim of this cross-sectional study was to examine the period prevalence of under 16-year-olds attendance to medical emergency departments (MED) with oral and dental problems over a 5-year period and investigate reason for attendance. This cross-sectional study was carried out as part of a service evaluation at the Newcastle upon Tyne Hospitals NHS Foundation Trust.

Retrospective data were collected between 1 January 2012 and 31 December 2016 from the MED database using coding and a free text search of all paediatric attendances. The data were then analysed using descriptive statistics.

Over the 5-year period, 135 760 under 16-year-olds attended the MED. Of these, 868 (0.6%) attended for dental problems. The most common dental reasons for attendance were as follows: Candida accounted for 22.6% of the 0- to 5-year-olds; dental trauma accounted for 29.5% of 6- to 11-year-olds; and mandibular fractures accounted for 18.9% of the 12- to 16-year-olds. Of those who attended the MED for dental problems, 28.5% resided in areas with an Index of Multiple Deprivation decile of 1, the areas of highest deprivation in the UK.

Many of the diagnoses may have been appropriately managed elsewhere in the community, which may result in improved treatment provision and tailored care pathways, as well as reducing strain on the MED. Further research is needed to investigate why patients attend MED with dental problems.