Non-traumatic dental presentations at emergency departments in New Zealand

Many low-income New Zealanders attend emergency departments (EDs) for relief of dental pain and infection. This places a substantial burden on EDs. Better understanding of non-traumatic dental presentations (NTDPs) will aid the development of relevant health policy and clinical management strategies.

To explore the nature, context and impact of NTDPs on New Zealand EDs.

A mixed-methods approach was used. Routinely collected data on NTDPs to ED at four New Zealand hospitals were analysed descriptively, and semi-structured interviews with ED and dental personnel (n=20) from the four hospitals were conducted and analysed thematically.

Young adults (20-39 years), and Māori and Pacific people, were frequent ED attenders for NTDPs; repeat visits were common. Most were seen by non-dental health practitioners. Cost and access were identified as barriers to dental care. Management of NTDPs generally involved analgesics for relief of pain and antibiotics for infection management. All participants said definitive care pathways for NTDPs were lacking. There is potential to improve staff training in diagnosis and anaesthetic administration. However, participants were more interested in referral pathways and public funding for dental care.

Accessible and equitable dental care pathways and policies are urgently required to enable timely and appropriate care for NTDPs.