A five-year retrospective observational study of dental presentations to Waikato Hospital's emergency department

Within New Zealand (NZ) there is limited research concerning demographics and utilisation of the Emergency Department (ED) for dental-related conditions. The aim of this research was to identify the prevalence of dental presentations to Waikato Hospital ED, defining patient demographics, discharge diagnoses, management, and re-presentation rates.

Patients who presented to the Waikato Hospital ED from 2015 to 2019 with ICD-10 dental diagnoses were included in the study. Data collected included patient demographics, discharge diagnosis and management of these presentations. Statistical analysis was completed using IBM SPSS Statistical Version 26.0.

Over the five-year study period, 4030 presentations to Waikato Hospital ED were dentally related, making up 0.98% of all ED presentations. Patients were primarily male (54%), NZ European (45%) or Māori (42%), from regions of high deprivation, presenting outside of work hours (68%). Seventy-three percent of dental presentations were non-traumatic. Ninety percent of patients were discharged with symptomatic management. Of patients admitted only 4% required management under general anaesthesia (GA). Representation occurred in 6% of patients, primarily for non-traumatic dental disease (89%). Fifty-one percent of re-attenders were male, 42% Māori and 50% of patients had a deprivation index of 9 or 10. Forty-one percent of patients re-presented within a week.

At Waikato Hospital, males, NZ European, and patients of high deprivation most commonly presented to ED for dental related presentation, which were primarily non-traumatic in origin. Many patients did not require hospital care, and were managed by ED and discharged. Few patients re-presented to ED for further care. Dental presentations to ED are potentially preventable, and may be related to barriers such as cost, access or health knowledge, or an increased need. Further research is required on strategies to reduce ED presentations for dental conditions.