COVID-19 Pandemic Emergency Department Utilization for Pediatric Dental

Early in the COVID-19 pandemic, restrictions from mid-March to mid-May 2020 curtailed community dental practice. The study purpose was to analyze the utilization of a pediatric hospital emergency department (ED) for dental emergencies over six months of practice disruption compared to two previous years.

Records of patients presenting to the ED were analyzed for volume, demographics, dental emergency type/acuity, and treatment. Study patients presented between March and September 2020; controls presented between March and September 2018 and March and September 2019.

A total of 138 study patients (mean age equals 6.4 years) and 171 controls (mean age equals 7.0 years) were assessed. Emergency types were trauma (68 percent), caries (25 percent), and "other" (seven percent) for both periods (P=0.997). Nearly all patients triaged as "urgent." Medical radiology (P<0.001), laboratory tests (P<0.001), medication administration (P=0.016), ketamine sedation (P=0.014), and procedures by the medical team (P=0.014) increased for trauma patients in the study versus control period. Significantly more study patients with caries identified as persons of color: 69.7 percent versus 36.8 percent of controls (P=0.006).

The emergency department medical and dental teams served as a safety net for both public health and the private practice dental community during the early pandemic. The effect on tertiary medical facilities should be considered when closing venues for the management of routine emergencies; it is more time-efficient and cost-effective and less resource-intensive to manage patients with dental emergencies in dental clinics.