This paper investigates the effect of the COVID-19 outbreak and closure of dental practices on the frequency and severity of dental infections presenting in our emergency department. We compared the mean number of daily emergency department referrals for dental abscesses in the two weeks prior to and following the Chief Dental Officer’s statement advising general dental practitioners to cease routine appointments, the mean number decreased from 1 to 0.37. In contrast, the severity and requirement for admission of these infections rose from 35% to 80%. This highlights the importance of the provision of local urgent dental centres during the COVID-19 outbreak in order to reduce pressure on secondary and tertiary care centres.
Dental infections make up a significant proportion of the OMFS workload. On the 25th March 2020 the Chief Dental Officer (CDO) for England released a statement calling for primary dental care services to cease all routine dental care. General dental practitioners were advised to provide telephone triage for their patients offering advice, analgesia and antimicrobials where appropriate. Plans were put in place for urgent dental care centres to treat those patients requiring emergency dental treatment, however this was not immediate due to the requirement for strategic planning and personal protective equipment (PPE) provision. Many speculated that this would lead to an increase in the presentation of dental infections to emergency departments (ED) around the country.
In this paper we have analysed the OMFS on call log to compare the incidence of dental infections presenting to the ED prior to and during the COVID-19 outbreak and closure of general dental practices.
We analysed the OMFS on-call log of patients referred to the OMFS team from the ED with a diagnosis of dental/orofacial infection and whether admission was required. Comparison was made between attendances in the two weeks prior to and following the CDO’s guidance for dental practitioners to cease routine dental treatment due to the COVID-19 outbreak, whilst the local urgent dental centres were still in the organisational phase.
Daily attendances for dental abscesses decreased in the two weeks following the closure of dental practices from 1 to 0.36, a 64% decrease. In contrast the proportion of those abscesses requiring admission increased significantly from 35% to 80% ( Fig. 1 ).