Home > Review Articles > Quality of care > A retrospective observational study of the management of non-traumatic dental presentations at a tertiary centre in New Zealand: a Choosing Wisely approach

A retrospective observational study of the management of non-traumatic dental presentations at a tertiary centre in New Zealand: a Choosing Wisely approach

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Authors:
Summary:

Non-traumatic dental presentations (NTDPs) may receive suboptimal care in emergency departments (EDs), according to a study of presentations to the Christchurch Hospital ED in 2020. A total of 931 individuals with dental pain or dental abscesses were included, with over-representation of young adults, Māori, Pacific peoples and those living in high-deprivation areas. An orthopantomogram was performed in 37% of patients, and was considered low value in 24% of cases. Of patients managed by ED staff who were not referred to specialist dental services, 42% were prescribed antibiotics, of whom only half had facial swelling, and 71% were prescribed analgesia, including an opiate in 78% of cases. Definitive treatment was given in fewer than 20% of NTDPs. Continuing to provide care for NTDPs in the ED setting may increase healthcare costs and contribute to poor opioid and antimicrobial stewardship, the study authors concluded.

Comment:
Further evidence to keep oral health (and disease prevention including smoking cessation) on the health agenda!
Reference: N Z Med J. 2023;136(1582):14-27.
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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