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Did the March 2020 Lockdown cause an increase in patients presenting to the Emergency Department with Odontogenic pain and infection? A Single Centre, Retrospective Analysis

  • Author Footnotes
    1 Joint first authors
    Emily Gray
    Correspondence
    Corresponding author at: Oral and Maxillofacial Department, Bristol Dental Hospital, Lower Maudlin Street, BS1 2LY. 0117 342 4422.
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    1 Joint first authors
    Affiliations
    Bristol Dental Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Lower Maudlin Street, Bristol BS1 2LY
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  • Author Footnotes
    1 Joint first authors
    Constance Hardwick
    Footnotes
    1 Joint first authors
    Affiliations
    Bristol Dental Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Lower Maudlin Street, Bristol BS1 2LY

    Bristol Dental School, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY
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  • Nicola Gradwell
    Affiliations
    Bristol Dental Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Lower Maudlin Street, Bristol BS1 2LY
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  • Annie Pellatt
    Affiliations
    Bristol Dental Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Lower Maudlin Street, Bristol BS1 2LY
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  • Naomi Cassells
    Affiliations
    Dept. of Anaesthesia, University Hospitals Bristol and Weston NHS Foundation Trust, Lower Maudlin Street Bristol BS1 2LY
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  • Rachael Craven
    Affiliations
    Dept. of Anaesthesia, University Hospitals Bristol and Weston NHS Foundation Trust, Lower Maudlin Street Bristol BS1 2LY
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  • Author Footnotes
    2 Joint last authors
    Jacqueline Cox
    Footnotes
    2 Joint last authors
    Affiliations
    Bristol Dental Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Lower Maudlin Street, Bristol BS1 2LY
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  • Author Footnotes
    2 Joint last authors
    Tom Dudding
    Footnotes
    2 Joint last authors
    Affiliations
    Bristol Dental Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Lower Maudlin Street, Bristol BS1 2LY

    Bristol Dental School, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY

    MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN
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Published:July 30, 2022DOI:https://doi.org/10.1016/j.bjoms.2022.07.006
Did the March 2020 Lockdown cause an increase in patients presenting to the Emergency Department with Odontogenic pain and infection? A Single Centre, Retrospective Analysis
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      Abstract

      On the 25thMarch 2020 the Chief Dental Officer (CDO) published guidance to restrict the provision of routine dental care in England due to the rapid spread of the severe acute respiratory syndrome coronavirus 2 (COVID-19). We analysed the impact of the pandemic on the number of patients presenting with odontogenic pain and infection to the emergency department (ED) an urban based teaching hospital, the Bristol Royal Infirmary (BRI). Furthermore, we investigated the severity of infection at first presentation to ED. The study period encompassed three phases representing the stages of pandemic restrictions: phase 1 prior to lockdown measures, with no restrictions to dental practice; phase 2 during the government lockdown, with the severest restrictions on dental practices; and phase 3 following the ease of lockdown measures, with return to limited dental services. Data was collected retrospectively from electronic patient records (EPR) regarding adult patients presenting to the ED with dental pain. The rate of presentations (per week) was calculated for each timepoint and compared. A severity score was assigned to each patient using a grading system based on signs of clinical infection and treatment modality. Patients' presentations were analysed at each phase of the pandemic.
      There was a 42.8% attendance increase in presentation of oral facial pain and infection to ED from phase 1 to 3. The COVID-19 pandemic resulted in restrictions to routine primary dental care services which were deemed necessary to reduce the spread of the virus. However, this increased demand on secondary care services as patients increasingly struggled to access primary dental care to manage dental pain.

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      Article Info

      Publication History

      Accepted: July 18, 2022

      Publication stage

      In Press Accepted Manuscript

      Identification

      DOI: https://doi.org/10.1016/j.bjoms.2022.07.006

      Copyright

      © 2022 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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