The COVID-19 pandemic enforced the cessation of routine dentistry and the creation of local urgent dental care systems in the UK. General dental practices are obligated by NHS guidance to remain open and provide remote consultation and referral where appropriate to patients having pain or problems.

To compare two urgent dental centres with different triage and referral systems with regard to quality and appropriateness of referrals, and patient management outcomes.

110 consecutive referrals received by a primary care urgent dental centre and a secondary care urgent dental centre were assessed. It was considered whether the patients referred had access to remote primary care dental services, fulfilled the criteria required to be deemed a dental emergency as mandated by NHS guidance, and what the outcomes of referrals were.

At the primary care centre, 100% of patients were referred by general dental practitioners and had access to remote primary care dental services. 95.5% of referrals were deemed appropriate and were seen for treatment. At the secondary care site, 94.5% of referrals were direct from the patient by contacting NHS 111. 40% had received triaging to include 'advice, analgesia and antimicrobial' from a general dental practitioner, and 25.5% were deemed appropriate and resulted in treatment.

Urgent dental centres face many issues, and it would seem that easy access to primary care services, collaboration between primary care clinicians and urgent dental centres, and training of triaging staff are important in operating a successful system.
Urgent dental centres face many issues, and it would seem that easy access to primary care services, collaboration between primary care clinicians and urgent dental centres, and training of triaging staff are important in operating a successful system.Fabricating a crown for a tooth that serves as an abutment for an existing removable partial denture (RPD) provides a restorative challenge. Typically, the compromised tooth requiring an extra-coronal restoration is initially restored. It is followed by the construction of a new RPD that accurately fits the restored abutment. An increasingly common scenario is that the existing RPD is deemed clinically acceptable and, therefore, does not require replacing. This results in the clinical dilemma of fabricating a crown for an abutment tooth, while also considering how the contours of this restoration will fit with the RPD's clasps and rests. This can be achieved through the use of various techniques subdivided into indirect, direct and combined indirect-direct. This article describes an indirect-direct technique used in conjunction with the functionally generated path technique to achieve accurately a stable record of the patient's occlusion in the fabrication of a new crown to an existing RPD.We evaluated the quality of general dental practitioner (GDP) tooth wear (TW) referrals to secondary care services in Kent, Surrey and Sussex.Prospective consecutive referrals received via an electronic pathway were assessed from 1 June to 30 October 2019. Reasons for referral, patient demographics, quality of referral, opinion of the triaging clinician and outcome were assessed.Of 671 referrals, 32% were for TW. Males were referred more commonly (1.71.0). The median age was 52. Patients were more likely to be referred from distant locations than places closer to the referral centre (p less then 0.001). https://www.selleckchem.com/products/thiostrepton.html Only 55% of referrals suggested a cause for the TW, 33% provided a clinical photograph and 1% recorded a tooth wear index of any type. Referring clinicians most commonly cited attrition as reason for referral (p less then 0.001). Those under 40 years were referred for erosion (p=0.001) and those over 40 years, attrition (p=0.019). The triaging clinician was more likely to allocate a tooth wear score of three for those under 40 years and a score of four for over 40 years (p less then 0.001). 47% of referrals were rejected. Males and referrals with photographs were more likely to be accepted for treatment (p=0.017 and p less then 0.001, respectively).There is a high demand for specialist TW services. The number of referrals being rejected has not changed using the electronic referral system. We advocate the inclusion of mandatory fields for completion by GDPs as well as compulsory clinical photographs and tooth wear indices (Smith and Knight Tooth Wear Index or a basic erosive wear examination - BEWE index).As dentists, we are well positioned to detect signs of abuse. Though many practitioners are aware of their duty to report concerns, multiple barriers to referral still exist. This article defines abuse, safeguarding and our role as dental healthcare professionals. It provides an overview of the types of abuse and signs that raise concern.Uncertainty over the findings was highlighted as the most common barrier to referral. This article provides an overview of the referral process. Regular training is recommended to improve familiarisation with the safeguarding procedure. Furthermore, discussing concerns with colleagues when uncertain can provide reassurance to the referring practitioner. Additional barriers include fear of the consequences to the patient, fear of implications for the practice, and time pressures. By focusing on preparation and a supportive environment, we can reduce the influence of these barriers.Although raising concerns can be stressful, there are many resources available to support dental healthcare professionals. The key focus must be the wellbeing and safety of the vulnerable patient. Your referral may help the patient and family access the support they need.This case report describes a 52-year-old female patient who attended a specialist adult dental trauma clinic with a confusing history about a re-implanted avulsed maxillary left central incisor (UL1). Following examination, further investigations and clinical investigations, it was determined that the tooth had been re-implanted in the sub-periosteal space. The upper central incisor was extracted and re-implanted into the correct position and then managed by following the 2020 guidelines of the International Association for Dental Traumatology (IADT).This case highlights an unusual complication of managing avulsed teeth and draws attention to the challenges posed by using two-dimensional radiographic imaging when assessing dental injuries.A six-month follow-up appointment confirmed functional success and a reasonably satisfactory aesthetic outcome for the patient.
The COVID-19 pandemic enforced the cessation of routine dentistry and the creation of local urgent dental care systems in the UK. General dental practices are obligated by NHS guidance to remain open and provide remote consultation and referral where appropriate to patients having pain or problems. To compare two urgent dental centres with different triage and referral systems with regard to quality and appropriateness of referrals, and patient management outcomes. 110 consecutive referrals received by a primary care urgent dental centre and a secondary care urgent dental centre were assessed. It was considered whether the patients referred had access to remote primary care dental services, fulfilled the criteria required to be deemed a dental emergency as mandated by NHS guidance, and what the outcomes of referrals were. At the primary care centre, 100% of patients were referred by general dental practitioners and had access to remote primary care dental services. 95.5% of referrals were deemed appropriate and were seen for treatment. At the secondary care site, 94.5% of referrals were direct from the patient by contacting NHS 111. 40% had received triaging to include 'advice, analgesia and antimicrobial' from a general dental practitioner, and 25.5% were deemed appropriate and resulted in treatment. Urgent dental centres face many issues, and it would seem that easy access to primary care services, collaboration between primary care clinicians and urgent dental centres, and training of triaging staff are important in operating a successful system. Urgent dental centres face many issues, and it would seem that easy access to primary care services, collaboration between primary care clinicians and urgent dental centres, and training of triaging staff are important in operating a successful system.Fabricating a crown for a tooth that serves as an abutment for an existing removable partial denture (RPD) provides a restorative challenge. Typically, the compromised tooth requiring an extra-coronal restoration is initially restored. It is followed by the construction of a new RPD that accurately fits the restored abutment. An increasingly common scenario is that the existing RPD is deemed clinically acceptable and, therefore, does not require replacing. This results in the clinical dilemma of fabricating a crown for an abutment tooth, while also considering how the contours of this restoration will fit with the RPD's clasps and rests. This can be achieved through the use of various techniques subdivided into indirect, direct and combined indirect-direct. This article describes an indirect-direct technique used in conjunction with the functionally generated path technique to achieve accurately a stable record of the patient's occlusion in the fabrication of a new crown to an existing RPD.We evaluated the quality of general dental practitioner (GDP) tooth wear (TW) referrals to secondary care services in Kent, Surrey and Sussex.Prospective consecutive referrals received via an electronic pathway were assessed from 1 June to 30 October 2019. Reasons for referral, patient demographics, quality of referral, opinion of the triaging clinician and outcome were assessed.Of 671 referrals, 32% were for TW. Males were referred more commonly (1.71.0). The median age was 52. Patients were more likely to be referred from distant locations than places closer to the referral centre (p less then 0.001). https://www.selleckchem.com/products/thiostrepton.html Only 55% of referrals suggested a cause for the TW, 33% provided a clinical photograph and 1% recorded a tooth wear index of any type. Referring clinicians most commonly cited attrition as reason for referral (p less then 0.001). Those under 40 years were referred for erosion (p=0.001) and those over 40 years, attrition (p=0.019). The triaging clinician was more likely to allocate a tooth wear score of three for those under 40 years and a score of four for over 40 years (p less then 0.001). 47% of referrals were rejected. Males and referrals with photographs were more likely to be accepted for treatment (p=0.017 and p less then 0.001, respectively).There is a high demand for specialist TW services. The number of referrals being rejected has not changed using the electronic referral system. We advocate the inclusion of mandatory fields for completion by GDPs as well as compulsory clinical photographs and tooth wear indices (Smith and Knight Tooth Wear Index or a basic erosive wear examination - BEWE index).As dentists, we are well positioned to detect signs of abuse. Though many practitioners are aware of their duty to report concerns, multiple barriers to referral still exist. This article defines abuse, safeguarding and our role as dental healthcare professionals. It provides an overview of the types of abuse and signs that raise concern.Uncertainty over the findings was highlighted as the most common barrier to referral. This article provides an overview of the referral process. Regular training is recommended to improve familiarisation with the safeguarding procedure. Furthermore, discussing concerns with colleagues when uncertain can provide reassurance to the referring practitioner. Additional barriers include fear of the consequences to the patient, fear of implications for the practice, and time pressures. By focusing on preparation and a supportive environment, we can reduce the influence of these barriers.Although raising concerns can be stressful, there are many resources available to support dental healthcare professionals. The key focus must be the wellbeing and safety of the vulnerable patient. Your referral may help the patient and family access the support they need.This case report describes a 52-year-old female patient who attended a specialist adult dental trauma clinic with a confusing history about a re-implanted avulsed maxillary left central incisor (UL1). Following examination, further investigations and clinical investigations, it was determined that the tooth had been re-implanted in the sub-periosteal space. The upper central incisor was extracted and re-implanted into the correct position and then managed by following the 2020 guidelines of the International Association for Dental Traumatology (IADT).This case highlights an unusual complication of managing avulsed teeth and draws attention to the challenges posed by using two-dimensional radiographic imaging when assessing dental injuries.A six-month follow-up appointment confirmed functional success and a reasonably satisfactory aesthetic outcome for the patient.
0 Reacties 0 aandelen 18 Views 0 voorbeeld
Sponsor