Acute dental conditions attending A&E: Is there an epidemic of surgical admissions for dental infections?

Abstract

Background: Since the introduction of the Dental Contract (April 2006) there has been a perception that the rate of A&E attendance for acute dental conditions has increased. Previous analysis of hospital data suggests that the number of admissions for surgical drainage for dental abscesses has been steadily increasing. If genuine, this has significant public health implications. We retrospectively analysed attendance and admission data for the period 2004-2013 at the Royal Derby Hospital. Method: The A&E database was searched for all attendances that included the key words "dental", "toothache", "abscess" or "swelling". Anomalies were removed by hand. This data was cross referenced with admission data for the same time period. Results: During the 2004-2013 study period there were significant increases in the number of A&E attendances- 56.95% - with a corresponding increase in hospital admission for acute treatment from 9.67% of attenders to 18.42%, 52.49% of which needed to stay in over at least one night. Conclusions: As perceived there has been a significant increase in A&E workload for acute dental conditions. The severity of these conditions appears to have escalated, which is reflected by the increased admission rate. This has a direct impact on the unplanned activity of maxillofacial units. Despite changes in the dental contract emergency admissions for dental conditions remains a major public health issue.