An Analysis of the Out-of-Hours Demand and Treatment Provided by a General Dental Practice Rota over a Five-Year Period

Abstract

Objective To obtain information about the frequency of call-outs, relative frequency of different types of dental emergencies that presented, and treatment provided between 1999 and 2003 by an out-of-hours on-call rota run by a cooperative of 12 dentists in Herefordshire. Method A retrospective analysis was undertaken of the data recorded in the on-call log of the cooperative from March 1999 to December 2003. Data recorded were: date of call, time of call, dentist on call, contract type (National Health Service, Denplan, other capitation scheme, private fee-per-item-of-service, or unregistered), time seen, nature of complaint and treatment provided. Results The log produced 1070 usable entries. The gender mix of patients seeking care was 61% female and 39% male. Most call-outs were on Saturday; the next most frequent days were Sunday and Friday. The most common presenting complaint was ‘toothache’ in the form of acute pulpitis or periapical periodontitis, which together accounted for 52.3% of all calls. The next most frequent complaints were: broken or lost tooth, lost or fractured restorations and fractured teeth, which accounted for a further 27.7% of all calls. The most serious presenting complaints, avulsion or postoperative bleeding, accounted for 0.5% and 1.3% of the calls, respectively. One hundred and ninety-six (18.3%) of the callers were not subsequently seen in person, 39 of whom were not seen because they were private patients who declined to pay the call-out fee. The other 157 unseen patients (14.7%) appeared to be happy just to receive advice over the telephone. Of patients who were seen, 62.9% were seen within one hour and only 9.2% waited longer than two hours. Some patients who telephoned late on a Friday or Saturday were happy to wait until the next morning. Conclusions The most common dental emergency with which patients presented at an emergency rota service was periapical periodontitis, followed by pulpitis and fractured tooth. The treatments most commonly provided were extirpation of the pulp, temporary dressing or advice only.