Emergency management of traumatic dental injuries in 42 countries

Availability and quality of emergency services for traumatic dental injuries (TDI) are important as the prognosis of TDI is decided at the place of accident or during the first hours after the injury has occurred. - Aim: To report how emergency services for TDI are provided in some places around the world. Subjects and methods: This is a preliminary observational study of descriptive character. One-hundred and three participants from 83 cities in 42 countries described the emergency services in their city by answering a questionnaire related to: (1) availability of advice per telephone at the place of the accident; (2) availability of emergency treatment resources at different times of the day; and; (3) assessment of competence level of the person carrying out the service. Answers and comments were scored with regard to availability and level of competence. Results: 62% of the participants were not satisfied with their current emergency services. 50% reported organized emergency telephone service always available. 43% of the advice given by phone was from professionals with dental training. An organized on-call 24/7 service was available in 33%. Treatment of TDI within the first hour was available in 53%. A competent dentist was available in 40%. 56% reported compromised competency outside office hours. Places with a well-organized system built on a well-developed first-line care managed by trauma-trained general dentists, ideally on a 24/7 basis, supported by on-call specialists outside office working hours, achieved the highest scores. Conclusions: With all the limitations of a preliminary questionnaire study, we can conclude that there is a need to perform more comprehensive well-designed studies in this field to understand more of the varying quality of emergency services worldwide. The major problem today seems to be related to limited availability and competence, especially outside office working hours.