Pediatric Dental Resident Alfred I DuPont Hospital for Children Alfred I DuPont Hospital for Children Wilmington, Delaware, United States
Background: Studies of dental emergencies presenting to the emergency department (ED) have shown that up to 83% need immediate attention and that the ED is an important resource for those with dental complaints, particularly amongst those without private insurance. Our hospital began the first pediatric dental residency in the state in July 2019.
Objective: The purpose of this study is to compare the impact of Delaware’s first pediatric dental residency program on treatment of patients presenting to the Pediatric ED (PED).
Design/Methods: We reviewed charts of patients presenting to the PED with an oral or dental chief complaint from July 1, 2018-March 1, 2019 and from July 1, 2019 – March 1, 2020. Patients over 19 years of age at presentation and those with multi-system trauma were excluded. Charts were reviewed for chief complaint, diagnosis, treatment interventions, disposition, and demographic information. Chi-square, Fisher’s exact, and student’s t-tests were used to compare differences between study periods.
Results: A total of 458 patients met inclusion criteria, 206 prior to dental residency commencement, 252 after residency began. Dental consultation significantly increased (56.7% vs 7.3% p<0.01) between the study periods. There were no statistically significant differences in gender, race/ethnicity, insurance type, admissions, or proportion of presentations of trauma or infection between the study periods. Patients in the post residency time period were slightly older (7 vs 5.8 years p<0.01). Dental residents provided in-person evaluation for 41.3% of patients in the study period. The proportion of patients with a dental intervention performed in the PED increased significantly during the post residency period (59% vs 48% p=0.02). PED extractions and splints both occurred in a significantly larger portion of patients after the start of the residency program (18% vs 1% and 5% vs 0.5% p <0.01). A higher proportion of patients with dental complaints received procedural sedation in the PED after initiation of the residency program (16% vs 3% p<0.01). Conclusion(s): Pediatric dental residency availability to the PED significantly increased on-site dental consultations and intervention. A significantly higher percentage of PED patients received definitive treatment at point-of-service without requiring referral to another facility or delay of care until outpatient dental care was available.
Authors/Institutions: Jenelle Fleagle, Alfred I DuPont Hospital for Children, Wilmington, Delaware, United States; Wendi Xiao, Nemours/A. I. DuPont Hospital for Children, Wilmington, Delaware, United States; Michael R. Cottam, Alfred I DuPont Hospital for Children, Wilmington, Delaware, United States; Margarita Lorch, Nemours/A.I. DuPont Hospital for Children, Wilmington, Delaware, United States
