Management of odonto-stomatological emergencies during the COVID-19 alarm state in dental clinics in the Autonomous Community of Madrid (CAM), Spain: An observational study

BACKGROUND: Odontology practice has been severely compromised by the pandemic caused by COVID-19 and Spain is one of the countries with higher incidence. Our aim with this study is to find out the number of cases and type of odonto-stomatological emergencies (OSE) treated in four dental clinics of the Madrid capital area and region (CAM) in the period covered between March 17th and 4th of May. MATERIAL AND METHODS: We search the cases in the demographic/epidemiological databases of the CAM regional government and the Illustrious Official College of Dentists and Stomatologists of the First Region (Madrid). RESULTS: We found that the most prevalent pathology was acute apical periodontitis whereas odontogenic abscess showed the lowest frequency. Prosthetic-orthodontic OSE represented 14% of cases. CONCLUSIONS: In this period of time, the most prevalent pathology acute apical periodontitis, odontogenic abscess reported the lowest frequency and prosthetic-orthodontic treatments were the third in number of cases. Most of OSE were resolved, without referring the patient to a hospital emergency department

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Cambios en el perfil de las urgencias atendidas por un dentista de guardia 24 horas durante las etapas iniciales de la primera ola de COVID-19 / Changes in urgent dental care provided by a 24-hour on-call dentist during the first wave of the covid-19 pandemic

OBJETIVO: Comparar la asistencia urgente prestada por un dentista de guardia 24 horas a dos grupos de pacientes en dos periodos de la primera ola de Covid-19 en Madrid: durante el confinamiento de la población y cierre de la mayoría de las clínicas dentales y una vez levantado el confinamiento y reabiertas las clínicas. MÉTODO: En ambos grupos se compararon edad y sexo, tiempo transcurrido desde el comienzo de los síntomas, frecuencia de citas nocturnas, frecuencia y duración de tratamientos médicos previos, patologías objeto de consulta y tratamientos realizados. RESULTADOS: En el primer periodo (45 días) se vieron 187 pacientes y en el segundo (19 días), 94 (4.15 y 4.8 pacientes/día, respectivamente). El tiempo transcurrido desde el comienzo de los síntomas en ambos periodos fue 10+/1 y 3+/-1 días. Habían recibido tratamiento antibiótico/antiinflamatorio previo el 80% y el 30% de los pacientes, respectivamente. El diagnóstico más frecuente en el primer periodo fue inflamación pulpar (p = 0.001) y en el segundo, pulpitis irreversible (p < 0.05). En el primer periodo se realizaron más extracciones (58.7% vs 41.5%, p < 0.05) y en el segundo más endodoncias (8.5% vs 2.1%, p < 0.05) y tratamientos farmacológicos (19.1% vs 9.6%, p < 0.05). CONCLUSIONES: Durante el segundo periodo de la primera ola de COVID-19, cuando el confinamiento se levantó y se reabrieron las clínicas, la atención dental urgente cambió con respecto a las primeras 6 semanas de confinamiento estricto, tanto en el perfil de la patología, como en los tratamientos realizados que fueron más conservadores

AIM: To compare urgent dental care provided by a general dentist 24-hours on-call at two early stages of the first wave of Covid-19 pandemic in Madrid (Spain): during the lockdown of the population and closure of most dental clinics, and once the lockdown was relaxed and dental offices partially reopened. METHOD: In both groups we compared demographic data, time elapsed from onset of symptoms, rate of late-night appointments, proportion of patients receiving pharmacologic treatment and frequencies of the pathologies causing the consultation and treatments performed. RESULTS: In the first and second stages -45 and 19 days respectively- 187 and 94 patients, (4.15 and 4.8 patients/day, respectively) were seen. The time elapsed from onset of symptoms was 10+/1 days in the first group and 3+/-1 days in the second, while 80% and 30% of patients were receiving some medical treatment respectively. Pulpal inflammation predominated in the first stage (p = 0.001) and irreversible pulpitis in the second (p < 0.05). Extractions were more frequent in the first stage (58.7% vs 41.5%, p < 0.05), and root canal therapy (8.5% vs 2.1%, p < 0.05) and pharmacological treatment (19.1% vs 9.6%, p < 0.05) in the second. CONCLUSION: During the second stage of the first wave of COVID-19 pandemic, once lockdown was partially relaxed, significant differences were observed in urgent dental care compared with the first six weeks of the pandemic, both in the profile of the pathology and the treatments provided, which were more conservative