From Volume 47, Issue 11, December 2020 | Pages 924-926
Challenges arose in ascertaining accurate diagnoses for patients via remote phone triage during the COVID-19 crisis in 2020. We report on a case that highlights possible pitfalls in remote consultation versus chairside contact in making clinical diagnoses and illustrates a complication that may arise in orthodontic patients who have not been seen for an extended period of time.
A myriad of factors make accurate diagnosis of dental pain challenging. The practitioner is reliant on a thorough history and clinical examination, supplemented by appropriate special tests, including radiographic investigations, to establish the correct diagnosis and treatment plan.
The ability to differentiate between pain from odontogenic and non-odontogenic origins can be complicated in situations where patients present with non-specific symptoms and unclear clinical findings. This is further complicated when remote consultation is required instead of contemporaneous clinical examination.
The SARS-CoV-2 (‘COVID-19’) pandemic led to a ‘lockdown’ in the United Kingdom from 23rd March 2020. An aspect of lockdown was that practice of dentistry was limited due to a multitude of factors including the requirement for social distancing, the aerosol-generating procedure (AGP) nature of most dental procedures and lack of appropriate PPE, to name but a few reasons. Remote consultations were arranged for emergency patients over the phone by the patient's dental practice or by an urgent treatment centre, such as a dental hospital, where patients could be assessed if advice, analgesia and remote antibiotic prescription had been previously ineffective.1
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