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A review of the available guidance regarding management of medical emergencies in primary dental care

From Volume 43, Issue 10, December 2016 | Pages 928-932

Authors

Suzanne Lello

MOralSurg RCSEng, MFDS RCSEd, MJDF RCSEng, BChD(Hons)

Clinical Teaching Fellow in Oral Surgery, School of Dentistry, University of Leeds, Liverpool, UK (suzanne.lello@gmail.com)

Articles by Suzanne Lello

Julie Burke

PhD, FDS RCS FHEA

Senior Lecturer and Honorary Consultant in Oral Surgery, Edinburgh Dental Institute, Lauriston Place, Edinburgh EH3 9HA, UK.

Articles by Julie Burke

Kathryn Taylor

PhD, FDS RCS(Oral Surg), FDS RCS, BDS, BSc(Hons)

Senior Lecturer and Honorary Consultant in Oral Surgery, School of Dentistry, University of Liverpool, Liverpool, UK

Articles by Kathryn Taylor

Abstract

This article provides an overview of the recent changes in guidance relating to the management of medical emergencies in primary dental care in the UK. The guidance relating to automated external defibrillators is also presented. The expectations of our regulatory bodies are discussed, as are the requirements for continued professional development. The potential shortcomings of the changes to the guidance are also discussed, as well as proposed solutions, such as the development of algorithms to use in a dental practice setting.

CPD/Clinical Relevance: All dental practitioners should be able to deal with medical emergencies in their practice.

Article

Medical emergencies occur in general dental practice. Previous surveys suggested that the prevalence of emergency events occurring in dental practice was low, but these were undertaken over 16 years ago.1,2 A more recent survey in Germany showed that, over 12 months, 57% of dentists reported up to three medical emergencies, and 36% up to 10 emergencies. The most common was vasovagal syncope, but 42 severe life-threatening events were also reported.3

As our population ages, dental practitioners will deal with more medically complex patients being treated with polypharmacy and it is likely, therefore, that the prevalence of medical emergency events occurring in dental practice will increase.

The General Dental Council (GDC) expect dental practitioners to be able to manage any emergency events should they arise in the surgery.4,5 Additionally, it is worth noting that the Care Quality Commission (CQC) also sets out standards expected of dentists concerning medical emergencies6 and failure to comply with these can leave the dentist open to criminal prosecution. This is highlighted in a review of the law surrounding deaths in dentistry7 which states that:

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