Medical emergencies in the dental office are a relatively rare event. However, due to the increased age of the general population, increase morbidities, and increased number of dental visits, medical emergencies are something we should expect. Controlling for the differences in training and regulations worldwide, how ready are dentists, if a medical emergency should arise?
A meta-analysis of 24 studies was done, analyzing reports of medical emergencies occurring worldwide (in a dental setting), and how adequate the practitioner’s response was.
Prevalence
Nearly half of all dentists sampled reported dealing with a medical emergency in the dental office. Interestingly, from the respondents in the US, over 77% reported having to attend to a medical emergency, a rate much higher than elsewhere in the world.
The most common medical emergency was syncope, accounting for 34.3% of all cases. Following syncope, epileptic episodes, hypoglycemia represented 16.1% and 8.4% of medical emergency cases, respectively. 9.3% of medical emergency cases could not be diagnoses by the attending practitioner.
Confidence of the Dentist
The comfort and confidence of dentists were measured, if faced with a medical emergency. There was a direct correlation between confidence of the dentist and hand-on training in medical emergency response, as compared to only didactic training. In one study (in a pediatric setting), only 35%-55% of practitioners felt comfortable dealing with all medical emergencies, and applying adrenaline or oxygen in those cases. This confidence increased dramatically with simulation training. Interestingly, following receiving simulation training, dentists’ proficiency in managing emergencies fell quickly, as time went on from the training date.
Knowledge of Medical Emergency Management
Analyzing German dentistry students, 93% could not use oxygen, 46% couldn’t correctly perform CPR, and 47% could not properly use an automated external defibrillator (AED). This was mirrored with students in Saudi Arabia, Japan, and Iran.
The good news is, compared to similar studies done more than two decades ago, dentists’ preparedness for managing medical emergencies are higher than ever before. However, taking into account that these emergency cases are increasing, our current level proficiency is nowhere near where it should be. This is simply reported by dentists themselves.
Yet, the solution to such a great problem is simple and outlined in research.
Frequently administered simulated training is essential. This is true both at the dental school level and during the practicing years of one’s career. It should be taken on as a personal responsibly of the dentists themselves. A simple procedure such as CPR can make the difference between life and death.