Introduction

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This guide, based on the SDCEP Emergency Dental Care and Management of Acute Dental Problems guidance publications, describes modified management of commonly presenting oral conditions for use during the COVID-19 pandemic. It aims to encourage a consistent approach to the management of acute dental problems, while recognising the challenges that the COVID-19 pandemic presents for provision of dental care. It can be used in conjunction with health board or other local procedures that have been established for managing patients based on their COVID-19 status. Refer to the SDCEP webpage Acute Dental Problems - COVID-19 for more information on this resource.

The management options presented here focus on dental triage, the relief of pain or infection and provision of care using remote consultation (i.e. by telephone or videocall1). Patients should only be referred for urgent dental care when there are severe or uncontrolled symptoms that they cannot manage themselves. It is essential to minimise the number of patients referred to designated urgent dental care centres2 both to reduce the risk of transmission of COVID-19 to healthcare workers and patients, and to lessen the pressure on these services.

1 Triage using photographs or video, where available, might be useful for diagnosis.
2 The facilities used as designated urgent dental care centres will vary across the country.

General Principles
  • Assessment of patients should take account of patient and staff safety, the best interests of the patient, professional judgement, local urgent dental care centre arrangements and prioritisation of the most urgent care needs
  • During the assessment, each patient’s COVID-19 status must be established and recorded using your health board or local health system protocol. This will determine how their care is managed at the designated urgent dental care centres if referral is required.
  • Primary care dental triage should focus on the provision of the three As:
    • Advice;
    • Analgesia;
    • Antimicrobials (where appropriate).

Patients should be advised that treatment options are severely restricted at this time and to call back in 48-72 hours if their symptoms have not resolved.

  • It is advisable to liaise with local pharmacy colleagues to ensure that the products you might be recommending are available to your patients.
  • Dental conditions that cannot be managed by the patient and require urgent dental care should be referred via NHS24/111 or local pathways to the designated urgent dental care centre following local protocols.
  • Appropriate records should be kept of all patient contacts, including care management and onward referrals.
  • Referrals should follow local handover guidelines and templates.